Habituation of the Nociceptive Blink Reflex in Experimentally Induced Migraine Attack
Status:
Recruiting
Trial end date:
2024-12-01
Target enrollment:
Participant gender:
Summary
People with migraine typically show impaired responsivity to visual, auditory and pain
stimuli (Burstein et al, 2015). The electrophysiological study of the nociceptive blink
reflex (nBR) is widely adopted for the instrumental evaluation of trigeminal afferent
function.
Migraine sufferers characteristically show deficits in the habituation to repeated
stimulations of various sensory modalities, in the interictal phase of the disease (Bohotin
et al, 2002; Di Clemente et al, 2005).
It has been described how the habituation / sensitization pattern presents a characteristic
pattern over the course of the migraine cycle. Past evidence suggests that the habituation
deficit may turn towards a normalization of the pattern near the acute migraine attack
(Coppola et al, 2013; Katsarava et al, 2003).
However, the study of the spontaneous attack shows various limits and difficulties, mainly
due to the impossibility of predicting the onset of the next attack and of standardizing the
experimental conditions. The use of human models of migraine allows us to overcome these
obstacles. Di Clemente et al. (2009) evaluated the electrophysiological changes in nBR after
administration of nitroglycerin (NTG) in healthy subjects. The authors described a
modification of trigeminal circuits and cortical responses (visual evoked potentials) after
NTG. However, NTG administration does not induce migraine attack in healthy subjects,
therefore this model cannot be directly translated to migraine pathology (Ashina et al.
2017).
Our group has previously used the human model of migraine based on the administration of NTG
to study central and spinal level sensitization through the nociceptive avoidance reflex in
the lower limb (RIII) (De Icco et al. 2020). The results of the previous study deepened our
understanding of the central mechanisms of sensitization.
The investigation of the nBR allows to study the modulation of the caudal trigeminal complex
(TCC). In the present study we therefore intend to evaluate, under well-controlled
experimental conditions, the modulation of the trigeminal caudal complex during an
experimentally induced migraine attack. The study will allow us to confirm or not the
normalization of habituation described in the acute phase through the adoption of a solid
cross-over and placebo-controlled study design.
Phase:
N/A
Details
Lead Sponsor:
IRCCS National Neurological Institute "C. Mondino" Foundation