Abnormal cortical responses to somatosensory stimulation in medication-overuse headache

• DOI: 10.1186/1471-2377-10-126
• Publication Date: 2016-07-14T17:45:11Z
• Authors: Gianluca Coppola; Antonio Currà; Cherubino Di Lorenzo; Vincenzo Parisi; Manuela Gorini; Simona Liliana Sava; Jean Schoenen; Francesco Pierelli
• Keywords: Somatosensory evoked potential; Evoked potential

Medication-overuse headache (MOH) is a frequent, disabling disorder. Despite controversial pathophysiology convincing evidence attributes pivotal role to central sensitization. Most patients with MOH initially have episodic migraine without aura (MOA) characterized interictally by an absent amplitude decrease in cortical evoked potentials repetitive stimuli (habituation deficit), despite normal initial (lack of sensitization). Whether sensitization alters this electrophysiological profile unknown. We therefore sought differences somatosensory potential (SEP) and habituation MOA.We recorded median-nerve SEPs (3 blocks 100 sweeps) 29 MOH, 64 MOA 42 controls. Episodic migraineurs were studied during between attacks. measured N20-P25 amplitudes from 3 sweeps, assessed block 1 amplitude, changes the sequential blocks.In migraineurs, interictal SEP 1, but thereafter failed habituate. Ictal increased then habituated normally. Patients had larger-amplitude than controls, also lacked habituation. smaller triptan overusers overusing nonsteroidal anti-inflammatory drugs (NSAIDs) or both medications combined, lowest longest history, highest those longest-lasting chronification.In especially NSAIDs, cortex becomes increasingly sensitized. Sensory might add behavioral that favors compulsive drug intake, may reflect drug-induced serotoninergic transmission.