Institute of Physiology and Pathophysiology, Friedrich-Alexander-University of Erlangen-Nürnberg, Universitätsstr. 17, 91054, Erlangen, Germany.
Department of Health Science and Technology, Medical Faculty, Aalborg University, Aalborg, Denmark.
J Headache Pain. 2016 Dec;17(1):75. doi: 10.1186/s10194-016-0668-z. Epub 2016 Aug 26.
Tension-type headache and other primary headaches may be triggered or aggravated by disorders of pericranial muscles, which is possibly due to convergent or collateral afferent input from meningeal and muscular receptive areas. In rodent models high extracellular concentrations of ATP caused muscle nociception and central sensitization of second order neurons. In a rat model of meningeal nociception we asked if spinal trigeminal activity induced by ATP can be modulated by local anaesthesia of distinct muscles.
Ongoing activity was recorded from spinal trigeminal neurons with afferent input from the cranial dura mater, the temporal muscle and neck muscles. The stable ATP analogue α,β-methylene adenosine 5'-triphosphate (α,β-meATP, 10 mM) was injected into the ipsilateral temporal muscle, 30 min later followed by injection of local anaesthetics (lidocaine, 2 %) into the ipsilateral neck muscles and/or the temporal muscle.
Injection of α,β-meATP into the temporal muscle caused progressive increase in ongoing activity of most of the spinal trigeminal neurons within 30 min. Injection of lidocaine into the neck muscles and/or the temporal muscle reduced this activation to previous levels within 10 min.
Distinct spinal trigeminal neurons processing meningeal nociceptive information are under the control of convergent afferent input from several pericranial muscles. Blockade of at least one of these inputs can normalize central trigeminal activity. This may explain why therapeutic manipulations of head muscles can be beneficial in primary headaches.
紧张型头痛和其他原发性头痛可能由颅周肌肉紊乱引发或加重,这可能是由于脑膜和肌肉接受区域的会聚或侧支传入输入。在啮齿动物模型中,细胞外 ATP 浓度升高会导致肌肉伤害感受和二级神经元的中枢敏化。在脑膜伤害感受的大鼠模型中,我们询问了 ATP 诱导的脊髓三叉神经活动是否可以通过对不同肌肉进行局部麻醉来调节。
用来自颅顶硬膜、颞肌和颈肌的传入输入记录脊髓三叉神经神经元的持续活动。将稳定的 ATP 类似物α,β-亚甲基腺苷 5'-三磷酸(α,β-meATP,10 mM)注入同侧颞肌,30 分钟后,同侧颈肌和/或颞肌注射局部麻醉剂(利多卡因,2%)。
α,β-meATP 注入颞肌可在 30 分钟内逐渐增加大多数脊髓三叉神经神经元的持续活动。利多卡因注入颈肌和/或颞肌可在 10 分钟内将这种激活降低到以前的水平。
处理脑膜伤害感受信息的不同脊髓三叉神经神经元受到来自几个颅周肌肉的会聚传入输入的控制。至少阻断其中一个输入可以使中枢三叉神经活动正常化。这可能解释了为什么对头肌肉的治疗性操作在原发性头痛中可能是有益的。