A Novel Neural Circuit for the Modulation of Trigeminal Neuropathic Pain

Trigeminal neuropathic pain is a debilitating condition and represents a challenge to clinicians because such pain is often refractory to currently available therapies. However, brain neural circuit mechanisms underlying this type of pain remain poorly understood. Using a cutting-edge approach called "Targeted Recombination in Active Populations (TRAP)", we identify that neurons in the anterior paraventricular thalamic nucleus (aPVT) are markedly activated by trigeminal nerve injury, which causes trigeminal neuropathic pain. We further investigate the role of aPVT and relevant neural circuitry in the pathogenesis of trigeminal neuropathic pain using multidisciplinary approaches, including anterograde and retrograde viral tracing, optogenetic and chemogenetic manipulation, and behavioral observation. We found that the TRAPed aPVT neurons directly project to anterior cingulate cortex (ACC), and that excitation of the TRAPed aPVT neurons or activation of the pathway from aPVT to ACC enhances both evoked mechanical hypersensitivity and spontaneous pain in a mouse model of peripheral nerve injury-induced trigeminal neuropathic pain. Using miniscope-based in vivo neuronal activity recording, we reveal that specific excitation of the TRAPed aPVT neurons increases neuronal activity in the ACC. Our results indicate a modulatory role of the activated aPVT neurons and the aPVT−ACC pathway in trigeminal neuropathic pain.