Abnormal Modulatory Influence of Diffuse Noxious Inhibitory Controls in Migraine and Chronic Tension-Type Headache Patients

Sandrini, Giorgio; Rossi, Paolo; Milanov, Ivan; Serrao, Mariano; Cecchini, A; Nappi, Giuseppe

doi:10.1111/j.1468-2982.2006.01130.x

Cited by 236 publications

(196 citation statements)

References 47 publications

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“…There were 19 studies that met the inclusion criteria for the review but could not be included in the meta-analyses because raw data could not be extracted (Peters et al, 1992;Leroux et al, 1995;Knost et al, 1997;de Tommaso et al, 2000;Nappi et al, 2002;Desmeules et al, 2003;Katsarava et al, 2003;Banic et al, 2004;Lang et al, 2005;Ayzenberg et al, 2006;Carleton et al, 2006;Sandrini et al, 2006;Al-Azzawi et al, 2008;Filatova et al, 2008;Mendak et al, 2010;Neziri et al, 2010;Biurrun Manresa et al, 2013a,b;Desmeules et al, 2014). We were unable to obtain a meaningful outcome relevant to our research question for eight studies (see Table 2 for details).…”

Section: Studies Not Included In the Meta-analysesmentioning

confidence: 99%

“…For example, for five studies, the authors were unable to access their data (Peters et al, 1992;Knost et al, 1997;Nappi et al, 2002;Katsarava et al, 2003;Sandrini et al, 2006), two considered that it was inappropriate to use their data and declined to share their results (Carleton et al, 2006;Biurrun Manresa et al, 2013a,b), and the authors of nine studies did not respond to several enquiries about their data (Leroux et al, 1995;de Tommaso et al, 2000;Desmeules et al, 2003Desmeules et al, , 2014Banic et al, 2004;Lang et al, 2005;Ayzenberg et al, 2006;Al-Azzawi et al, 2008;Mendak et al, 2010). As noted in the peer review process of the current review, this does reflect a kind of bias -towards papers the authors of which are willing and able to share their data for the purposes of the meta-analysis.…”

Section: Limitationsmentioning

confidence: 99%

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Defensive reflexes in people with pain – a biomarker of the need to protect? A meta-analytical systematic review

Wallwork

Grabherr

O’Connell

et al. 2017

Reviews in the Neurosciences

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AbstractUpregulation of defensive reflexes such as the nociceptive flexion reflex (NFR) has been attributed to sensitisation of peripheral and spinal nociceptors and is often considered biomarkers of pain. Experimental modulation of defensive reflexes raises the possibility that they might be better conceptualised as markers of descending cognitive control. Despite strongly held views on both sides and several narrative reviews, there has been no attempt to evaluate the evidence in a systematic manner. We undertook a meta-analytical systematic review of the extant English-language literature from inception. Thirty-six studies satisfied our a priori criteria. Seventeen were included in the meta-analysis. Reflexive threshold was lower in people with clinical pain than it was in pain-free controls, but reflex size, latency, and duration were unaffected. The pattern of difference was not consistent with sensitisation of nociceptive neurones, as these changes were not isolated to the affected body part but was more consistent with top-down cognitive control reflective of heightened protection of body tissue. The pattern of modulation is dependent on potentially complex evaluative mechanisms. We offer recommendations for future investigations and suggest that defensive reflex threshold may reflect a biomarker of a broader psychological construct related to bodily protection, rather than sensitisation of primary nociceptors, spinal nociceptors, or pain.

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Section: Studies Not Included In the Meta-analysesmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Defensive reflexes in people with pain – a biomarker of the need to protect? A meta-analytical systematic review

Wallwork

Grabherr

O’Connell

et al. 2017

Reviews in the Neurosciences

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“…The effect of DNIC was evident on the N2 and P2 amplitude and on the N2 latency, while a non-significant reduction of amplitude and prolongation of latency were induced on the N1 component at both the hand and trigeminal levels during the remote capsaicin application. In previous studies, where only the vertex LEP components were evaluated, they appeared inhibited for the effect of DNIC [8,11,12], while the N1 component was not reduced by either homotopical or remote experimental pain [20]. According to the LEP dipolar model, the N1/P1 potential reflects the activity of the SII area contralateral to stimulation, while the vertex N2-P2 LEP component is mainly generated in the anterior cingulate gyrus [17].…”

Section: Discussionmentioning

confidence: 99%

“…The laserevoked potentials (LEPs) obtained by the stimulation of the facial skin constitute a reliable neurophysiological method for the assessment of the trigeminal nociceptive pathways function [8]. In recent years we have performed some studies of LEPs in migraine.…”

Section: Introductionmentioning

confidence: 99%

Effects of remote cutaneous pain on trigeminal laser-evoked potentials in migraine patients

et al. 2007

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The present study aimed to evaluate heat pain thresholds and evoked potentials following CO2 laser thermal stimulation (laser-evoked potentials, LEPs), during remote application of capsaicin, in migraine patients vs. non-migraine healthy controls. Twelve outpatients suffering from migraine without aura were compared with 10 healthy controls. The LEPs were recorded by 6 scalp electrodes, stimulating the dorsum of the right hand and the right supraorbital zone in basal condition, during the application of 3% capsaicin on the dorsum of the left hand and after capsaicin removal. In normal subjects, the laser pain and the N2-P2 vertex complex obtained by the hand and face stimulation were significantly reduced during remote capsaicin application, with respect to preand post-capsaicin conditions, while in migraine LEPs and laser pain were not significantly modified during remote painful stimulation. In migraine a defective brainstem inhibiting control may coexist with cognitive factors of focalised attention to facial pain, less sensitive to distraction by a second pain.

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“…On the other hand, the finding of a paradoxical facilitation of the R3 reflex response during the cold pressor test 17 pointed to an associated deficient descending inhibition 18 . To further complicate the puzzle, individuals with TTH were found to have increased pericranial muscle tenderness even in the absence of headache 17 .…”

mentioning

confidence: 98%

Neurotrophic factors and tension-type headache: another brick in the wall?

Folchini

Kowacs

2015

Arq. Neuro-Psiquiatr.

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T ension-type headache (TTH) is the most prevalent primary headache and the second most prevalent disorder in the world 1 . However, despite the great progress made in understanding the putative physiological and biological abnormalities of migraines in recent decades 2 , the same cannot be said for their counterpart, TTH, which has been relegated to the background by most investigators 3 and, now neglected 4 , can be considered the "ugly duckling" of headache disorders classified by the International Headache Society (IHS). In what is perhaps a vicious circle, few initiatives have been taken by independent academic or industry-financed researchers to change this situation.The physiological basis of TTH was explored in the 1990s 5, and the findings allowed hypotheses for putative biochemical mechanisms associated with this type of headache to be drawn up 6 . Nevertheless, these hypothetical mechanisms have yet to be confirmed and, with few exceptions, the studies that have been carried out did not use animal models or test these mechanisms to the same level of detail as in migraine studies 2 . It is against this background that the paper in this edition by Domingues et al., who studied the role of neurotrophic factors in TTH down to the molecular level, acquires particular importance 7 . In a well-designed and carefully conducted cross-sectional study, Domingues et al. determined serum levels of brain-derived neurotrophic factor (BDNF), nerve-growth factor (NGF), neurotrophin-3 (NT-3) and neurotrophin-4/5 (NT-4/5) in forty-eight TTH patients and forty-eight age and gender-matched controls. The authors searched for a correlation between these neurotrophic factors and TTH (both episodic and chronic) as well as other measurable psychosocial variables 7 . Early studies of the pathophysiology of TTH supported the muscle-contraction theory, although TTH can occur with or without pericranial tenderness. The widespread acceptance this theory gained can be observed in a review by Maekawa et al. 8 , who discussed the factors supporting and refuting the putative role of adrenergic receptors and muscle hypoperfusion in myofascial pain.Following a different line of investigation, and probably considering the similarities between migraine and TTH, such as their sharing of common triggers 3,9 , Ashina et al. searched unsuccessfully for changes in neuropeptides such as substance P, neuropeptide Y and vasoactive intestinal polypeptide (VIP) in peripheral blood of patients with chronic tension-type headache (CTTH) 10,11 . Their findings may have in fact been anticipated by Bach et al., who found normal levels of calcitonin gene-related peptide (CGRP) in the cerebrospinal fluid of patients with TTH 12,13 . To date, the most consistent finding in the pathophysiology of CTTH has been the evidence that glyceryl-nitrate (GNT) infusion can induce late-onset tension-type-like headache in CTTH sufferers 14,15 . These findings prompted a cross-over trial, which showed that NG-monomethyl-L-arginine hydrochloride (L-NMMA), an NOS inhib...

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Abnormal Modulatory Influence of Diffuse Noxious Inhibitory Controls in Migraine and Chronic Tension-Type Headache Patients

Cited by 236 publications

References 47 publications

Defensive reflexes in people with pain – a biomarker of the need to protect? A meta-analytical systematic review

Defensive reflexes in people with pain – a biomarker of the need to protect? A meta-analytical systematic review

Effects of remote cutaneous pain on trigeminal laser-evoked potentials in migraine patients

Neurotrophic factors and tension-type headache: another brick in the wall?

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