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Substanz P, Somatostatin Und Monoaminerge Transmitter In Der Zerebrospinalflüssigkeit Von Patienten Mit Chronischer Idiopathischer Trigeminusneuralgie

M. Strittmatter, M. Grauer, G. Hamann, C. Fischer, K. Hoffmann, F. Blaes, K. Schimrigk, E. Isenberg
Published 2006 · Medicine

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ZusammenfassungBei der Trigeminusneuralgie werden periphere und zentrale Entstehungsmechanismen diskutiert. Daher wurden bei 16 Patienten (53,3±8,3 Jahre) mit einer idiopathischen Trigeminusneuralgie in der Zerebrospinalflüssigkeit (CSF) die Neuropeptide Substanz P und Somatostatin, die Neurotransmitter Noradrenalin und Adrenalin sowie die Metaboliten Homovanillinmandelsäure (HVA), Vanillinmandelsäure (VMA) und 5-Hydroxyindoleessigsäure (5-HIAA) bestimmt. Während die Substanz P in der CSF signifikant (p<0,01) erhöht gefunden wurde, war das Somatostatin gegenüber den Kontrollpersonen signifikant erniedrigt (p<0,05). Noradrenalin (p<0,01), 5-HIAA (p<0,01), HVA (p<0,05) und VMA (p<0,05) waren signifikant erniedrigt. Während die Erhöhung der Substanz P einen Hinweis auf eine lokal beschränkte neurogene Entzündung im trigemino-vaskulären System geben könnte, spricht die Reduktion monoaminerger Transmitter für eine zentral gestörte Schmerzmodulation. Diese scheint mit zunehmender Krankheitsdauer und begleitender Depression stärker zu werden. Die zahlreichen Korrelationen der Neuromediatoren untereinander, insbesondere auch zwischen den Neuropeptiden und den Klassischen Neurotransmittern, sprechen für komplexe neurochemische Interaktionen im Rahmen der Schmerzentstehung.AbstractThe etiology of trigeminal neuralgia is unknown, but both peripheral and central causes have been suggested. To investigate the role of central neurochemical mechanisms we measured epinephrine, norepinephrine and their breakdown product, vanilly mandelic acid (VMA), in the cerebrospinal fluid (CSF) of 16 patients (53.3±8.3 years) suffering from trigeminal neuralgia. As markers for the dopaminergic system, we determined CSF levels of dopamine and its metabolite homovanillic acid (HVA). As a marker for the serotonergic system, we measured CSF levels of serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA). In addition, levels of the neuropeptides substance P and somatostatin were determined. The concentration of norepinephrine (P<0.01), VMA (P<0.05) and HVA (P<0.05) were significantly decreased in patients with trigeminal neuralgia and correlated with the duration of the disease and depression scores. 5-HIAA was also significantly decreased (P<0.05) compared to control patients. Whereas substance P was significantly elevated (P<0.05), somatostatin was significantly decreased (P<0.05). Various correlations between the classical neurotransmitters and the neuropeptides could be established. We hypothesize than the sum of complex neurochemical changes plays a role in the etiology of trigeminal neuralgia, which can be separated in local and more central proceedings. The increase in substance P, a major nociceptive neuromodulator, supports the concept of a local neurogenic inflammation, possibly located in the trigeminovascular system. Depending on the duration of the disease and depression, the loss of serotonergic, dopaminergic and noradrenergic innervation seems to reflect more central changes, possibly due to alterations in their antinociceptive descending pathways.
This paper references
Contribution of central plasticity to pathological
TJ Coderre (1993)
Trigeminal facial pain: a model of peptides and monoamines in intracerebral cerebrospinal fluid.
A. Bouckoms (1991)
Basic mechanisms in vascular headache.
M. Moskowitz (1990)
Pharmacology of chronic pain.
A. Dray (1994)
Monoamines in the brain cerebrospinal fluid of facial pain patients.
A. Bouckoms (1992)
The long-term outcome of microvascular decompression for trigeminal neuralgia.
F. Barker (1996)
Substance P and serotonergic inputs to sympathetic preganglionic neurons.
P. Pilowsky (1995)
Evidence that substance P is a mediator of antidromic vasodilatation using somatostatin as a release inhibitor.
B. Gazelius (1981)
The McGill
R Melzack (1975)
Serotonergic Activity in Man as a Function of Pain, Pain Mechanisms, and Depression
J. Ghia (1981)
The trigeminovascular system and migraine: Studies characterizing cerebrovascular and neuropeptide changes seen in humans and cats
P. J. Goadsby (1993)
Algesia and local responses induced by neurokinin A and substance P in human skin and temporal muscle
U. Pedersen-Bjergaard (1989)
Human in vivo evidence for trigeminovascular activation in cluster headache. Neuropeptide changes and effects of acute attacks therapies.
P. J. Goadsby (1994)
Macroscopic effects of percutaneous trigeminal ganglion compression (Mullan's technique): an anatomic study.
E. Úrculo (1995)
Pain measurements in persons in pain
R Melzack (1994)
Tic douloureux and atypical facial pain.
Loeser Jd (1985)
The German counterpart to McGill Pain Questionnaire
C. Stein (1988)
Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society.
[Reduced sympathetic nervous system activity during the cluster period of cluster-headache].
M. Strittmatter (1996)
Magnetic resonance tomographic angiography: diagnostic value in trigeminal neuralgia
F. Umchara (2004)
Trigeminal projections to supratentorial pial and dural blood vessels in cats demonstrated by horseradish peroxidase histochemistry
M. Mayberg (1984)
The medical and surgical management of trigeminal neuralgia
A. Sidebottom (1995)
Peptide-containing nerve fibres in human extracranial tissue: a morphological basis for neuropeptide involvement in extracranial pain?
R. Uddman (1986)
Pain and Central Nervous System Disease: The Central Pain Syndromes
S. Hassenbusch (1992)
"Serotonin depression"--a biochemical subgroup within the affective disorders?
M. Åsberg (1976)
The origin of brainstem noradrenergic and serotonergic projections to the spinal cord dorsal horn in the rat.
G. Kwiat (1992)
Neurobiologie des Schmerzsystems
M. Zimmermann (1995)
5-HIAA and HVA in CSF in patients with idiopathic pain disorders
B. Almay (1987)
5-Hydroxytryptaminergic Receptor-Stimulated Growth Hormone Secretion Occurs Independently of Changes in Peripheral Somatostatin Concentration
P. Gaynor (1995)
Substance P in trigeminal nerve endings: occurrence and release.
E. Brodin (1981)
CSF monoamine metabolites in chronic pain
R. France (1987)
Altered activity of the sympathetic nervous system and changes in the balance of hypophyseal, pituitary and adrenal hormones in patients with cluster headache
M. Strittmatter (1996)
Migraine and depression: biological aspects.
V. Glover (1993)
Reduzierte Aktivit~it des sympathischen Nervensystems wahrend der Clusterperiode des Cluster-Kopfschmerzes
M Strittmatter (1996)
Flunarizine in Prophylaxis of Childhood Migraine: A Double-Blind, Placebo-Controlled, Crossover Study
Fulvio Sorge (1988)
Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence
T. J. Coderre (1993)
M. Hamilton (1960)
Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study.
P. Hamlyn (1992)
Pimozide therapy for trigeminal neuralgia.
F. Lechin (1989)
Trigeminal neuralgia treated by microvascular decompression: a long-term follow-up study.
N. Illingworth (1995)
The long-term outcome of mikrovascular decompression for trigeminal neuralgia
FG Barker (1996)
Macroscopic effects of percutaneous trigeminal ganglion compression (Mullan's technique) : an anatomic study. Commentaries
E. Úrculo (1995)
Neuroactive peptides: Unique phases in research on mammalian brain over three decades
R. D. Myers (1994)
Neurogenic inflammation in the pathophysiology and treatment of migraine
M. Moskowitz (1993)
Substance P in CSF of Patients with Chronic Pain Syndromes
B. Almay (1988)
The short-form McGill pain questionnaire
R. Melzack (1987)
Release of vasoactive peptides in the extracerebral circulation of humans and the cat during activation of the trigeminovascular system
P. J. Goadsby (1988)
The McGill Pain Questionnaire: Major properties and scoring methods
R. Melzack (1975)
Demonstration of neurovascular compression in trigeminal neuralgia with magnetic resonance imaging. Comparison with surgical findings in 52 consecutive operative cases.
James F. Meaney (1995)
Effects of acute systemic treatment with the 5 HT-uptake blocker alaproclate on tissue levels and release of substance P in rat periaqueductal grey
A. Rosén (1995)
: review of clinical and experimental evidence
A Dray (1994)
Chemical activation of nociceptive peripheral neurones.
H. Rang (1991)
A neurophysiological theory for the pain mechanism of tic douloureux
W. Calvin (1977)
Pain, Tenderness, Wheal and Flare Induced by Substance-P, Bradykinin and 5-Hydroxytryptamine in Humans
K. Jensen (1991)

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