Sandrini G, Martignoni E, Micieli G, Alfonsi E, Sances G, Nappi G
Funct Neurol. 1986 Oct-Dec;1(4):423-9.
Nociceptive flexion reflexes, RIII reflex in particular, have been demonstrated to be a useful tool for pain research in humans, since the threshold of RIII reflex is that of pain. In this study a reduction of RIII reflex threshold, strictly related to the severity of the disease, is described in migraine with interval headache (MIH), that is considered a severe and evolutive form of common migraine (CM). These abnormalities were not found in CM or in other chronic pain conditions, i.e. chronic tensive headache (CTH), suggesting that this electrophysiological parameter may be useful in the clinical assessment of primary headache. Moreover, the administration of amitriptyline, a drug producing analgesia mainly by blocking serotonin uptake, was able to markedly increase the RIII reflex threshold in MIH. This fact supports the hypothesis that an impairment of serotoninergic antinociceptive system may exist in this type of headache. A significant correlation between percentage increase in RIII reflex threshold and reduction of PTI was also observed after amitriptyline treatment, indicating that pain reflex may be used for predicting treatment response in migraine.
伤害性屈曲反射，尤其是RIII反射，已被证明是人类疼痛研究的有用工具，因为RIII反射的阈值就是疼痛阈值。在本研究中，我们描述了在发作性偏头痛（MIH）中RIII反射阈值的降低，这与疾病的严重程度密切相关，MIH被认为是普通偏头痛（CM）的一种严重且渐进性的形式。在CM或其他慢性疼痛疾病，即慢性紧张性头痛（CTH）中未发现这些异常，这表明该电生理参数可能有助于原发性头痛的临床评估。此外，阿米替林是一种主要通过阻断5-羟色胺摄取来产生镇痛作用的药物，它能够显著提高MIH患者的RIII反射阈值。这一事实支持了在这类头痛中可能存在5-羟色胺能抗伤害感受系统受损的假说。在阿米替林治疗后，还观察到RIII反射阈值的百分比增加与疼痛阈值指数（PTI）降低之间存在显著相关性，这表明疼痛反射可用于预测偏头痛的治疗反应。
