| Description |
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Abstract: A 53-year old woman with tic doloureaux, affecting her right
maxillary division of the trigeminal nerve (V2), could elicit shooting pains by
slightly tapping her teeth when off medication. The pains, which she normally rated
as > 6/10 on a visual analog scale (VAS), were electric shock-like in nature. She
had no other spontaneous ... read moreor ongoing background pain affecting the region. Based on
her ability to elicit these tics, functional magnetic resonance imaging (fMRI) was
performed while she produced brief shocks every 2 minutes on cue (evoked pain) over a
20 min period. In addition, she had 1-2 spontaneous shocks manifested between these
evoked pains over the course of functional image acquisition. Increased fMRI
activation for both evoked and spontaneous tics was observed throughout cortical and
subcortical structures commonly observed in experimental pain studies with healthy
subjects; including the primary somatosensory cortex, insula, anterior cingulate, and
thalamus. Spontaneous tics produced more decrease in signals in a number of regions
including the posterior cingulate cortex and amygdala, suggesting that regions known
to be involved in expectation/anticipation may have been activated for the evoked,
but not spontaneous, tics. In this patient there were large increases in activation
observed in the frontal regions, including the anterior cingulate cortex and the
basal ganglia. Spontaneous tics showed increased activation in classic aversion
circuitry that may contribute to increased levels of anxiety. We believe that this is
the first report of functional imaging of brain changes in
tic-doloureaux.
Springer Open.read less
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| Citation |
- Borsook, David, Eric A. Moulton, Gautam Pendse, Susie Morris,
Sadie H. Cole, Matthew Aiello-Lammens, Steven Scrivani, and Lino R. Becerra.
"Comparison of evoked vs. spontaneous tics in a patient with trigeminal neuralgia
(tic doloureux)." Molecular Pain 3, no. 1 (12, 2007):
1-16.
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