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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neurostimulation methods are used in the treatment of chronic pain, although mainly for pharmacology resistant pain. Transcranial Direct Current Stimulation (tDCS) is a non-invasive neurostimulation method using low direct current (0.029-0.08 mA/cm2) applied to a cathode and anode, which directly stimulates the cranial surface. The applied current causes the most significant changes directly under the electrodes: the cathode reduces the excitability of cortical neurons, whereas the anode increases excitability. The effect of stimulation usually lasts a few hours up to a few days. We observed 19 patients with chronic orofacial pain. Inclusion criteria for the study were the following: orofacial pain, stable analgesic medication for at least one week before the beginning of stimulation and during its course, and age 18-75 years old. Patients with severe organic brain damage or seizure disease (epilepsy) were not included. The most common diagnosis was secondary trigeminal neuralgia after dental surgery. We measured thermal and tactile stimulation on the face before and after tDCS, then at 14 days. The total follow-up period lasted six months. We evaluated pain on a numerical scale (0-10) at each follow-up. We used sets of inventories focused on the examination of pain (a short form of McGill inventory), depression, anxiety, and pain interference with daily activities. tDCS is a non-invasive stimulation technique that is affordable and can be easily administered, especially when compared to other neurostimulation techniques. Only 15 patients out of the total number of 19 responded to the questionnaires.
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PMID:The treatment of orofacial pain by using transcranial direct current stimulation. 3192 55

Stereotactic radiosurgery (SRS) is a non-invasive technique that enables to create brain focal lesions with a high precision and localization. Thus, functional brain disorders can be treated by SRS in case of pharmacoresistance or inoperability. To date, treatment of trigeminal neuralgia is the most described and known indication. Other indications will be developed in the future like movement disorders, refractory epilepsy, obsessive compulsive disorder and severe depression. We present here a review of actual and future indications of functional brain SRS with their level of evidence. All these SRS treatments have to be strictly conducted by trained teams with an excellent collaboration between radiation physicists, medical physicists, neurosurgeons, neurologists, psychiatrists and probably neuroradiologists.
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PMID:[Functional stereotactic radiosurgery: Indications and perspectives]. 3222 May 62

Primary trigeminal neuralgia is a common clinical refractory neuralgia characterized by an onset of excruciating pain that can severely affect patients' quality of life. Long-term suffering from this pain may lead to depression, anxiety, and suicide. Current treatments, however, are associated with high recurrent rates and severe complications. We hypothesize that both the applicability and efficacy of magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) treatment in primary trigeminal neuralgia can be achieved under the following conditions: a specific target focus and incident channel, a temperature measurement system that does not incur damage to surrounding tissues, and an optimal radiation dose. Successful non-invasive treatment of primary trigeminal neuralgia by MR-HIFU systems could represent a breakthrough of this technology applied to the oral and maxillofacial region.
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PMID:The applicability and efficacy of magnetic resonance-guided high intensity focused ultrasound system in the treatment of primary trigeminal neuralgia. 3224 Aug 78

Depression and anxiety are frequently observed in patients suffering from neuropathic pain. The underlying mechanisms remained unclear. The ventrolateral orbital cortex (VLO) has attracted considerable interest in its role in antidepressive effect in rodents. In the present study, we further investigated the role of the VLO in the anxiodepressive consequences of neuropathic pain in a chronic constriction injury of infraorbital nerve-induced trigeminal neuralgia (TN) mouse model. Elevated plus maze, open field, forced swimming, tail suspension, and sucrose preference tests were used to evaluate anxiodepressive-like behaviors. The results show that chemogenetic activation of bilateral VLO neurons, especially CaMK2A+ pyramidal neurons, blocked the TN-induced anxiodepressive-like behaviors. Chemogenetic and optogenetic activation of VGLUT2+ or inhibition of VGAT+ VLO neurons was sufficient to produce an antianxiodepressive effect in TN mice. Pharmacological activation of D1-like receptors (D1Rs) but not D2Rs in the VLO significantly alleviated TN-induced depressive-like behaviors. Electrophysiological recordings revealed a decreased excitability of VLO excitatory neurons following neuropathic pain. Furthermore, activation of submedius thalamic nucleus-VLO (Sm-VLO) projection mimicked the antianxiodepressive effect of VLO excitation. Conversely, activation of VLO-periaqueductal gray matter (PAG) projection had no effect on TN-induced anxiodepressive behaviors. This study provides a potentially novel mechanism-based therapeutic strategy for the anxiodepressive consequences of neuropathic pain.
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PMID:Activation of ventrolateral orbital cortex improves mouse neuropathic pain-induced anxiodepression. 3300 87


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