Identification of the NRF2 transcriptional network as a therapeutic target for trigeminal neuropathic paint
We discovered that oxidative stress drives facial neuropathic pain through TRPA1 channels. Activating the NRF2 transcriptional network reverses this damage and opens new pathways for repurposing FDA-approved therapeutics like exemestane
Deep learning-based segmentation of the trigeminal nerve and surrounding vasculature in trigeminal neuralgia
We developed a deep learning tool that automatically segments and reconstructs the trigeminal nerve and surrounding blood vessels from routine MRI scans of trigeminal neuralgia patients, addressing the limitations of time-consuming and subjective manual analysis. Our best AI model achieved high accuracy (Dice score of 0.775) and identified neurovascular conflict with 100% sensitivity and specificity. It also automatically calculated geometric features like contact area and distance from the brainstem, matching the accuracy of manual measurements. This fast, objective tool standardizes the evaluation of neurovascular compression and has the potential to improve surgical decision-making and treatment selection for patients.
A mouse model of classical trigeminal neuralgia via intradural compression of the trigeminal nerve
We developed a new mouse model that accurately replicates classical trigeminal neuralgia by compressing the trigeminal nerve root intradurally, mimicking the neurovascular compression seen in human patients. Our model produced both spontaneous and evoked pain behaviors, which were significantly reduced by carbamazepine (the only FDA-approved drug for TN), validating its clinical relevance. Mechanistically, we found heightened spontaneous neuronal activity in the trigeminal ganglia, neuronal hyperexcitability, and key signs of neuroinflammation including immune cell infiltration, demyelination, and increased CGRP expression. This robust platform overcomes limitations of previous peripheral injury models and offers a valuable tool for studying TN mechanisms and testing new therapies.
