Sensitization of trigeminal brainstem pathways in a model for tear deficient dry eye

Rahman, Mostafeezur; Okamoto, Keiichiro; Thompson, Roby C.; Katagiri, Ayano; Bereiter, David A.

doi:10.1097/j.pain.0000000000000135

Cited by 55 publications

(52 citation statements)

References 57 publications

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“…In animal models of uveitis and photokeratitis, evidence of central sensitization was demonstrated as ocular neurons in the Vc/C 1 region became more sensitive to ocular stimuli [76, 77] and had increased convergent input from periocular skin [76]. In a rat model of tear deficiency after lacrimal gland removal, neurons in both the Vi/Vc and Vc/C 1 regions were more responsive to ocular stimuli with hypertonic saline and had increased convergent input was found from periocular skin [78]. Such central sensitization processes can explain DE symptoms such as pain in response to natural stimuli such as wind (i.e.…”

Section: Shared Neurophysiological Abnormalities Between Ocular Drynementioning

confidence: 99%

Neuropathic symptoms of the ocular surface: dryness, pain, and itch

Andersen

Yosipovitch

2017

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review To describe recent findings on epidemiology, pathophysiology and management of neuropathic symptoms of the ocular surface, with a focus on potential similarities between sensations of dry eye, pain and itch. Recent findings A narrative review of the literature was undertaken. Key references from research in dry eye, neuropathic symptoms of the ocular surface, ocular pain and itch as well as general references on itch and pain neurobiology were included. Recent findings suggest aspects of DE, chronic ocular pain, and itch symptomatology is driven by neuropathic pain mechanisms involving peripheral and central sensitization processes. Summary Ocular dryness, pain, and itch are prevalent complaints with several of shared features. Multiple lines of evidence suggest that peripheral and central neuronal sensitization processes are involved in generating and maintaining ocular sensory symptoms. Research is warranted on the epidemiology of ocular sensations, molecular mechanisms involved in nociception and pruriception in the eye, electrophysiological alterations in animal models of eye conditions, and therapeutic modalities that can alleviate unpleasant ocular sensations.

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Section: Shared Neurophysiological Abnormalities Between Ocular Drynementioning

confidence: 99%

Neuropathic symptoms of the ocular surface: dryness, pain, and itch

Andersen

Yosipovitch

2017

Current Opinion in Allergy &Amp; Clinical Immunology

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“…Une activation des cellules microgliales est également observée dans le CST, à proximité des neurones secondaires activés, dans un modèle murin de douleur oculaire (Figure 3). Dans un autre modèle de sécheresse/douleur oculaire, une sensibilisation des ocular-responsive neurons est mise en évidence dans la zone de transition Vi/Vc [31,32,33]. Cette sensibilisation se caractérise par une activité électrique plus importante après stimulation chimique de la cornée, une augmentation de la taille des champs récepteurs périorbitaires, et une augmentation du nombre de clignements reflexes palpébraux 5 .…”

Section: Sensibilisation Centrale Dans Le Complexe Sensitif Trigéminaunclassified

La douleur oculaire chronique : mieux la comprendre pour mieux la traiter

Goazigo¹,

Labbé²,

Baudouin³

et al. 2017

Med Sci (Paris)

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> La sècheresse oculaire est un des premiers motifs de consultation en ophtalmologie. Sa prévalence varie de 5 à 35 % chez des sujets âgés de plus de 50 ans. Cette pathologie du segment antérieur de l'oeil est caractérisée par des sensations de douleur variables dans leurs intensités, allant du simple inconfort à une douleur oculaire prononcée. Les douleurs oculaires sont très invalidantes et très difficiles à traiter, et leurs mécanismes physiopathologiques demeurent mal connus de nos jours. Ce constat impose un approfondissement de nos connaissances fondamentales sur l'anatomie du système nociceptif cornéen et sur les mécanismes cellulaires impliqués dans l'initiation et la chronicisation de la douleur oculaire. Cette revue présente, dans une première partie, l'anatomie de l'innervation cornéenne et les différentes classes de récepteurs sensitifs cornéens. La seconde partie fait un état des lieux des données précliniques et cliniques portant sur les mécanismes inflammatoires mis en jeu dans cette pathologie. Enfin la dernière partie de cette revue décrit les différents dispositifs actuellement utilisés pour évaluer la douleur et l'inflammation oculaire en clinique humaine. < sulaire présent ou potentiel, ou décrite en terme d'un tel dommage ». Les pathologies de la surface oculaire représentent l'un des principaux motifs de consultation pour douleurs oculaires en ophtalmologie. La douleur oculaire est le plus important signe cardinal d'alerte en réaction à une inflammation ou à un traumatisme des structures du segment antérieur de l'oeil comme la cornée, la conjonctive, la sclère 2 et les structures uvéales. La douleur oculaire chronique est tout à fait remarquable par la variabilité de l'intensité qu'elle peut générer, allant du simple inconfort oculaire à une douleur intense voire insupportable. La douleur chronique consé-cutive à une pathologie de la surface oculaire affecte la qualité de la vie : près de 60 % des patients se déclarent gênés dans leurs activités quotidiennes [1]. En outre, 80 % des patients qui souffrent de douleur oculaire ne l'estiment pas suffisamment prise en considération tant par leur entourage que par leurs médecins. Les douleurs chroniques oculaires sont malheureusement parmi les plus difficiles à traiter et leurs mécanismes physiopathologiques, de nature neurogène et/ou inflammatoire, demeurent de nos jours très mal connus [2,3]. Innervation cornéenne : anatomie et physiologieLa sensibilité somatique de la face, incluant les cavités buccale et nasales, et des méninges, est assurée par les trois branches du ganglion trigéminal : ophtalmique (V1), maxillaire (V2) et mandibulaire (V3). Le nerf ophtalmique V1 se divise en trois branches sensitives : les 2 Enveloppe fibreuse externe du globe oculaire.

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“…This hypothesis was very recently exemplified in an animal model of dry eye, where tear deficient rats exhibited conspicuous up-regulation of ocular responsive neural activity, characterized by central sensitization of trigeminal pathways at multiple levels in the brainstem. 17 Thus, for at least a subset of patients diagnosed with dry eye, the presence of physiologic dysfunction within the corneal somatosensory pathways, including peripheral and central neurons, (i.e. neuropathic ocular pain) may drive symptoms.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Ocular Pain Complaints in Patients With Idiopathic Dry Eye Symptoms

Kalangara

Galor

Levitt

et al. 2017

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Objective The purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms. Methods Subjects with clinically-relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared to similar measures from published data in other chronic pain populations. Results The study sample consisted of 154 subjects, of which 91% were male and ranged in age from 27 to 89 (mean age = 61). Fifty-three percent of participants reported an average ocular pain of at least moderate intensity (numerical rating scale (NRS) ≥ 4), with specific characteristics (i.e., “burning” spontaneous pain) reported at frequencies comparable to prevalent chronic neuropathic pain syndromes as reported in the literature. Significant correlations were found between ocular pain metrics and dry eye symptom severity scores (r=0.57 to 0.66). Dry eye signs, however, did not generally correlate with ocular pain severity. Conclusions A significant proportion of subjects with idiopathic dry eye symptoms reported moderate or greater ocular pain intensity, with the majority endorsing descriptors commonly used by patients with non-ocular neuropathic pain conditions. Identifying sub-groups of dry eye patients based on the presence and characteristics of ocular pain complaints may improve dry eye sub classification and better individualize treatment strategies.

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Sensitization of trigeminal brainstem pathways in a model for tear deficient dry eye

Abstract: Persistent tear deficiency was sufficient to cause sensitization of neurons at multiple regions of the trigeminal brainstem and enhanced orbicularis oculi muscle activity.

Cited by 55 publications

References 57 publications

Neuropathic symptoms of the ocular surface: dryness, pain, and itch

Neuropathic symptoms of the ocular surface: dryness, pain, and itch

La douleur oculaire chronique : mieux la comprendre pour mieux la traiter

Characteristics of Ocular Pain Complaints in Patients With Idiopathic Dry Eye Symptoms

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Sensitization of trigeminal brainstem pathways in a model for tear deficient dry eye

Abstract: Persistent tear deficiency was sufficient to cause sensitization of neurons at multiple regions of the trigeminal brainstem and enhanced orbicularis oculi muscle activity.

Cited by 55 publications

References 57 publications

Neuropathic symptoms of the ocular surface: dryness, pain, and itch

Neuropathic symptoms of the ocular surface: dryness, pain, and itch

La douleur oculaire chronique : mieux la comprendre pour mieux la traiter

Characteristics of Ocular Pain Complaints in Patients With Idiopathic Dry Eye Symptoms

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Product

Resources

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La douleur oculaire chronique : mieux la comprendre pour mieux la traiter