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

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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).