Functional Connectivity between Trigeminal and Occipital Nerves Revealed by Occipital Nerve Blockade and Nociceptive Blink Reflexes

Cephalalgia - Tập 26 Số 1 - Trang 50-55 - 2006
Volker Busch1, Wolfgang Jakob1, T Juergens1, W. Schulte-Mattler1, Holger Kaube2, Arne May1
1Department of Neurology, University of Regensburg, Regensburg, Germany
2Headache Group, Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK

Tóm tắt

Headache syndromes often suggest occipital and neck involvement, although it is still unknown to what extent branches of segment C1-C3 contribute actively to primary headache. Pain within the occipital area may be referred to the trigeminal territory. However, a modulation of trigeminal transmission by affecting cervical input in humans has not been elucidated so far. A convergence of cervical and trigeminal input at the level of the caudal part of the trigeminal nucleus in the brainstem has been suggested due to anatomical and neurophysiological studies in animals. We examined the R2 components of the nociceptive blink reflex responses in 15 healthy subjects before and after unilateral nerve blockade of the greater occipital nerve with 5 ml prilocain (1%). R2 response areas (AUC) decreased and the R2 latencies increased significantly after the nerve blockade only on the side of injection. AUC and latencies on the non-injection side remained stable. Thresholds for sensory or pain perception did not differ significantly between the repeated measurements on both sides. Our findings extend previous results related to anatomical and functional convergence of trigeminal and cervical afferent pathways in animals and suggest that the modulation of this pathway is of potential benefit in primary headache disorders.

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Tài liệu tham khảo

10.1097/00007611-194708000-00005

10.1212/01.WNL.0000052998.58526.A9

10.1111/j.1526-4610.1987.hed2708452.x

10.1046/j.1468-2982.2002.00403.x

10.3171/jns.1961.18.5.0605

10.1093/brain/awf166

Goadsby PJ, 2001, The pathophysiology of headache, 7

10.1016/0006-8993(93)90486-7

10.1002/cne.902680110

10.1093/brain/awg190

10.1016/0304-3959(92)90131-T

Hu J, 1995, J Manipulative Physiol Ther, 18, 577

10.1016/0924-980X(96)95684-2

10.1002/(SICI)1097-4598(199703)20:3<265::AID-MUS1>3.0.CO;2-9

10.1016/S1388-2457(99)00295-3

10.1016/S1388-2457(02)00307-3

10.1212/WNL.59.9.1450

10.1212/WNL.58.8.1234

10.1212/WNL.46.2.479

10.1016/S1388-2457(03)00132-9

10.1007/s00415-003-1073-5

10.1046/j.1468-1331.2003.00531.x

10.1016/S0022-510X(96)00124-4

Kimura J, 2001, Electrodiagnosis in diseases of nerve and muscle, 3

10.1016/S0006-8993(98)00646-5

10.1016/S0304-3959(97)00074-2

10.1016/0006-8993(72)90408-8

10.1159/000016109

10.1152/jn.1988.59.2.648

Busch V, 2004, Schmerz, 18, 404, 10.1007/s00482-004-0347-x

10.1093/brain/awh022

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Cephalalgia

Tập 26 Số 1

50-55

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