Cansu Köseoğlu Toksoy, Hayri Demirbaş, Erhan Bozkurt, Hakan Acar, and Ülkü Türk Börü. Korean J Pain 2021;34:241-5. https://doi.org/10.3344/kjp.2021.34.2.241

Objective: A considerable number of individuals are diagnosed with idiopathic trigeminal neuralgia. In order to achieve a more complete understanding of the pathophysiology, it is essential to adopt a range of novel approaches and utilize new animal models. This study investigated changes in the messenger RNA (mRNA) expression of ion-channels in a newly developed animal model of trigeminal neuropathic pain induced by cervical spinal dorsal horn compression. Methods: Eighteen rabbits were randomly assigned into three groups (spinal cord compression, sham, and control groups), and a previously developed animal model was applied. Quantitative polymerase chain reaction was applied to examine the genetic expression of Na, K, and Ca channels in the cervical dorsal horn, trigeminal ganglion, and infraorbital nerve. Results: The mRNA expression levels of SCN8A and SCN9A exhibited a marked increase in the infraorbital nerve of the spinal cord compression group when compared to the sham group. Furthermore, the mRNA expression levels of CACNA1C, KCNK1, and SCN9A demonstrated a significant increase in all investigated regions when compared to the control group. Conclusions: The present findings indicate the potential critical involvement of Nav1.6 and Nav1.7 in the pathogenesis of trigeminal neuropathic pain. However, the potential involvement of the CaV2.1, CaV1.2, and K2P1.1 channels cannot be ruled out at this juncture.

Background: Despite the identification of various environmental factors that increase the risk of multiple sclerosis (MS), the effects of many factors on the etiology of MS remain to be elucidated. In this study, we aimed to investigate the effects of radon, a factor previously studied in relation to various other neurodegenerative diseases, on the epidemiology of MS. Methods: A door-to-door field study was conducted in residential areas with relatively high and low radon gas concentrations to determine the prevalence of MS. The study area comprises the Bolvadin and İhsaniye regions, which have different geological characteristics, such as seismic activity, active faults, and distributions of volcanic rocks. CR-39 detectors, with an accepted limit of 300 Bq/m³, were utilized to measure radon gas concentrations. During the screening field, the patients diagnosed with multiple sclerosis were confirmed with their hospital records. Mc Donald’s revised diagnostic criteria were used for multiple sclerosis diagnosis. Results: The regions were grouped into higher radon areas and lower radon areas. The İhsaniye city center, Kayıhan, Kemerkaya, Döğer, and Bolvadin city center were classified as higher radon regions, whereas Dişli, Yaylabağı, Gazlıgöl, and Özburun were identified as lower radon regions. A total of 40,841 individuals were surveyed in the field. The crude MS prevalence was 41.8/100,000 in settlements with high radon gas concentrations and 20.5/100,000 in settlements with low radon gas concentrations. Conclusions: In this study, we revealed that the prevalence of MS was greater in settlements with high radon gas concentrations than in settlements with low radon gas concentrations. These results demonstrated that radon gas is an important environmental risk factor in the etiopathogenesis of MS.

Idiopathic trigeminal neuralgia (TN) cases encountered frequently in daily practice indicate significant gaps that still need to be illuminated in the etiopathogenesis. In this study, a novel TN animal model was developed by compressing the dorsal horn (DH) of the upper cervical spinal cord. Eighteen rabbits were equally divided into three groups, namely control (CG), sham (SG), and spinal cord compression (SCC) groups. External pressure was applied to the left side at the C3 level in the SCC group. Dorsal hemilaminectomy was performed in the SG, and the operative side was closed without compression. No procedure was implemented in the control group. Samples from the SC, TG, and ION were taken after seven days. For the histochemical staining, damage and axons with myelin were scored using Hematoxylin and Eosin and Toluidine Blue, respectively. Immunohistochemistry, nuclei, apoptotic index, astrocyte activity, microglial labeling, and CD11b were evaluated. Mechanical allodynia was observed on the ipsilateral side in the SCC group. In addition, both the TG and ION were partially damaged from SC compression, which resulted in significant histopathological changes and increased the expression of all markers in both the SG and SCC groups compared to that in the CG. There was a notable increase in tissue damage, an increase in the number of apoptotic nuclei, an increase in the apoptotic index, an indication of astrocytic gliosis, and an upsurge in microglial cells. Significant increases were noted in the SG group, whereas more pronounced significant increases were observed in the SCC group. Transmission electron microscopy revealed myelin damage, mitochondrial disruption, and increased anchoring particles. Similar changes were observed to a lesser extent in the contralateral spinal cord. Ipsilateral trigeminal neuropathic pain was developed due to upper cervical SCC. The clinical finding is supported by immunohistochemical and ultrastructural changes. Thus, alterations in the DH due to compression of the upper cervical region should be considered as a potential cause of idiopathic TN.

OBJECTIVE: Burnout syndrome is an important problem among healthcare workers. During the Covid-19 pandemic, healthcare professionals have struggled with an unprecedented effort. The aim of this study is to investigate occupational burnout levels among healthcare professionals working at Afyonkarahisar Health Sciences University during the Covid-19 pandemic.MATERIAL AND METHODS: This study was carried out at the Afyonkarahisar Health Sciences University between February 1st and March 1st, 2021. G* power package software was used in the sample calculation. A questionnaire form consisting of 20 parameters on demographic data and work life was used. Maslach Burnout Inventory was used as the burnout scale.RESULTS: A total of 312 healthcare professionals participated in this study. 139 of the participants were men (44.6%) and 173 were women (55.4%). The mean age of the participants was 30.7± 7.28. 138 of the participants were doctors (44.2%) and 174 were nurses (55.8%). 110 of the participants were working in a covid ward or covid intensive care unit (ICU) (35.3%) and 202 were working in other departments (64.7%). The mean subscale scores were 19.21±7.28 for emotional exhaustion, 7.31±7.19 for depersonalization, and 20.05±3.88 for personal accomplishment. These results show that healthcare workers experience high levels of burnout according to the emotional exhaustion and personal accomplishment subscales and moderate burnout according to the depersonalization subscale.CONCLUSIONS: The results of this study are very valuable for establishing future prevention protocols and educating healthcare professionals in the face of a pandemic. Based on our findings, we suggest closely monitoring risk groups that work directly with Covid-19 patients and providing psychological support when necessary. Also, making the necessary arrangements in working conditions is crucial to increase job satisfaction and reduce burnout in healthcare workers.

Trigeminal neuralgia (TN) is a debilitating neuropathic pain disorder characterized by severe paroxysmal facial pain. Increasing evidence indicates that Schwann cell dysfunction and altered nerve repair mechanisms contribute to TN pathology. MicroRNAs (miRNAs), as key regulators of Schwann cell plasticity, myelination, inflammation, and nerve regeneration, represent promising biomarker candidates. This study aimed to investigate differential expression patterns of Schwann cell-associated miRNAs (miR-221-3p, miR-132-3p, miR-210-5p, miR-340-3p, miR-98-5p, miR-182-5p) in patients with trigeminal neuralgia and evaluate their diagnostic biomarker potential. Expression analysis was performed using quantitative real-time PCR with 5s rRNA as the reference gene. miRNA expression levels were evaluated by qRT-PCR. Differential expression was calculated using ΔCt, ΔΔCt, and fold-change analyses. Diagnostic performance was assessed using ROC curve analysis. Integrated visualization was carried out using scatter plots, volcano plots, and z-score-normalized heatmaps. miR-221-3p was significantly upregulated in patients with trigeminal neuralgia (TN), whereas miR-340-3p and miR-182-5p were downregulated. Hierarchical clustering and principal component analysis (PCA) demonstrated a clear separation between patient and control miRNA expression profiles. In receiver operating characteristic (ROC) analyses, miR-221-3p emerged as the most powerful individual biomarker (AUC = 0.699), while the combined miRNA panel achieved high diagnostic performance (AUC = 0.89). Downregulated miRNAs reflect suppressed inhibitory signaling pathways, suggesting that miRNA profiling may provide valuable insights into Schwann cell pathology in TN. The selected miRNAs, which are implicated in impaired Schwann cell repair mechanisms, represent promising molecular biomarker candidates for the diagnosis of TN and potentially for guiding therapeutic strategies.