Trigger point evaluation in migraine patients:: an indication of peripheral sensitization linked to migraine predisposition?
Trigger point evaluation in migraine patients:: an indication of peripheral sensitization linked to migraine predisposition?
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DOI：
10.1111/j.1468-1331.2006.01181.x
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发表时间：
2006-03-01
影响因子：
5.1
通讯作者：
Rico-Villademoros, F
中科院分区：
文献类型：
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作者：
Calandre, EP;Hidalgo, J;Rico-Villademoros, F
虽然偏头痛是一种神经血管疾病，但在偏头痛患者中观察到头皮压痛和牵涉性疼痛。本研究调查了98名偏头痛患者和32名健康受试者中触发疼痛的触发点的存在情况。92例(93.9%)偏头痛患者和9例(29%)对照组(P<；0.0001)有触发点。单个偏头痛触发点的数量从0到14(模式数：4)不等，并且被发现与偏头痛发作的频率(P<；0.0001)和疾病的持续时间(P=0.017)有关。约74%的触发点位于颞区和/或枕下区；其他部位主要见于触发点超过4个的患者。触发点触诊在30例(30.6%)患者中引发偏头痛发作。15例(15.3%)患者有颅周异位痛觉。这些数据表明，伤害性外周敏感化是偏头痛的常见表现，而中枢敏感化可以在频繁发作和长期疾病的患者中发展。偏头痛患者中触发点的检测在应用针灸、针刺或肉毒杆菌毒素注射等治疗方法以减少外周过敏时可能有用。
Although migraine is a neurovascular disorder, both scalp tenderness and referred pain have been observed in migraine patients. The present study was carried out to investigate the presence of trigger points eliciting referred pain in 98 migraine patients and in 32 healthy subjects. Trigger points were found in 92 (93.9%) migraineurs and in nine (29%) controls (P < 0.0001). The number of individual migraine trigger points varied from zero to 14 (modal number: 4), and was found to be related to both the frequency of migraine attacks (P < 0.0001), and the duration of the disease (P = 0.017). About 74% of the total detected trigger points were found in temporal and/or suboccipital areas; other locations were mainly found in patients showing more than four trigger points. Trigger point palpation provoked a migraine attack in 30 (30.6%) patients. Pericraneal allodynia was found in 15 (15.3%) patients. These data indicate that nociceptive peripheral sensitization is a usual finding in migraine, and that central sensitization can develop in patients with frequent attacks and long-lasting disease. Trigger points' detection in migraine patients could be useful when applying therapies like acupuncture, needling or botulinum toxin injections directed to reduce peripheral sensitization.