Gierse-Plogmeier Barbara, Colak-Ekici Reyhan, Wolowski Anne, Gralow Ingrid, Marziniak Martin, Evers Stefan
Department of Neurology, University of Münster, Albert-Schweitzer-Str. 33, Münster 48129, Germany.
J Headache Pain. 2009 Aug;10(4):249-54. doi: 10.1007/s10194-009-0118-2. Epub 2009 Apr 15.
Pain perception studies in migraine patients have shown trigeminal and peripheral pain facilitation during the migraine attack. We were interested in differences of trigeminal and peripheral pain perception between migraine patients during the migraine interval and healthy subjects. Perception of electrical pain stimulation was measured in 20 migraine subjects outside a migraine attack (10 migraine with aura and 10 migraine without aura) and in 20 healthy subjects. We recorded sensory and pain thresholds, pain ratings after suprathreshold stimulation, and pain rating after two trains of repetitive stimulation (i.e., pain facilitation). Migraine subjects showed a significantly higher pain rating after suprathreshold stimulation in the trigeminal region as compared to healthy subjects (4.8 +/- 1.6 versus 3.8 +/- 2.2, p < 0.04 after Bonferroni correction) but not in the peripheral region. Furthermore, migraine subjects showed a pain facilitation after repetitive trigeminal stimulation whereas healthy subjects showed a pain habituation. We observed no significant differences between migraine subjects and healthy subjects for all parameters in the peripheral stimulation. Migraine patients with and without aura did not differ in any parameter. All subjects showed decreased sensory and pain thresholds after trigeminal as compared to peripheral stimulation. Migraine subjects show an increased pain perception after trigeminal but not after peripheral pain stimulation as compared to healthy subjects. This phenomenon is probably due to the observed pain facilitation after painful trigeminal stimulation.
偏头痛患者的疼痛感知研究表明，在偏头痛发作期间存在三叉神经和外周疼痛易化现象。我们感兴趣的是偏头痛患者在偏头痛间歇期与健康受试者之间三叉神经和外周疼痛感知的差异。对20名处于偏头痛发作间期的偏头痛患者（10名有先兆偏头痛患者和10名无先兆偏头痛患者）以及20名健康受试者进行了电痛刺激感知测量。我们记录了感觉阈值和疼痛阈值、阈上刺激后的疼痛评分以及两串重复刺激后的疼痛评分（即疼痛易化）。与健康受试者相比，偏头痛患者在三叉神经区域阈上刺激后的疼痛评分显著更高（4.8±1.6对3.8±2.2，经Bonferroni校正后p<0.04），但在外周区域则不然。此外，偏头痛患者在重复三叉神经刺激后出现疼痛易化，而健康受试者则出现疼痛习惯化。在外周刺激中，我们观察到偏头痛患者与健康受试者在所有参数上均无显著差异。有先兆和无先兆的偏头痛患者在任何参数上均无差异。与外周刺激相比，所有受试者在三叉神经刺激后感觉阈值和疼痛阈值均降低。与健康受试者相比，偏头痛患者在三叉神经疼痛刺激后疼痛感知增加，但在外周疼痛刺激后则不然。这种现象可能是由于观察到的三叉神经疼痛刺激后的疼痛易化所致。
