Pharmacological modulation of trigeminal nociception in healthy volunteers and migraine patients using event-related f-MRI

本研究的目的是直接延续我们以前在原发性头痛综合征中的功能性神经影像学工作，使用事件相关f-MRI来间接调节疼痛的三叉神经传递。假设是，用于中止头痛发作的药物，如曲坦类和NSAID，不仅在外周（三叉神经血管水平）有效，而且在脊髓/脑干水平（即三叉神经枕叶复合体）也有效。第二个假设是，在偏头痛治疗中用作预防的药物，如β受体阻滞剂或托吡酯，在丘脑水平上发挥其作用。我们自己的工作表明，这也可能发生在三叉神经脊髓水平。为了检验这两个假设，我们将调查患者和没有预防性和头痛免费健康志愿者流产或预防性药物使用验证和标准化的三叉神经伤害性刺激和事件相关的f-MRI。在对照和偏头痛患者中使用随机化、安慰剂对照设计将允许使用2x2析因设计，其还允许相互作用分析（患者与对照，独立于因子药物/安慰剂并且独立于因子患者/健康对照）。

This study aims in direct continuance to our previous functional neuroimaging work in primary headache syndromes to pharmacologically modulate the trigeminal transmission of pain using event related f-MRI. The hypothesis is, that medications which are used to abort the headache attack such as triptans and NSAID are not only effective in the periphery (trigemino-vascular level), but also centrally on the spinal/brainstem level, i.e. the trigemino-occipital complex. The second hypothesis is that medications that are used as preventatives in migraine treatment, such as betablockers or topiramate, exert their effect amongst others on the thalamic level. Our own work suggests that this may also happen on the trigemino-spinal level. To test both hypotheses we will investigate patients with and without a preventative and headache free healthy volunteers with and without abortive or preventative medication using a validated and standardized trigemino-nociceptive stimuli and event-related f-MRI. Using a randomized, placebo-controlled design in controls and migraine patients will allow to use a 2x2 factorial design, which also allows for an interaction-analyses (patient vs. control, independent from factor medication/placebo and independent from factor patient/healthy control).