Impairment of Inhibition of Trigeminal Nociception via Conditioned Pain Modulation in Persons with Migraine Headaches

Author:

Williams Amy E1,Miller Megan M2,Bartley Emily J3,McCabe Klanci M4,Kerr Kara L56,Rhudy Jamie L7

Affiliation:

1. Department of Psychiatry, Riley Child and Adolescent Psychiatry Clinic, Indiana University School of Medicine, Indiana University Health Physicians, Indianapolis, Indiana

2. Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana

3. Department of Community Dentistry and Behavioral Science, Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, Florida

4. Section of Psychology, Division of Developmental and Behavioral Sciences, Children’s Mercy Kansas City, University of Missouri Kansas City School of Medicine, Kansas City, Missouri

5. Department of Human Development and Family Science, Oklahoma State University, Tulsa, Oklahoma

6. Laureate Institute for Brain Research, Tulsa, Oklahoma

7. Department of Psychology, The University of Tulsa, Tulsa, Oklahoma, USA

Abstract

Abstract Objective To assess conditioned pain modulation efficiency in persons with and without migraine headaches. Design Cross-sectional assessment of experimental pain. Setting University campus and surrounding community in a large Midwestern US city. Subjects Twenty-three adults with and 32 without a history of migraine headaches participated in the study. Participants were mostly female (N = 40) with an average age of 23 years. Methods Four electrocutaneous stimulations of the supraorbital branch of the left trigeminal nerve were delivered at 150% of an individually determined pain threshold. Conditioned pain modulation was assessed by applying a noxious counterstimulus (forearm ischemia) and delivering four more electrocutaneous stimulations. After each stimulation, pain and the nociceptive blink reflex were assessed. Depression and pain catastrophizing were assessed to control for the potential influence of these variables on pain modulation. Results Participants with and without migraine headaches had similar baseline pain responsivity, without significant differences in pain report or nociceptive blink reflexes. Pain report was inhibited by conditioned pain modulation in both the migraine and control groups. However, unlike nonmigraine controls, participants with migraines did not exhibit an inhibition of nociceptive blink reflexes during the ischemia task. This pattern persisted after controlling for level of pain catastrophizing and depression. Conclusions Migraine sufferers exhibited impaired conditioned pain modulation of the nociceptive blink reflex, suggesting a deficiency in inhibition of trigeminal nociception, which may contribute to the development of migraine headaches.

Funder

NIH

Publisher

Oxford University Press (OUP)

Subject

Anesthesiology and Pain Medicine,Neurology (clinical),General Medicine

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