Abnormal pain processing in chronic tension-type headache: a high-density EEG brain mapping study
Abnormal pain processing in chronic tension-type headache: a high-density EEG brain mapping study
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DOI：
10.1093/brain/awn199
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发表时间：
2008-12-01
期刊：
影响因子：
14.5
通讯作者：
Bendtsen, L.
中科院分区：
文献类型：
--
作者：
Buchgreitz, L.;Egsgaard, L. L.;Bendtsen, L.
由肌肉长时间的伤害性输入引起的中枢致敏被认为在紧张性头痛的慢性化中起重要作用。在本研究中，我们使用一种新的高密度脑电图脑成像技术来研究19例慢性紧张性头痛（CTTH）患者和19例年龄和性别匹配的健康对照者对肌肉疼痛的脑活动时空反应。对斜方肌施加肌内电刺激（单脉冲和5脉冲组合，频率为2hz），在引起强直性颈/肩肌肉疼痛（向斜方肌注射谷氨酸）的条件下和条件外，用128通道脑电图记录体感诱发电位。在第一次（基线与强直性肌肉疼痛：P 0.001；基线与强直性肌肉疼痛：P 0.002）和第五次（基线与强直性肌肉疼痛：P 0.04；基线与强直性肌肉疼痛：P 0.04）刺激训练时，对照组P200偶极子在诱导强直性肌肉疼痛期间和之后的强度显著降低。相比之下，患者之间的情况没有差异。偶极子的定位和峰潜伏期没有一致的差异。在控制组而非CTTH患者中，在诱导强直性肌肉疼痛期间和之后，强度降低可能是由于这些患者的伤害性输入抑制受损。这可能是CTTH患者对肌肉疼痛的椎上反应异常的第一个证据。
Central sensitization caused by prolonged nociceptive input from muscles is considered to play an important role for chronification of tension-type headache. In the present study we used a new high-density EEG brain mapping technique to investigate spatiotemporal aspects of brain activity in response to muscle pain in 19 patients with chronic tension-type headache (CTTH) and 19 healthy, age- and sex-matched controls. Intramuscular electrical stimuli (single and train of five pulses delivered at 2 Hz) were applied to the trapezius muscle and somatosensory evoked potentials were recorded with 128-channel EEG both in- and outside a condition with induced tonic neck/shoulder muscle pain (glutamate injection into the trapezius muscle). Significant reduction in magnitude during and after induced tonic muscle pain was found in controls at the P200 dipole in response to both the first (baseline versus tonic muscle pain: P 0.001; baseline versus post-tonic muscle pain: P 0.002) and fifth (baseline versus tonic muscle pain: P 0.04; baseline versus post-tonic muscle pain: P 0.04) stimulus in the train. In contrast, there were no differences between the conditions in patients. No consistent difference was found in localization or peak latency of the dipoles. The reduction in magnitude during and after induced tonic muscle pain in controls but not in patients with CTTH may be explained by impaired inhibition of the nociceptive input in these patients. This may be the first evidence that the supraspinal response to muscle pain is abnormal in patients with CTTH.