1 Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy.
2 Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Cephalalgia. 2018 Sep;38(10):1658-1664. doi: 10.1177/0333102417742347. Epub 2017 Nov 20.
Introduction The mechanism of action of non-invasive vagal nerve stimulation in the treatment of migraine is elusive. We studied its effect in a human model of pain, the nociceptive withdrawal reflex. Methods We enrolled 10 healthy subjects who underwent active non-invasive vagal nerve stimulation and sham treatment in a randomized, cross-over, sham-controlled study. Non-invasive vagal nerve stimulation was delivered with gammaCore®. The assessment of the nociceptive withdrawal reflex was performed at baseline (T0) and at 5 (T5) and 30 (T30) minutes after stimulation. Results Non-invasive vagal nerve stimulation significantly increased the reflex threshold to single stimulus at both T5 and T30 and the temporal summation threshold at T30. Sham treatment did not modify any parameters. Discussion These findings are consistent with a modulation of central descending pathways for pain control. An altered spinal and supraspinal control of pain has been described in primary headache, so this effect may partially explain the therapeutic effect of non-invasive vagal nerve stimulation.
介绍 经颅磁刺激治疗偏头痛的作用机制尚不清楚。我们在疼痛的人体模型（伤害性回避反射）中研究了它的效果。
方法 我们招募了 10 名健康受试者，他们在一项随机、交叉、假对照研究中接受了主动经颅磁刺激和假刺激治疗。使用 gammaCore®进行经颅磁刺激。在刺激前（T0）、刺激后 5 分钟（T5）和 30 分钟（T30）评估伤害性回避反射。
结果 经颅磁刺激显著提高了 T5 和 T30 时单次刺激的反射阈值和 T30 时的时程总和阈值。假刺激治疗未改变任何参数。
讨论 这些发现与疼痛控制的中枢下行通路的调制一致。原发性头痛中已描述了脊髓和脊髓上疼痛的改变控制，因此这种效应可能部分解释了经颅磁刺激的治疗效果。
