Kaube H, Katsarava Z, Przywara S, Drepper J, Ellrich J, Diener H-C
Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
Neurology. 2002 Apr 23;58(8):1234-8. doi: 10.1212/wnl.58.8.1234.
To investigate trigeminal sensory processing in patients with migraine using a novel "nociception-specific" blink reflex.
Seventeen patients with unilateral migraine headache were studied within 6 hours of onset. Blink reflexes were elicited with a standard stimulating electrode (standard blink reflex) and concentric stimulating electrode (nociception-specific blink reflex) during the acute migraine attack, after treatment with IV lysine acetylsalicylate (1,000 mg) or oral zolmitriptan (5 mg) and interictally.
After standard stimulation, no differences were detected for the R1 and R2 onset latencies and areas under the curve (AUC) between the different time points and the headache and nonheadache side. Nociception-specific stimulation revealed a shortening of R2 onset latencies (44.3 +/- 5.4 ms for headache side vs 48.9 +/- 5.8 ms for nonheadache side) during the acute migraine attack compared with the headache-free interval (49.8 +/- 5.3 vs 49.8 +/- 4.5 ms). The AUC of the R2 increased on the headache side by 680% and on the nonheadache side by 230% compared with the headache-free interval. Drug treatment parallel to pain relief increased the onset latencies (zolmitriptan: 48.0 +/- 8.2 ms for headache side vs 52.3 +/- 7.6 ms for nonheadache side; lysine acetylsalicylate: 48.0 +/- 5.0 ms for headache side vs 51.2 +/- 5.6 ms for nonheadache side) and reduced the AUC of R2 (zolmitriptan by 45% and lysine acetylsalicylate by 48%).
The data suggest temporary sensitization of central trigeminal neurons during acute migraine attacks.
使用一种新型的“伤害性刺激特异性”眨眼反射来研究偏头痛患者的三叉神经感觉处理。
对17例单侧偏头痛性头痛患者在发病6小时内进行研究。在急性偏头痛发作期间、静脉注射赖氨酸阿司匹林（1000毫克）或口服佐米曲普坦（5毫克）治疗后以及发作间期，用标准刺激电极（标准眨眼反射）和同心刺激电极（伤害性刺激特异性眨眼反射）引出眨眼反射。
标准刺激后，不同时间点以及头痛侧和非头痛侧之间的R1和R2起始潜伏期及曲线下面积（AUC）均未检测到差异。伤害性刺激特异性刺激显示，与无头痛间期相比，急性偏头痛发作期间头痛侧的R2起始潜伏期缩短（头痛侧为44.3±5.4毫秒，非头痛侧为48.9±5.8毫秒）（无头痛间期分别为49.8±5.3毫秒和49.8±4.5毫秒）。与无头痛间期相比，头痛侧R2的AUC增加了680%，非头痛侧增加了230%。与疼痛缓解平行的药物治疗增加了起始潜伏期（佐米曲普坦：头痛侧为48.0±8.2毫秒，非头痛侧为52.3±7.6毫秒；赖氨酸阿司匹林：头痛侧为48.0±5.0毫秒，非头痛侧为51.2±5.6毫秒）并降低了R2的AUC（佐米曲普坦降低45%，赖氨酸阿司匹林降低48%）。
数据表明急性偏头痛发作期间中枢三叉神经神经元存在暂时的致敏作用。
