Migraine and Conditioned Pain Modulation Efficiency
Migraine sufferers exhibited impaired conditioned pain modulation of the nociceptive blink reflex, suggesting a deficiency in inhibition of trigeminal nociception, which may contribute to the development of migraine headaches. This according to a recent study that aimed to assess conditioned pain modulation efficiency in persons with and without migraine headaches. Twenty-three adults with and 32 without a history of migraine headaches participated in the study. Four electrocutaneous stimulations of the supraorbital branch of the left trigeminal nerve were delivered at 150% of an individually determined pain threshold. Conditioned pain modulation was assessed by applying a noxious counterstimulus (forearm ischemia) and delivering 4 more electrocutaneous stimulations. After each stimulation, pain and the nociceptive blink reflex were assessed. Researchers found:
Participants with and without migraine headaches had similar baseline pain responsivity, without significant differences in pain report or nociceptive blink reflexes.
Pain report was inhibited by conditioned pain modulation in both the migraine and control groups.
However, unlike non-migraine controls, participants with migraines did not exhibit an inhibition of nociceptive blink reflexes during the ischemia task.
Williams AE, Miller MM, Bartley EJ, McCabe KM, Kerr KL, Rhudy JL. Impairment of inhibition of trigeminal nociception via conditioned pain modulation in persons with migraine headaches. [Published online ahead of print January 25, 2019]. Pain Med. doi:10.1093/pm/pny305.