Salivarna alfa amilaza i evocirani potencijali zubne pulpe kod bolesnika sa paroksizmalnom trigeminalnom neuralgijom
Sažetak
Uvod/Cilj. Paroksizmalna trigeminalna neuralgija (PTN) se karakteriše iznenadnim i intenzivnim bolom koji nepovoljno utiče na stanje obolelog i može prouzrokovati psihičku uznemirenost. Nivo salivarne alfa amilaze (sAA) predstavlja objektivnu procenu fizičkog, fiziološkog i psihološkog stresa. Evocirani potencijali (EP) odražavaju sprovodnu funkciju neurona, zbog čega se mogu primeniti za procenu neurotransmisije duž puta trigeminalnog nerva. Cilj rada bio je da se kod bolesnika sa PTN registrovanjem EP zubne pulpe ispitaju promene u prenošenju bolnih impulsa u odnosu na nivo sAA. Metode. Studijom je obuhvaćeno 10 bolesnika sa PTN i 12 zdravih ispitanika. Aktivnost sAA određivana je upotrebom aparata „Nipro Salivary Amylase Monitor”. U cilju dobijanja odgovora EP, zubna pulpa je stimulisana električnom strujom preko intaktne gleđi. Za stimulaciju i registraciju korišćen je apparat „Xltek Protektor 32 sistem”, softver „EPWorks”, verzija 5.0. Rezultati. Rezultati dobijeni od bolesnika sa PTN pokazuju veći broj talasa i značajno kraće latence na neuralgičnoj strani u poređenju sa zdravom stranom i sa kontrolnom grupom ispitanika (p < 0,05). Na neuralgičnoj strani su sve latence bile značajno kraće, a amplitude N2-P2 i N3-P3 značajno niže kod bolesnika sa povišenim nivoom sAA u odnosu na one koji su imali normalan nivo sAA (p < 0,05). Kasne latence (N2 i P2) na zdravoj strani kod bolesnika sa povišenim nivoom sAA bile su značajno kraće u poređenju sa bolesnicima čiji je nivo sAA bio normalan (p < 0,05). Zaključak. Naše istraživanje je pokazalo da psihički stres udružen sa PTN dodatno povećava hiperekscitabilnost i brzinu sprovođenja neurona. Osim toga, anticipirani stres povećava brzinu sprovođenja na talamokortikalnom nivou čak i na nepogođenoj strani kod pacijenata sa PTN. Međutim, kod zdravih ispitanika, stres sam po sebi nema uticaja na brzinu prenosa bolnih impulsa.
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