title: Modulation of trigeminal reflex excitability in migraine: effects of attention and habituation on the blink reflex.
abstract: The modulation of trigeminal reflex excitability in migraine patients was evaluated during the asymptomatic phase by studying the effects of attention, habituation and preconditioning stimulus on the R2 and R3 components of the blink reflex (BR). Fifty patients suffering from migraine without aura, 20 affected by migraine with aura and 35 sex- and age-matched controls were selected. In subgroups of migraine with-aura and without-aura patients, and normal controls, the blink reflex was elicited during different cognitive situations: (a) spontaneous mental activity; (b) stimulus anticipation; (c) recognition of target numbers. In the remaining subjects, R2 and R3 habituation was evaluated by repetitive stimulation at 1, 5, 10, 15, 20, 25 and 30 s intervals. The R2 and R3 recovery curves were also computed. A reduced R3 threshold with a normal pain threshold was found in migraine with-aura and without-aura patients; the R3 component was not significantly correlated with the pain thresholds in patients and controls. The R2 and R3 components were less influenced by the warning of the stimulus in migraine without-aura and migraine with-aura patients, in comparison with the control group. A slight increase of both R2 and R3 recovery after preconditioning stimulus was also observed in migraine patients, probably caused by a phenomenon of trigeminal hyperexcitability persisting after the last attack. The abnormal BR modulation by alerting expresses in migraine a dysfunction of adaptation capacity to environmental conditions, probably predisposing to migraine.
authors.affiliation: Clinical Neurologica I Policlinico, Piazza G. Cesare II, 70124, Bari, Italy. m.detommaso@neurol.uniba.it
authors.forename: Marina
authors.initials: M
authors.lastname: de Tommaso
authors.forename: Donatella
authors.initials: D
authors.lastname: Murasecco
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Libro
authors.forename: Marco
authors.initials: M
authors.lastname: Guido
authors.forename: Vittorio
authors.initials: V
authors.lastname: Sciruicchio
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Specchio
authors.forename: Virgilio
authors.initials: V
authors.lastname: Gallai
authors.forename: Francomichele
authors.initials: F
authors.lastname: Puca
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001288:Attention; D001767:Blinking; D004056:Differential Threshold; D005260:Female; D006185:Habituation, Psychophysiologic; D006801:Humans; D008297:Male; D008568:Memory; D008881:Migraine Disorders / Q000503:physiopathology* / Q000523:psychology*; D017288:Pain Threshold; D012016:Reference Values; D012018:Reflex; D012021:Reflex, Abnormal; D013850:Thinking; D014276:Trigeminal Nerve / Q000503:physiopathology*