title: Effects of amitriptyline and intra-oral device appliance on clinical and laser-evoked potentials features in chronic tension-type headache.
abstract: In the present study, we examined clinical and laser-evoked potentials (LEP) features in two groups of chronic tension-type headache (CTTH) patients treated with two different approaches: intra-oral appliance of prosthesis, aiming to reduce muscular tenderness, and 10 mg daily amitriptyline. Eighteen patients suffering from CTTH (IHS, 2004) participated in the study. We performed a basal evaluation of clinical features and LEPs in all patients (T0) vs. 12 age- and sex-matched controls; successively, patients were randomly assigned to a two-month treatment by amitriptyline or intra-oral device appliance. The later LEPs, especially the P2 component, were significantly increased in amplitude in the CTTH group. Both the intra-oral prosthesis and amitriptyline significantly reduced headache frequency. Total Tenderness Score was significantly reduced in the group treated by the prosthesis. The amplitude of P2 response elicited by stimulation of pericranial zones showed a reduction after amitriptyline treatment. The results of this study may confirm that pericranial tenderness is primarily a phenomenon initiating a self-perpetuating circuit, favoured by central sensitisation at the level of the cortical nociceptive areas devoted to the attentive and emotive compounds of pain. Both the interventions at the peripheral and central levels may interrupt this reverberating circuit, improving the outcome of headache.
authors.affiliation: Clinica Neurologica II, Policlinico, Piazza Giulio Cesare 11, I-70124, Bari, Italy. m.detommaso@neurol.uniba,it
authors.forename: M
authors.initials: M
authors.lastname: de Tommaso
authors.forename: E
authors.initials: E
authors.lastname: Shevel
authors.forename: G
authors.initials: G
authors.lastname: Libro
authors.forename: M
authors.initials: M
authors.lastname: Guido
authors.forename: D
authors.initials: D
authors.lastname: Di Venere
authors.forename: S
authors.initials: S
authors.lastname: Genco
authors.forename: C
authors.initials: C
authors.lastname: Monetti
authors.forename: C
authors.initials: C
authors.lastname: Serpino
authors.forename: G
authors.initials: G
authors.lastname: Barile
authors.forename: P
authors.initials: P
authors.lastname: Lamberti
authors.forename: P
authors.initials: P
authors.lastname: Livrea
mesh_terms: D000284:Administration, Oral; D000639:Amitriptyline / Q000008:administration & dosage*; D000704:Analysis of Variance; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage; D005069:Evaluation Studies as Topic; D005071:Evoked Potentials / Q000187:drug effects* / Q000528:radiation effects; D006801:Humans; D007834:Lasers; D019736:Prostheses and Implants; D018781:Tension-Type Headache / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline