Experimental Neurosurgery Section, Department of Neurosurgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Headache. 2011 May;51(5):734-43. doi: 10.1111/j.1526-4610.2011.01854.x. Epub 2011 Mar 11.
Neck muscle nociception mediated by nitric oxide may play a role in the pathophysiology of tension-type headache.
The present study addresses the involvement of neuronal nitric oxide synthase (nNOS) in the facilitation of neck muscle nociception after local application of nerve growth factor (NGF).
After administration of NGF into semispinal neck muscles, the impact of neck muscle noxious input on brainstem processing was monitored by the jaw-opening reflex in anesthetized mice. The modulatory effect of preceding and subsequent administration of an inhibitor of neuronal nitric oxide synthase on central facilitation was addressed in a controlled study.
With preceding i.p. application of saline or 0.096 mg/kg of the specific nNOS inhibitor Nω-propyl-L-arginine (NPLA), NGF induced a sustained reflex facilitation within 60 minutes. Preceding injection of 0.96 mg/kg or 1.92 mg/kg NPLA completely prevented the potentially facilitatory effect of NGF. Subsequent administration of 0.96 mg/kg NPLA did not affect established NGF-evoked reflex facilitation. Thus, NPLA prevents facilitation of brainstem processing by noxious myofascial input from neck muscles in a dose-dependent manner.
These findings suggest that nNOS is involved in the induction but not the maintenance of NGF-evoked facilitation of nociception in the brainstem. These results from an experimental animal model may support the idea of NOS and nNOS as potential targets for pharmacological treatment of tension-type headache.
一氧化氮介导的颈部肌肉伤害感受可能在紧张型头痛的病理生理学中起作用。
本研究探讨了神经元型一氧化氮合酶(nNOS)在局部给予神经生长因子(NGF)后促进颈部肌肉伤害感受中的作用。
在颈部半棘肌给予 NGF 后,通过麻醉小鼠的张口反射监测颈部肌肉伤害性传入对脑干处理的影响。在对照研究中,研究了 nNOS 抑制剂的预先和随后给药对中枢易化的调节作用。
预先腹腔内给予生理盐水或 0.096 mg/kg 的特异性 nNOS 抑制剂 Nω-丙基-L-精氨酸(NPLA),NGF 可在 60 分钟内引起持续的反射易化。预先注射 0.96 mg/kg 或 1.92 mg/kg NPLA 可完全阻止 NGF 的潜在促发作用。随后给予 0.96 mg/kg NPLA 并不影响已建立的 NGF 诱发的反射易化。因此,NPLA 以剂量依赖的方式防止来自颈部肌肉的有害肌筋膜传入引起的脑干处理的易化。
这些发现表明,nNOS 参与 NGF 诱导的但不参与维持脑干伤害感受的易化。来自实验动物模型的这些结果可能支持 NOS 和 nNOS 作为紧张型头痛药物治疗潜在靶点的想法。