Inhibition of the Blink Reflex R2 Component after Supraorbital and Index Finger Stimulations Is Reduced in Cluster Headache: An Indication for Both Segmental and Suprasegmental Dysfunction?
[en] Peripheral as well as central mechanisms are thought to play a role in cluster headache pathogenesis. We have studied recovery curves of the R2 component of the blink reflex after conditioning by supraorbital or index finger stimuli in 10 episodic cluster headache (CH) patients during a cluster period and in 10 healthy controls. There was no significant change of R2 threshold, latency or area in CH patients. After paired supraorbital stimuli, R2 recovered more rapidly in patients on the symptomatic side. After index stimulations, R2 recovery was more rapid on both symptomatic and non-symptomatic sides in patients compared to controls. Naloxone (0.4 mg) i.v. in two subjects partially reversed the R2 suppression induced by index finger stimuli. The unilateral decrease of R2 inhibition after a segmental supraorbital stimulus most likely reflects sensitisation in the spinal trigeminal nucleus. Whether the latter is due to irritation of the ophthalmic nerve within the cavernous sinus region, which is thought to be pivotal in CH pathogenesis, remains to be proven. In addition, we propose that the bilateral deficit of R2 inhibition after an extrasegmental exteroceptive stimulus might reflect hypoactivity of reticular nuclei, possibly because of reduced central opioid activity.
Disciplines :
Neurosciences & behavior Neurology
Author, co-author :
Lozza, A.
Schoenen, Jean ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Neuro-anatomie
Delwaide, P. J.
Language :
English
Title :
Inhibition of the Blink Reflex R2 Component after Supraorbital and Index Finger Stimulations Is Reduced in Cluster Headache: An Indication for Both Segmental and Suprasegmental Dysfunction?
Anselmi, B., Saldi, E., Casacci, F. and Salmon, S., Endogenous opioids in cerebrospinal fluid and blood in idiopathic headache sufferers, Headache, 20 (1980) 294-299.
Boelhouwer, A.J.W. and Brunia, C.H.M., Blink reflexes and the state of arousal, J. Neurol. Neurosurg. Psych., 40 (1977) 58-63.
Boulu, Ph., Willer, J.V. and Gambier, J., Analyse electrophysiologique du réflexe de clignement chez l'homme. Interactions des afférences sensitives segmentaires et intersegmentaires, des afférences auditives et visuelles, Rev. Neurol., 137 (1981) 523-533.
Bussone, G. and Waldenlind, E., Biochemistry, circannual and circadian rhythms, endocrinology, and immunology. In: J. Olesen, P. Felt-Hansen and K.M.A. Welch (Eds.), Headache, Raven Press, New York, 1993, pp. 551-559.
Cadden, S.W., Newton, J.P., Maillou, P. and Ridley, S.M.C., The spinal control of jaw-closing muscles in man. In: D. van Steenberghe and A. de Laat (Eds.), EMG of Jaw Reflexes in Man, Leuven University Press, Leuven, 1989, pp. 65-84.
Delwaide, P.J., Pepin, J.L. and Maertens de Noordhout, A., Contribution of reticular nuclei to the pathophysiology of parkinsonian rigidity. In: H. Narabayashi, T. Nagatsu, N. Yanagisawa, and Y. Mizuno (Eds.), Advances in Neurology, Vol. 60, Raven Press, New York, 1993, pp. 381-385.
Delwaide, P.J., Lozza A., Pepin J.-L., Schoenen J. and Rapisarda G., Pathophysiologic implications of differences between two types of R2 blink reflex conditioning in Parkinson's disease, Neurology, 46 (1996) P01.094.
Dostrovsky, J., Hu, J., Sessle, B. and Sumino, R., Stimulation sites in periaqueductal gray, nucleus raphe magnus and adjacent regions effective in suppressing oral-facial reflexes, Brain Res., 252 (1982) 287-297.
Fanardjian, V.V., Kasabyan, S.A. and Manvelyan, L.R., Mechanism regulating the activity of facial nucleus motoneurones - 2. Synaptic activation from the caudal trigeminal nucleus, Neuroscience, 9 (1983) 823-835.
Fanciullacci, M., Pietrini, U., Fusco, B.M., Alessandri, M., Marabini, S. and Sicuteri, F., Does anisocoria by clonidine reflect a central sympathetic dysfunction in cluster headache?, Clin. Neuropharmacol., 11 (1988) 56-62.
Formisano, R., Cerbo, R., Ricci, M., Agostino, R., Cesarino, F., Cruccu, G. and Agnoli, A., Blink reflex in cluster headache, Cephalalgia, 7 (1987) 353-354.
Hardebo, J.E., Ekman, R. and Eriksson, M., CSF met-encephalin levels in cluster headache are elevated by acupuncture, Headache, 29 (1989) 494.
Hardebo, J.E. and Moskowitz, M.A., Synthesis of cluster headache pathophysiology. In: J. Olesen, P. Felt-Hansen and K.M.A. Welch (Eds.), Headache, Raven Press, New York, 1993, pp. 569-576.
Holstege, H., Neuronal organization of the blink reflex. In: G. Paxinos (Ed.), The Human Nervous System, Academic Press, London, 1990, pp. 287-296.
International Headache Society, Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain, Cephalalgia, 8 (Suppl. 7) (1988) 1-96.
Kimura, J., Disorder of interneurons in parkinsonism: the orbicularis oculi reflex to paired stimuli, Brain, 96 (1973) 87-96.
Kimura, J., Effect of hemispheral lesions on the contralateral blink reflex: a clinical study, Neurology, 24 (1974) 168-174.
Kimura, J. and Lyon, L.W., Orbicularis oculi reflex in the Wallenberg syndrome: alteration of the late reflex by lesions of the spinal tract and nucleus of the trigeminal nerve, J. Neurol. Neurosurg. Psych., 35 (1972), 228-233.
Koch, M., Kungel, M. and Herbert, H., Cholinergic neurons in the pedunculo-pontine tegmental nucleus are involved in the mediation of prepulse inhibition of the acoustic startle response in the rat, Brain Res., 97 (1993) 71-82.
Lindquist, C., Facilitation and inhibition of facial reflexes in the cat induced by peripheral stimulation, Acta Physiol. Scand., 85 (1972) 126-135.
Martin, G., Holstege, G. and Mehler, W., Reticular formation of the pons and medulla. In: G. Paxinos (Ed.), The Human Nervous System, Academic Press, London, 1990, pp. 203-220.
Mohrland, J.S. and Gebhart, G.F., Effects of focal electrical stimulation and morphine microinjection in the periaqueductal gray of the rat mesencephalon on neuronal activity in the medullary reticular formation, Brain Res., 201 (1980) 23-37.
Nappi, G., Facchinetti, F., Martignoni, E., Petraglia, F., Manzoni, G.C., Sances, G., Sandrini, G. and Genazzani, A.R., Endorphin patterns within the headache spectrum disorders, Cephalalgia, 5 (Suppl. 2) (1985) 201-210.
Ongerboer de Visser, B.W. and Kuypers, H.G.J.M., Late blink reflex changes in lateral medullary lesions: an electrophysiological and neuro-anatomical study of Wallenberg's syndrome, Brain, 101 (1978) 285-294.
Pavesi, G., Granella, F., Brambilla, S., Medici, D., Mancia, D. and Manzoni, G.C., Blink reflex in cluster headache: evidence of a trigeminal system dysfunction, Cephalalgia, 7 (Suppl. 6) (1987) 100-102.
Penders, C. and Delwaide, P.J., Physiologic approach to the human blink reflex. In: J.E. Desmedt (Ed.), New Developments in Electromyography and Clinical Neurophysiology, Vol. 3, Karger, Basel, 1973, pp. 649-657.
Raudino, F., The blink reflex in cluster headache, Headache, 30 (1990) 584-585.
Rees, H. and Roberts, M.H.T., The anterior pretectal nucleus: a proposed role in sensory processing, Pain, 53 (1993) 121-135.
Rossi, A. and Scarpini, C., Gating of trigemino-facial reflex from low-threshold trigeminal and extratrigeminal cutaneous fibres in humans, J. Neurol. Neurosurg. Psych., 55 (1992) 774-780.
Saitoh, K., Tilson, H.A., Shaw, S. and Dyer, R.S., Possible role of the brainstem in the mediation of prepulse inhibition in the rat, Neurosci. Lett., 75 (1987) 216-222.
Sandrini, G., Alfonsi, E., Ruiz, L., Micieli, G., Moglia, A. and Nappi, G., Electrophysiological study of trigemino-facial reflexes in cluster headache, Pain, 47 (1991) 299-304.
Schoenen, J., Exteroceptive suppression of temporalis muscle activity in patients with chronic headache and in normal volunteers: methodology, clinical and physiological relevance, Headache, 33 (1993) 3-17.
Schoenen, J., Wang, W. and Gérard, P., Modulation of temporalis muscle exteroceptive suppression by limb stimuli in normal man, Brain Res., 657 (1994) 214-220.
Sessle, B.J. and Hu, J.W., Raphe-induced suppression of the jaw-opening reflex and single neurons in trigeminal subnucleus oralis, and influence of naloxone and subnucleus caudalis, Pain, 10 (1981) 19-36.
Shahani, B., The human blink reflex, J. Neurol. Neurosurg. Psych., 33 (1970) 792-800.
Sjaastad, O., Cluster Headache Syndrome, W.B. Saunders Company Ltd., London, 1992, 429 pp.
Sjaastad, O., Saunte, C., Russell, D., Hestnes, A. and Marvik, R., Cluster headache: the sweating pattern during spontaneous attacks, Cephalalgia, 1 (1981) 233-244.
Sjaastad, O., Saunte, C. and Fredriksen, T.A., Bilaterality of cluster headache: an hypothesis, Cephalalgia, 5 (1985) 55-58.
Valls-Solé, J., Cammarota, A., Alvarez, R. and Hallett, M., Orbicularis oculi responses to stimulation of nerve afferents from upper and lower limbs in normal humans, Brain Res., 650 (1994) 313-316.
Yu, X.M., Sessle, B.J. and Hu, J.W., Differential effects of cutaneous and deep application of inflammatory irritant on the mechanoreceptive field properties of trigeminal brain stem nociceptive neurons, J. Neurophysiol., 70 (1993) 1704-1707.
Wall, P.D. and Woolf, C.J., Muscle, but not cutaneous C-afferent input produces prolonged increases in the excitability of the flexion reflex in the rat, J. Physiol., 356 (1984) 453-458.
Willis, W.D. and Coggeshall, R.E., Sensory Mechanisms of the Spinal Cord, John Wiley and Sons, New York, 1978, pp. 301-361.
Woolf, C.J., The dorsal horn: state dependent sensory processing and the generation of pain. In: P.D. Wall and R. Melzack (Eds.), Textbook of Pain, Chap. 5, Churchill Livingstone, Edinburgh, 1994, pp. 101-112.
