Schoenen J, Jamart B, Gerard P, Lenarduzzi P, Delwaide P J
Department of Neurology and Clinical Neurophysiology, Baviere Hospital, University of Liege, Belgium.
Neurology. 1987 Dec;37(12):1834-6. doi: 10.1212/wnl.37.12.1834.
Early (ES1) and late (ES2) exteroceptive suppression periods elicited by electrical stimulation of the labial commissure during teeth-clenching were recorded over the temporalis muscle in 45 headache patients (25 tension headaches and 20 migraines) and 22 controls. Mean duration of ES2 for single shocks was significantly reduced in tension headache when compared with migraine or controls. At a stimulation rate of 2 Hz, ES2 was abolished in 40% of tension headache sufferers, but in none of the migraineurs. EMG analysis of temporalis late exteroceptive suppression might be a helpful diagnostic tool in functional headaches. Reduction of ES2 suggests that there is deficient activation or excessive inhibition of pontobulbar inhibitory interneurons which receive a strong input from limbic structures. ES2 might thus represent an interface between psychogenic and myogenic factors putatively involved in the pathogenesis of tension headache.
在45例头痛患者（25例紧张性头痛和20例偏头痛）和22例对照者中，记录了在紧咬牙时唇联合处电刺激诱发的早期（ES1）和晚期（ES2）外感受性抑制期，记录部位为颞肌。与偏头痛患者或对照者相比，紧张性头痛患者单次电击的ES2平均持续时间显著缩短。在2Hz的刺激频率下，40%的紧张性头痛患者ES2消失，但偏头痛患者中无一例出现这种情况。颞肌晚期外感受性抑制的肌电图分析可能是功能性头痛的一种有用诊断工具。ES2的缩短表明，接受来自边缘结构强烈输入的脑桥延髓抑制性中间神经元存在激活不足或抑制过度的情况。因此，ES2可能代表了可能参与紧张性头痛发病机制的心因性和肌源性因素之间的一个界面。
