Researchers at Oregon Health & Science University’s School of Dentistry have uncovered two nerve cell proteins that interact to carry head and neck pain information to the brain. The significance of this finding is that improved therapies for treating ailments such as migraines or TMJ disorders may be found.
“Our discovery reveals the complexities of pain signaling mechanisms
from the head and neck to the brain,” said Agnieszka Balkowiec, MD, PhD, principal investigator, OHSU School of Dentistry assistant professor of integrative biosciences and OHSU School of Medicine adjunct assistant professor of physiology and pharmacology.
Head pain is signaled to the brain by the trigeminal nerve, which also conveys other kinds of information, such as the sensation of touch and temperature, from many structures of the face, including teeth, temporomandibular joints, cornea, ears, and skin. Research suggests that the trigeminal nerve provides the signaling pathway for neuropathic and inflammatory pain conditions such as migraines, TMJ disorder, periodontal pain, dental surgical pain, trigeminal neuralgia, head and neck cancer pain.
The two proteins are Calcitonin Gene-Related Peptide (CGRP), and Brain-Derived Neurotrophic Factor (BDNF). Previous studies have found that during a migraine attack, the stimulation of trigeminal nerve cells releases CGRP at the peripheral end of the cells, widening blood vessels in the brain coverings called meninges. Widening the blood vessels increases the flow of blood through the meninges and initiates an inflammatory process that likely contributes to the pain experience. Blocking CGRP helps alleviate migraine pain.
But the new discovery by Balkowiec’s team points to BDNF as being a likely culprit behind head pain — a previously unknown finding. BDNF has previously been shown to play an important role in pain signaling from other parts of the body, but this is the first time it has been considered to be a factor in head pain. The interaction between the two proteins is what is of interest. It also seems that BDNF is released by CGRP even when the trigeminal nerve cells are not stimulated.
The research is ongoing, “What we now need to better understand is how the interaction between CGRP and BDNF affects pain signaling to the brain in various disorders,” said Balkowiec.
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