Interictal habituation deficit of the nociceptive blink reflex: An endophenotypic marker for presymptomatic migraine?

Headache Research Unit, University Department of Neurology, University of Liège, Liège, Belgium.
Brain (Impact Factor: 10.23). 04/2007; 130(Pt 3):765-70. DOI: 10.1093/brain/awl351
Source: PubMed

ABSTRACT Habituation of the nociception-specific blink reflex (nBR) is reduced interictally in migraine patients. This could be related to the habituation deficit of evoked cortical responses, a reproducible abnormality in migraine which has a familial character, or to central trigeminal sensitization due to repeated attacks. We compared nBR habituation in healthy volunteers devoid of personal or family history of migraine (HV), in migraine without aura patients (MO) and in healthy volunteers with a family history of migraine in first degree relatives (HV-F). We elicited the nBR by stimulating the right supraorbital region with a custom-built electrode in 16 MO between attacks, 15 HV and 14 HV-F. Habituation was measured as the percentage area-under-the-curve decrease in 10 consecutive blocks of five averaged rectified responses. nBR habituation was clearly reduced in MO and HV-F compared to HV. Percentage area under the curve decreased between the 1st and the 10th block by 55.01% in HV, 25.71% in MO (P = 0.001) and 26.73% in HV-F (P = 0.043). HV-F had the most pronounced abnormality with potentiation instead of habituation in the second block. We found a positive intraindividual correlation between attack frequency and habituation in MO (r = 0.621; P = 0.010). Migraine patients have interictally a deficient habituation of the nBR which is inversely related to attack frequency, suggesting that it is not due to trigeminal sensitization. Surprisingly, the most pronounced habituation deficit is found in asymptomatic individuals with a family history of migraine. Deficient nBR habituation could thus be a trait marker for the genetic predisposition to migraine.

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Available from: Laura Di Clemente, Jul 30, 2015
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    • "Moreover, lack of habituation of the iCNV was found in asymptomatic subjects with a positive family history of migraine, defined ''at risk " , and the amplitude of the iCNV correlated significantly with the relative number of subjects suffering from migraine in the family (Siniatchkin et al., 2001). Recently, we performed the same observation with nociceptive blink reflex in a group of healthy asymptomatic subjects having a 1st degree relative affected by migraine (Di Clemente et al., 2007). These findings raise the possibility that subjects with a familial predisposition for migraine may present a presymptomatic neurophysiological abnormality in response habituation, i.e. the same habituation deficit as migraine patients. "
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