Effect of trigeminal tractotomy on behavioral response to dental pulp stimulation in the monkey.

Trigeminal tractotomy near the level of the obex was carried out in 10 macaque monkeys. Behavioral responses were evaluated by a quantitative paradigm measuring lever-press responses to electrical stimulation of the dental pulp or facial skin, and by assessing facial response to cutaneous pin-scratch before and after the tractotomy. Two pharmacological agents, strychnine and L-dopa, were administered and their effect on behavioral responses to these stimuli was studied. Tractotomy did not produce dental analgesia. Thresholds for escape from cutaneous electrical stimulation of facial skin, however, were elevated, consistent with marked hypalgesia to pin-scratch. The adversive responses to pin-scratch were absent in peripheral portions of the face, but near the midline and inside the oral cavity they were usually decreased or normal. Pharmacological agents caused a reduction in escape thresholds to cutaneous electrical stimulation and a shrinkage or abolition of the zone of analgesia to pin-scratch. The results imply that trigeminal nucleus caudalis, which undergoes deafferentation by tractotomy, may not be essential for processing of nociceptive information from the teeth, oral cavity, and midline facial zones. This findings is contrary to long-held hypotheses concerning facial pain mechanisms. The ability of strychnine and L-dopa to alter nociceptive escape thresholds is consistent with the idea, suggested by Denny-Brown, that facial nociception depends on central summation in the entire spinal trigeminal nucleus from overlapping afferent inputs contained in the trigeminal nerve, other cranial nerves, and the upper cervical nerve roots.