Habituation to Pain in “Medication Overuse Headache”: A CO<sub>2</sub> Laser‐Evoked Potential Study

Ferraro, Diana; Vollono, Catello; Miliucci, R.; Virdis, Daniela; Armas, Liala De; Pazzaglia, Costanza; Pera, Domenica Le; Tarantino, Samuela; Balestri, Martina; Trapani, G. Di; Valeriani, Massimiliano

doi:10.1111/j.1526-4610.2012.02151.x

Cited by 45 publications

(40 citation statements)

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“…A reduced LEP-amplitudes after sleep restriction could in theory be related to increased habituation since it is seemingly decreased in a painful disorder like migraine for various modalities (Coppola et al, 2013) although blinded studies have failed to confirm this regarding the visual domain (Omland et al, 2013). Lack of LEP-habituation has been reported for painful disorders like fibromyalgia (de Tommaso et al, 2014), migraine, (Di Clemente et al, 2013Valeriani et al, 2003) and medication-overuse headache (Ferraro et al, 2012). We observed habituation as expected in both groups, and as such, we found no effect of sleep restriction on LEP-habituation.…”

Section: Discussionmentioning

confidence: 92%

The effect of sleep restriction on laser evoked potentials, thermal sensory and pain thresholds and suprathreshold pain in healthy subjects

Ødegård¹,

Omland²,

Nilsen³

et al. 2015

Clinical Neurophysiology

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Section: Discussionmentioning

confidence: 92%

The effect of sleep restriction on laser evoked potentials, thermal sensory and pain thresholds and suprathreshold pain in healthy subjects

Ødegård¹,

Omland²,

Nilsen³

et al. 2015

Clinical Neurophysiology

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“…In a group of chronic migraine (CM) patients, a trend for an increase in LEP N2-P2 amplitudes [116] and a reorganization of the cortical areas devoted to pain processing [117], was also detected. Moreover, in CM due to medication overuse LEP N2-P2 amplitude still showed reduced habituation after both hand and face stimulation, similarly to the response behavior found with LEPs during interictal and ictal periods [118]. Interestingly, withdrawal from the acute medication overuse normalized the habituation curve [118].…”

Section: Reviewmentioning

confidence: 94%

“…Moreover, in CM due to medication overuse LEP N2-P2 amplitude still showed reduced habituation after both hand and face stimulation, similarly to the response behavior found with LEPs during interictal and ictal periods [118]. Interestingly, withdrawal from the acute medication overuse normalized the habituation curve [118]. …”

Section: Reviewmentioning

confidence: 94%

Habituation and sensitization in primary headaches

et al. 2013

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The phenomena of habituation and sensitization are considered most useful for studying the neuronal substrates of information processing in the CNS. Both were studied in primary headaches, that are functional disorders of the brain characterized by an abnormal responsivity to any kind of incoming innocuous or painful stimuli and it’s cycling pattern over time (interictal, pre-ictal, ictal). The present review summarizes available data on stimulus responsivity in primary headaches obtained with clinical neurophysiology. In migraine, the majority of electrophysiological studies between attacks have shown that, for a number of different sensory modalities, the brain is characterised by a lack of habituation of evoked responses to repeated stimuli. This abnormal processing of the incoming information reaches its maximum a few days before the beginning of an attack, and normalizes during the attack, at a time when sensitization may also manifest itself. An abnormal rhythmic activity between thalamus and cortex, namely thalamocortical dysrhythmia, may be the pathophysiological mechanism subtending abnormal information processing in migraine. In tension-type headache (TTH), only few signs of deficient habituation were observed only in subgroups of patients. By contrast, using grand-average responses indirect evidence for sensitization has been found in chronic TTH with increased nociceptive specific reflexes and evoked potentials. Generalized increased sensitivity to pain (lower thresholds and increased pain rating) and a dysfunction in supraspinal descending pain control systems may contribute to the development and/or maintenance of central sensitization in chronic TTH. Cluster headache patients are chrarcterized during the bout and on the headache side by a pronounced lack of habituation of the brainstem blink reflex and a general sensitization of pain processing. A better insight into the nature of these ictal/interictal electrophysiological dysfunctions in primary headaches paves the way for novel therapeutic targets and may allow a better understanding of the mode of action of available therapies.

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“…The ability to reduce and control a reflex response to nociceptive trigeminal stimulation may prevent migraine occurrence. In fact, even though reduced habituation to multimodal stimuli seems to be a genetic trait of migraine, habituation may be restored by preventive pharmacological treatments (Ferraro et al, 2012). Consequently, a training setting able to restore this behavior may result in an improvement of migraine outcome.…”

Section: Introductionmentioning

confidence: 99%

Nociceptive blink reflex habituation biofeedback in migraine

Tommaso¹,

Delussi²

2017

Functional Neurology

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SummaryReduced habituation of the nociceptive blink reflex (NBR) is considered a trait marker for genetic predisposition to migraine. In this open-label randomized controlled study, we aimed to test the efficacy of a biofeedback training based on learning of habituation of the NBR (NBR biofeedback) compared with pharmacological (topiramate) treatment and NBR biofeedback plus topiramate treatment in a cohort of migraine without aura patients eligible for prophylaxis. Thirty-three migraine patients were randomly assigned to three months of treatment with: 1) NBR biofeedback, 2) NBR biofeedback plus topiramate 50 mg (b.i.d.), or 3) topiramate 50 mg (b.i.d.). Frequency of headache and disability changes were the main study outcomes. Anxiety, depression, sleep, fatigue, quality of life, allodynia and pericranial tenderness were also evaluated. NBR biofeedback reduced the R2 area, without improving R2 habituation. However, it reduced the frequency of headache and disability, similarly to the combined treatment and topiramate alone. Reduced habituation of the NBR is a stable neurophysiological pattern, scarcely modifiable by learning procedures. Training methods able to act on stress-related responses may modulate cortical mechanisms inducing migraine onset and trigeminal activation under stressful trigger factors.

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Habituation to Pain in “Medication Overuse Headache”: A CO₂ Laser‐Evoked Potential Study

Abstract: The deficient habituation of the vertex N2/P2 complex was partly restored after successful treatment of medication-overuse headache, reflecting a modification in pain-processing pathways.

Cited by 45 publications

References 46 publications

The effect of sleep restriction on laser evoked potentials, thermal sensory and pain thresholds and suprathreshold pain in healthy subjects

The effect of sleep restriction on laser evoked potentials, thermal sensory and pain thresholds and suprathreshold pain in healthy subjects

Habituation and sensitization in primary headaches

Nociceptive blink reflex habituation biofeedback in migraine

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Habituation to Pain in “Medication Overuse Headache”: A CO2 Laser‐Evoked Potential Study

Abstract: The deficient habituation of the vertex N2/P2 complex was partly restored after successful treatment of medication-overuse headache, reflecting a modification in pain-processing pathways.

Cited by 45 publications

References 46 publications

The effect of sleep restriction on laser evoked potentials, thermal sensory and pain thresholds and suprathreshold pain in healthy subjects

The effect of sleep restriction on laser evoked potentials, thermal sensory and pain thresholds and suprathreshold pain in healthy subjects

Habituation and sensitization in primary headaches

Nociceptive blink reflex habituation biofeedback in migraine

Contact Info

Product

Resources

About

Habituation to Pain in “Medication Overuse Headache”: A CO₂ Laser‐Evoked Potential Study