Stereo-Smell via Electrical Trigeminal Stimulation

Background Retronasal olfaction is important in flavor detection and enjoyment. The ability to identify specific individual retronasal odors may play a role in quality of life for patients with chronic rhinosinusitis (CRS). Objective To identify patterns and improve understanding of retronasal identification of individual odors in CRS patients. Methods Patients diagnosed with CRS underwent retronasal and orthonasal (Sniffin’ Sticks) olfactory testing and taste testing (taste strips). Retronasal identification was tested with presentation of flavored powders on the posterior tongue. Retronasal identification for individual odors was compared with results of orthonasal and taste testing. Results Seventy participants were evaluated. Retronasal identification correlated with orthonasal identification and discrimination for most individual odors. Among all patients, cinnamon and apple were identified better retronasally and banana better orthonasally ( P < .05). Anosmics identified retronasal orange, cinnamon, mushroom, coffee, smoked ham, peach, ginger, grape, and cheese more than would be expected by chance for a forced-choice paradigm with 3 distractor items ( P < .05), and this was independent of objective taste function for most odors. Conclusion Retronasal and orthonasal identification of most odors correlate in CRS patients; however, patients with anosmia can still identify certain retronasal odors more often than expected. These odors do not appear to stimulate gustatory pathways and may involve trigeminal stimulation. Understanding preserved retronasal neural stimuli may allow providers to improve eating-related quality of life in these patients.

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Commentary: Percutaneous Trigeminal Stimulation for Intractable Facial Pain: A Case Series

Neurosurgery ◽

10.1093/neuros/nyaa124 ◽

2020 ◽

Vol 87 (3) ◽

pp. E305-E305

Author(s):

Jason M Schwalb

Keyword(s):

Facial Pain ◽

Case Series ◽

Trigeminal Stimulation

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Percutaneous Trigeminal Stimulation for Intractable Facial Pain: A Case Series

Neurosurgery ◽

10.1093/neuros/nyaa065 ◽

2020 ◽

Vol 87 (3) ◽

pp. 547-554 ◽

Cited By ~ 2

Author(s):

Pavlos Texakalidis ◽

Muhibullah S Tora ◽

J Tanner McMahon ◽

Alexander Greven ◽

Casey L Anthony ◽

...

Keyword(s):

Head Trauma ◽

Facial Pain ◽

Rating Scale ◽

Oral Surgery ◽

Treatment Options ◽

Case Series ◽

Lead Contamination ◽

Complication Rates ◽

Trial Period ◽

Trigeminal Stimulation

Abstract BACKGROUND Facial pain syndromes can be refractory to medical management and often need neurosurgical interventions. Neuromodulation techniques, including percutaneous trigeminal ganglion (TG) stimulation, are reversible and have emerged as alternative treatment options for intractable facial pain. OBJECTIVE To report the complication rates and analgesic effects associated with TG stimulation and identify potential predictors for these outcomes. METHODS A retrospective chart review of 59 patients with refractory facial pain who underwent TG stimulation was conducted. Outcomes following trial period and permanent stimulation were analyzed. Patients with >50% pain relief during trial stimulation received permanent implantation of the stimulation system. RESULTS Successful trial stimulation was endorsed by 71.2% of patients. During the trial period, 1 TG lead erosion was identified. History of trauma (facial/head trauma and oral surgery) was the only predictor of a failed trial compared to pain of idiopathic etiology (odds ratio: 0.15; 95% CI: 0.03-0.66). Following permanent implantation, approximately 29.6% and 26.5% of patients were diagnosed with lead erosion and infection of the hardware, respectively. TG lead migrations occurred in 11.7% of the patients. The numeric rating scale score showed a statistically significant reduction of 2.49 (95% CI: 1.37-3.61; P = .0001) at an average of 10.8 mo following permanent implantation. CONCLUSION TG stimulation is a feasible neuromodulatory approach for the treatment of intractable facial pain. Facial/head trauma and oral surgery may predict a nonsuccessful trial stimulation. Future development of specifically designed electrodes for stimulation of the TG, and solutions to reduce lead contamination are needed to mitigate the relatively high complication rate.

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Effects of KB-2796 on Plasma Extravasation Following Antidromic Trigeminal Stimulation in the Rat

The Japanese Journal of Pharmacology ◽

10.1016/s0021-5198(19)47128-x ◽

1995 ◽

Vol 67 ◽

pp. 291

Author(s):

Munehiro Hashimoto ◽

Yumi Yamamoto ◽

Shyh-Yuh Liou ◽

Mineo Kunihara

Keyword(s):

Plasma Extravasation ◽

Trigeminal Stimulation

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Trigeminal stimulation: A superhighway to the brain?

Neurology ◽

10.1212/wnl.0b013e318285c17d ◽

2013 ◽

Vol 80 (9) ◽

pp. 780-781 ◽

Cited By ~ 4

Author(s):

E. Faught ◽

W. Tatum

Keyword(s):

Trigeminal Stimulation ◽

The Brain

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Evidence for 5-HT1B/1D Receptors Mediating the Antimigraine Effect of Sumatriptan and Dihydroergotamine

Cephalalgia ◽

10.1046/j.1468-2982.1991.1104165.x ◽

1991 ◽

Vol 11 (4) ◽

pp. 165-168 ◽

Cited By ~ 104

Author(s):

Maria Gabriella Buzzi ◽

Michael A Moskowitz

Keyword(s):

Trigeminal Ganglion ◽

Dura Mater ◽

Plasma Protein ◽

Cell Activation ◽

Rank Order ◽

Plasma Extravasation ◽

Protein Extravasation ◽

Trigeminal Stimulation ◽

Plasma Protein Extravasation ◽

Pre Treatment

Neurogenic plasma extravasation, endothelial cell activation (increase in vesicle number and vacuole formation), platelet aggregation and adhesion, and mast cell degranulation occur selectively in postcapillary venules of the dura mater following electrical trigeminal ganglion stimulation, and are mediated by release of neuropeptides from perivascular unmyelinated C fibres. Pre-treatment with the antimigraine drugs dihydroergotamine and sumatriptan, two drugs that bind with high affinity to 5-HT1B/1D receptors, markedly attenuated plasma protein extravasation induced by electrical trigeminal ganglion stimulation. Trigeminal stimulation increased plasma calcitonin gene-related peptide levels in rat superior sagittal sinus. Pre-treatment with dihydroergotamine and, to a lesser extent, sumatriptan, attenuated this increase. Both drugs reduced morphological changes in post-capillary venules and mast cells within dura mater following electrical trigeminal ganglion stimulation. Plasma protein extravasation was selectively blocked in dura mater (but not in extracranial tissues) by pre-treatment with those receptor agonists showing a rank order of potency suggesting a 3-HT1B/1D interaction (5-CT > 5-BT > DHE > sumatriptan > 8-OH-DPAT). Pre-treatment with 5-HT2 and 5-HT3 antagonists was not effective. Taken together, these data are consistent with the interpretation that putative 5-HT-1B/1D receptors located on sensory fibres are coupled to inhibition of peptide release and blockade of neurogenic inflammation. An important therapeutic action of ergot alkaloids and sumatriptan in migraine headaches is so defined.

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