The blink reflex test does not show abnormalities in a large group of patients with chronic migraine

Brooks, Joseph Bruno Bidin; Fragoso, Yára Dadalti

doi:10.1590/0004-282x20130139

Cited by 15 publications

(11 citation statements)

References 14 publications

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“…In addition, the possibility that increased excitability of the trigeminal pathways may persist during the interictal period has been proposed in EM [ 15 ]; however, investigations of trigeminal sensory pathways in CM, particularly in regard to nociceptive processing, are rare. One previous study did not observe any changes [ 16 ], whereas other studies observed abnormal excitability [ 13 , 17 ]. These inconsistencies may result from the use of different study techniques, such as the conventional blink reflex, or different study groups, such as in individuals with combined medication-overuse headaches.…”

Section: Introductionmentioning

confidence: 99%

Differences in central facilitation between episodic and chronic migraineurs in nociceptive-specific trigeminal pathways

2016

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BackgroundThe trigeminal nociceptive system plays a pivotal role in the pathophysiology of migraines. The present study investigated whether there are differences between patients with episodic migraine (EM) and patients with chronic migraine (CM) in trigeminal pain processing at the brainstem and cortical levels using the nociceptive blink reflex (nBR) and pain-related evoked potentials (PREP).MethodsThis study assessed 68 female migraineurs (38 EM patients and 30 CM patients) and 40 age-matched controls using simultaneous recordings of nBR and PREP during the interictal period.ResultsIn terms of the nBR, EM patients displayed significantly decreased latencies and larger amplitudes and area-under-the-curve (AUC) values for the R2 component, whereas CM patients showed significantly prolonged latencies and smaller amplitudes and AUC values for the R2 component (p < 0.05). In terms of PREP, both the EM and CM patients had decreased latencies (N1, P1), with larger amplitude compared with the controls (p < 0.05), which indicates facilitation at the cortical level. Additionally, the amplitude and AUC values of the R2 component exhibited a negative correlation, whereas the latency of the R2 component for the nBR showed a positive correlation, with the frequency of headaches in migraineurs (p < 0.01).ConclusionsIn the present study, the facilitation in the trigeminal nociceptive pathway of the EM group suggests the occurrence of migraine-specific hyperexcitability. Additionally, the suppression of R2 at the brainstem level in the CM group may relate to impaired or dysfunctional descending pain modulation. These findings suggest that there are adaptive or maladaptive responses due to the chronification of migraine attacks.

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Section: Introductionmentioning

confidence: 99%

Differences in central facilitation between episodic and chronic migraineurs in nociceptive-specific trigeminal pathways

2016

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“…They stated that these findings can be considered evidence that migraine-specific trigeminal dysfunction is a transient condition [21,22]. …”

Section: Discussionmentioning

confidence: 99%

Blink Reflex in migrane headache

Ünal¹,

Domaç

Boylu

et al. 2016

North Clin Istanbul

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OBJECTIVE:Activation of trigeminovascular system is thought to play an important role in migraine pathogenesis. Blink reflex (BR) test is an easy method to study the trigeminal system. Latencies recorded in BR test were evaluated to examine neurophysiological changes that occur in migraine patients.METHODS:A total of 40 patients diagnosed with migraine (9 with aura and 31 without aura) according to the International Headache Society (IHS) International Classification of Headache Disorders, 2nd edition, and 30 healthy control subjects were assessed using BR test. Supraorbital nerve was stimulated on each side, and unilateral early component (R1), and bilateral late component (R2) latencies were evaluated.RESULTS:Significantly longer latency values were recorded on both right and left sides (RR1 and LR1) as well as both ipsilateral and contralateral R2 on the left side (LR2i and LR2c) in the migraine group compared to the control group. Longer RR1 and LR1 latencies were found in patients with migraine who had an attack at the time of study (p<0.01). There was no statistically significant correlation between the location of pain and latencies in the interictal period (p>0.05). But significantly longer R1 and R2i latencies were found at the symptomatic side of patients examined during the headache attack (p=0.037 and p=0.028 respectively). There was no statistically significant correlation between the recorded latencies and gender, attack duration, attack frequency and migraine type (p>0.05).CONCLUSION:Results of BR test in the present study are thought to point to a dysfunction in brainstem and trigeminovascular connections of patients with migraine headache and support the trigeminovascular theory of migraine.

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“…Th e second response, R2, involves a pathway of descent to the spinal trigeminal tract. Th e contralateral response, R2c, refl ects the crossing of the brainstem in the medulla and progresses through the reticular formation to elicit a response at the contralateral facial nucleus [7][8][9] . Th e results obtained by testing the blink refl ex in patients with headaches have been very heterogeneous.…”

Section: Introductionmentioning

confidence: 99%

The Role of Electromyographic Blink Reflex in The Evaluation of Headache Incidence

Cesarik

Zavoreo

Zadro-Matovina

et al. 2017

acc

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SUMMARY -Migraine and tension type headache are the most common disabling primary headache disorders. Epidemiological studies have documented their high prevalence and high socioeconomic and personal impacts. According to recent data, migraine ranks as the third most prevalent disorder and seventh-highest specifi c cause of disability worldwide. Tension-type headache has lifetime prevalence in the general population ranging between 30% and 78% in diff erent studies. According to the International Classifi cation of Headache Disorders, 3 rd edition, there also are many other headaches but their incidence in general population is lower than the previously mentioned headaches. Trigeminal nerve and upper cervical segments (C1-C3) are included in pain control of the head region and often evaluated in headache studies in order to improve diff erential diagnosis and headache treatment. In our study, we evaluated the potential role of electromyographic (EMG) blink refl ex in establishing diagnosis of headache and evaluation of trigeminal nerve dysfunction as the possible underlying pathomorphological headache mechanism. Our study included 60 patients with diff erent types of primary headaches and 30 control subjects. Statistical analysis was performed by use of χ 2 -test and statistical signifi cance was set at p<0.001. Study results showed that patients with trigeminal dysfunction in EMG blink refl ex had a 5.6-fold higher risk of developing headache in comparison to subjects with normal EMG blink refl ex fi nding.

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The blink reflex test does not show abnormalities in a large group of patients with chronic migraine

Cited by 15 publications

References 14 publications

Differences in central facilitation between episodic and chronic migraineurs in nociceptive-specific trigeminal pathways

Differences in central facilitation between episodic and chronic migraineurs in nociceptive-specific trigeminal pathways

Blink Reflex in migrane headache

The Role of Electromyographic Blink Reflex in The Evaluation of Headache Incidence

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