A Modified Hodgkin-Huxley model to Show the Effect of Motor Cortex Stimulation on the Trigeminal Neuralgia Network

BackgroundTrigeminal neuralgia (TN) is a severe neuropathic pain, which has an electric shock like characteristic. There are some common treatments for this pain such as medicine, microvascular decompression or radio frequency. In this regard, transcranial direct current stimulation (tDCS) is another therapeutic method to reduce the pain, which has been recently attracting the therapists’ attention. The positive effect of tDCS on TN was shown in many previous studies. However, the mechanism of tDCS effect has remained unclearObjectiveThis study aims to model the neuronal behavior of the main known regions of the brain participating in TN pathways to study the effect of transcranial direct current stimulationMethodThe proposed model consists of several blocks (block diagram): 1) trigeminal nerve, 2) trigeminal ganglion, 3) PAG (Periaqueductal gray in the brainstem), 4) thalamus, 5) motor cortex (M1) and 6) somatosensory cortex (S1). Each of these components represented by a modified Hodgkin-Huxley (HH) model (a mathematical model). The modification of the HH model was done based on some neurological facts of pain sodium channels. The input of the model is any stimuli to ‘trigeminal nerve,’ which cause the pain, and the output is the activity of the somatosensory cortex. An external current, which is considered as electrical current, was applied to the motor cortex block of the modelResultThe results showed that by decreasing the conductivity of the slow sodium channels (pain channels) and applying tDCS over the M1, the activity of the somatosensory cortex would be reduced. This reduction can cause pain reliefConclusionThe proposed model provided some possible suggestions about the relationship between the effects of tDCS and associated components in TN, and also the relationship between the pain measurement index, somatosensory cortex activity, and the strength of tDCS.