Central sensitization of the trigeminal and somatic nociceptive systems in medication overuse headache mainly involves cerebral supraspinal structures

Cephalalgia. 2006 Sep;26(9):1106-14. doi: 10.1111/j.1468-2982.2006.01183.x.

Abstract

Trigeminal and somatic nociceptive systems were studied in controls (n=15), episodic migraine (n=16), analgesics (n=14) and triptan-induced medication overuse headache (MOH) (n=15) before and after withdrawal. Patients with MOH and comorbid depressive symptoms and depression without headache were studied to investigate the influence of depression. Trigeminal nociception was studied by simultaneous registration of pain-related cortical potentials (PREP) and nociceptive blink reflex (nBR) following nociceptive-specific electrical stimulation of the forehead. Somatic nociception was evaluated using PREP of upper limbs. We found facilitation of both trigeminal and somatic PREP but not of nBR in MOH, which normalized after withdrawal. No differences were found comparing analgesics vs. triptan MOH. No differences were observed between controls and patients with episodic migraine and depression without headache. A transient facilitation was found of trigeminal and somatic nociceptive systems in MOH, which was more pronounced on a supraspinal level.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Analgesics / adverse effects*
  • Evoked Potentials, Somatosensory*
  • Female
  • Headache / chemically induced*
  • Headache / physiopathology*
  • Humans
  • Male
  • Somatosensory Cortex / drug effects
  • Somatosensory Cortex / physiopathology*
  • Spinal Cord / drug effects
  • Spinal Cord / physiopathology
  • Trigeminal Nerve / physiopathology*
  • Trigeminal Neuralgia / physiopathology

Substances

  • Analgesics