Abstract
Trigeminal neuralgia pain remains a challenge to treat. Natural compounds may be promising options for relieving pain. This study was aimed at investigating the effects of aconitine in a rat model of trigeminal neuralgia pain. Infraorbital nerve chronic constriction injury was performed in adult Wistar Albino rats. After the neuropathic pain developed, the rats were assigned to one of the treatment groups: carbamazepine 40 or 80 mg/kg; aconitine 0.25, 0.50, or 0.75 mg/kg; or saline injection (control group). Behavioral testing with von Frey filaments and the rotarod test were carried out before the surgical procedure and on the 24th to 29th postoperative days. Following the completion of tests, ipsilateral and contralateral spinal cords were harvested for Western blot analyses to assess NR-1 protein expression. ANOVA followed by Mann-Whitney U test was performed for the statistical analyses. P values of <0.05 were considered significant. Aconitine significantly reduced mechanical sensitivity in a dose-dependent manner. A significant reduction in motor coordination was noted for the higher doses of aconitine which was similar with the 40 and 80 mg/kg doses of carbamazepine. NR-1 expression was reduced in the ipsilateral spinal cord, whereas no significant difference was noted between the groups in the expression of NR-1 in the contralateral spinal cord. Aconitine had a significant pain relieving effect, which was similar to carbamazepine, in a dose-dependent manner. Aconitine may be an alternative pharmacological agent for the control of trigeminal neuralgia pain.
Highlights
Trigeminal neuralgia (TN) is a neuropathic pain condition in the distribution of one or more branches of the trigeminal nerve [1]
We investigated the effects of aconitine on TN in the rat chronic constriction injury (CCI)
It was demonstrated that aconitine reduced NR-1 expression in the ipsilateral spinal cord at all doses, but only 0.75 mg/kg of aconitine was found to be statistically significant (Figure 4)
Summary
Trigeminal neuralgia (TN) is a neuropathic pain condition in the distribution of one or more branches of the trigeminal nerve [1]. Studies have shown that medication is efficacious in most of the patients, and pharmacotherapy is considered as the first-line treatment for TN [4, 8,9,10]. Conventional analgesics and anti-inflammatory medications do not alleviate TN pain, whereas antiepileptics are usually beneficial [11]. Carbamazepine has been reported to provide a 100% pain relief in 70% of patients [13]. Numerous drug interactions with carbamazepine have been mentioned in the literature [14] This suggests a need to evaluate alternative pharmacologic agents with less side effects that can be used safely in all patient groups in the treatment of TN. The analgesic effects of the Aconitum species have been demonstrated in animal models of inflammatory and neuropathic pain [18].
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