title: Effects of OnabotulintoxinA on Habituation of Laser Evoked Responses in Chronic Migraine.
abstract: Onabotulintoxin A (BontA) is an efficacious preventive treatment for chronic migraine, though the specific mechanism of action is still under discussion. The study aims: (1) To evaluate pain processing modifications in chronic migraine patients (CM) under single BontA administration in pericranial muscles, by means of CO² Laser Evoked Potentials (LEPs) obtained by the stimulation of the skin over the right frontal and trapezius injection sites and hand dorsum, in a double blind placebo controlled crossover design. (2) To correlate main LEPs findings with clinical outcome after one year of BontA treatment. Twenty refractory CM patients were included in the analysis. The LEPs were recorded in basal conditions and seven days after BontA (PREEMPT protocol) and saline solution injection. The N1, N2 and P2 amplitude and latencies and N2P2 habituation index were evaluated and correlated with the percent change of headache frequency after one year of toxin treatment. After seven days of BontA treatment, a normalization of the trigeminal habituation index was observed, which was correlated with the clinical outcome after one year of BontA therapy. Patients displaying trigeminal LEPs facilitation at T0 time showed a more efficient therapeutic outcome. Neurotoxin may exert a modulating effect on trigeminal nociception, normalizing central neurotransmission.
authors.affiliation: Neurophysiopathology of Pain, SMBNOS Department, Policlinico General Hospital, Giovanni XXIII Building, Via Amendola 207 A 70124 Bari, Italy. marina.detommaso@uniba.it.
authors.forename: Marina
authors.initials: M
authors.lastname: de Tommaso
authors.affiliation: Neurophysiopathology of Pain, SMBNOS Department, Policlinico General Hospital, Giovanni XXIII Building, Via Amendola 207 A 70124 Bari, Italy. m.delussi@gmail.com.
authors.forename: Marianna
authors.initials: M
authors.lastname: Delussi
authors.affiliation: Neurophysiopathology of Pain, SMBNOS Department, Policlinico General Hospital, Giovanni XXIII Building, Via Amendola 207 A 70124 Bari, Italy. katiari86@gmail.com.
authors.forename: Katia
authors.initials: K
authors.lastname: Ricci
authors.affiliation: Neurophysiopathology of Pain, SMBNOS Department, Policlinico General Hospital, Giovanni XXIII Building, Via Amendola 207 A 70124 Bari, Italy. annamonte@live.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Montemurno
authors.affiliation: Neurophysiopathology of Pain, SMBNOS Department, Policlinico General Hospital, Giovanni XXIII Building, Via Amendola 207 A 70124 Bari, Italy. ireneottavia.carbone@policlinico.ba.it.
authors.forename: Irene
authors.initials: I
authors.lastname: Carbone
authors.affiliation: Neurophysiopathology of Pain, SMBNOS Department, Policlinico General Hospital, Giovanni XXIII Building, Via Amendola 207 A 70124 Bari, Italy. eleonora.vecchio@uniba.it.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Vecchio
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006185:Habituation, Psychophysiologic / Q000187:drug effects* / Q000502:physiology; D006261:Headache / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D066331:Laser-Evoked Potentials / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement; D017288:Pain Threshold; D010812:Physical Stimulation; D012008:Recurrence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D019274:Botulinum Toxins, Type A
keywords: chronic migraine; laser evoked potentials; neurotoxin mechanism