title: Different SEP recovery cycle in adolescent migraineurs with exploding or imploding pain.
abstract: Our aim was to investigate whether migraine adolescents with pain directed inside (imploding pain--IP) and outside (exploding pain--EP) the head may have different levels of cortical excitability underlying their migraineous syndrome. Ten migraine children referring prevalent EP (mean age 14.5 ± 1.4 years, 3 girls, 7 boys), 10 patients with IP (mean age 14.1 ± 2.2 years, 4 girls, 6 boys), and 13 control subjects (mean age 13 ± 1.8 years, 6 males, 7 females) participated to the study. The recovery cycle of the somatosensory evoked potentials to electrical median nerve stimuli at interstimulus intervals of 5, 20, and 40 ms was measured. Anger expression, anxiety, and somatic concerns were investigated in migraine patients. Overall, SEP recovery cycle was shorter in migraineurs than in healthy controls. The recovery cycle of the frontal N30 SEP component was significantly shorter in IP than in EP patients. While among the EP patients those with faster N30 recovery cycle had higher Trait-Anger score, the opposite was found among the IP patients. Our results suggest that the inhibitory mechanisms within the somatosensory cortex are more impaired in IP than in EP migraine adolescents. The pathophysiological difference between IP and EP migraineurs was strengthened also by the opposite correlations between the brain excitability and the anger expression.
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Viale dell'Università 30, 00185 Rome, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Iacovelli
authors.forename: Samuela
authors.initials: S
authors.lastname: Tarantino
authors.forename: Alessandro
authors.initials: A
authors.lastname: Capuano
authors.forename: Massimiliano
authors.initials: M
authors.lastname: De Luca
authors.forename: Cristiana
authors.initials: C
authors.lastname: De Ranieri
authors.forename: Federico
authors.initials: F
authors.lastname: Vigevano
authors.forename: Lars
authors.initials: L
authors.lastname: Arendt-Nielsen
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Valeriani
mesh_terms: D000293:Adolescent; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology* / Q000523:psychology; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement; D013003:Somatosensory Cortex / Q000503:physiopathology*
keywords: AX-Con; AX-IN; AX-OUT; AX/EX; Anger; Anger Expression-Control; Anger Expression-In; Anger Expression-Out; CS; EP; Exploding pain; ICDHD-2; IP; Imploding pain; International Classification of Headache Disorders, 2nd edition; Migraine; Psychiatric scales for self-administration for youths and adolescents; SA; SAFA; STAXI; Somatosensory evoked potentials; State Trait Anger Expression Inventory; State-Anger; TA; Trait-Anger; control subjects; exploding pain; general expression of anger; imploding pain