Coppola Gianluca, Di Lorenzo Cherubino, Bracaglia Martina, Di Lenola Davide, Parisi Vincenzo, Perrotta Armando, Serrao Mariano, Pierelli Francesco
Department of Neurophysiology of Vision and Neurophthalmology, G.B. Bietti Foundation-IRCCS, Italy
Don Carlo Gnocchi Onlus Foundation, Italy.
Cephalalgia. 2015 Jun;35(7):600-7. doi: 10.1177/0333102414550418. Epub 2014 Sep 16.
We previously observed impaired habituation mechanisms of the conventional blink reflex (BR) in patients with episodic cluster headache (ECH) during the bout, studying only the affected side. Here, we have studied the nociceptive-specific BR (nBR) both on the affected and non-affected sides, and in relation to clinical features.
We recorded nBR in 18 ECH patients during the bout, and in 18 healthy volunteers (HVs). We compared pain threshold, area, and habituation of the nBR, recorded both for the affected and non-affected sides.
In patients, the pain threshold on the affected side was lower than that of the non-affected side (p = 0.009), and lower than in HVs (p = 0.038). Reflex area was decreased on both sides (p < 0.05) compared with HVs, whereas habituation was significantly impaired only on the affected side (p = 0.025 vs. HVs; p = 0.003 vs. non-affected). The habituation slope was positively correlated with the number of days since the onset of the bout and the daily attack frequency.
Our data reflect lateralized pathological variations in craniofacial nociception in ECH patients over the course of the cluster period. We hypothesized that this is due to malfunctioning of mechanisms that regulate hypothalamic activity and descending aminergic controls.
我们之前观察到发作性丛集性头痛（ECH）患者在发作期间患侧传统眨眼反射（BR）的习惯化机制受损，当时仅研究了患侧。在此，我们研究了患侧和非患侧的伤害性特异性眨眼反射（nBR）及其与临床特征的关系。
我们记录了18例ECH患者发作期间以及18名健康志愿者（HV）的nBR。我们比较了患侧和非患侧记录的nBR的疼痛阈值、面积和习惯化情况。
患者患侧的疼痛阈值低于非患侧（p = 0.009），且低于健康志愿者（p = 0.038）。与健康志愿者相比，两侧的反射面积均减小（p < 0.05），而仅患侧的习惯化明显受损（与健康志愿者相比，p = 0.025；与非患侧相比，p = 0.003）。习惯化斜率与发作开始后的天数和每日发作频率呈正相关。
我们的数据反映了ECH患者在丛集期面部伤害性感受的单侧病理性变化。我们推测这是由于调节下丘脑活动和下行胺能控制的机制功能失调所致。
