Acetylsalicylic acid activates antinociceptive brain-stem reflex activity in headache patients and in healthy subjects

Abstract

The exteroceptive suppression (ES) of electrical activity in the temporal muscle is an inhibitory antinociceptive brain-stem reflex. We investigated whether aspirin can significantly modulate latencies or durations of the early (ES1) and late (ES2) exteroceptive suppression periods of electrical activity in the temporal muscle. Participating in the randomized double-blind crossover study were 20 patients with migraine without aura, 20 patients with tension-type headache, and 20 healthy subjects. ES1 and ES2 elicited by an electrical stimulus of 20 mA lasting 0.2 msec were recorded during maximal voluntary contraction of the mastication muscles before and 30 min after medication. In a randomized and double-blind fashion half of the subjects were given 1200 mg of aspirin in the form of an effervescent solution and the other half were given an identically tasting solution without aspirin. One week later the experiment was repeated with the substances exchanged in crossover fashion. The administration of placebo as well as aspirin caused a highly significant increase in ES1 duration (P less than or equal to 0.001). While aspirin caused a highly significant increase in ES2 duration (P less than or equal to 0.001) the taking of placebo showed no significant effect on ES2 duration. In giving aspirin as opposed to the placebo, there was a significant interaction between groups and drug effect on the latency of ES1; whereas in migraine patients and in patients with tension-type headache the latency of ES1 was reduced by administration of aspirin, it was increased in healthy subjects (P less than or equal to 0.05). Neither aspirin nor placebo significantly varied the ES2 latency.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical neurophysiology of chronic daily headache

“…Other authors did not confirm these findings, probably for the variability of technical conditions: Gobel et al [7] failed to detect ES2 abnormalities in a general sample of young chronic tension-type headache sufferers. Similarly, Zwart and Sand found no differences in the duration of ES2 in adult patients with either chronic TTH, migraine, or cervicogenic headache, relative to headache-free controls [8].…”

Central and peripheral mechanisms in chronic tension-type headache

“…Previous samples may thus have included subjects with long histories of recurrent headache problems and possibly analgesic use, who may have had concomitant physical or psychological problems that can complicate the interpretation of psychophysiological data. The only other study that used a general sample of young recurrent headache sufferers also failed to detect ES2 abnormalities (Gobel et al 1992a), but also used a different assessment methodology than has been used in more recent studies (Schoenen 1993a,b). Additional unpublished data (n = 178) collected in our laboratory utilizing the ES2 assessment methodology recently recommended by the European Headache Foundation (Schoenen 1993a,b) are consistent with the findings of the present study.…”

The influence of acetylsalicylic acid on cognitive processing: an event-related potentials study

“…In humans, amplitudes of the late but not of the early components of pain-related evoked potentials were reduced by ASA (Chen and Chapman 1980); these findings were confirmed by Kobal et al (1990). The exteroceptive suppression of antinociceptive brain-stem reflex activity was influenced by ASA, which caused an increased duration of ES2 period in migraine and tensiontype headache patients (Göbel et al 1992).…”