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Habituation to Pain in “Medication Overuse Headache”: A CO 2 Laser‐Evoked Potential Study
Author(s) -
Ferraro Diana,
Vollono Catello,
Miliucci Roberto,
Virdis Daniela,
De Armas Liala,
Pazzaglia Costanza,
Le Pera Domenica,
Tarantino Samuela,
Balestri Martina,
Di Trapani Girolamo,
Valeriani Massimiliano
Publication year - 2012
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2012.02151.x
Subject(s) - habituation , migraine , stimulation , medicine , anesthesia , ictal , evoked potential , audiology , psychology , physical therapy , electroencephalography , psychiatry
( Headache 2012;52:792‐807) Objective.— Our aim was to investigate CO 2 laser‐evoked potential (LEP) habituation to experimental pain in a group of patients affected by medication‐overuse headache, with a history of episodic migraine becoming chronic, before and after treatment, consisting in acute medication withdrawal and a preventive treatment cycle. Background.— One of the main features of LEPs in migraineurs is a lower habituation to repetitive noxious stimuli during the interictal phase. Methods.— LEPs were recorded to stimulation of both the right hand and the right perioral region in 14 patients and in 14 healthy subjects. The habituation of both the N1 and the vertex N2/P2 components was assessed by measuring the LEP amplitude changes across 3 consecutive repetitions of 30 trials each. Results.— In the 8 patients who had clinically improved after treatment, the N2/P2 amplitude habituation was significantly higher after treatment than before treatment following both hand ( F = 43.2, P < .0001) and face stimulation ( F = 6.9, P = .01). In these patients, the N2/P2 amplitude habituation after treatment was not different from that obtained in healthy controls ( P = .18 and P = .73 for hand and face stimulation, respectively). On the contrary, in the patients who did not improve, the N2/P2 amplitude still showed reduced habituation after both hand ( F = 3.1, P = .08) and face ( F = 0.7, P = .4) stimulation. Conclusion.— 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.