Effect of Occipital Nerve Stimulation (ONS) on the Orbicularis Oculi Reflex Triggered by a Standardized Air Flow in Patients with Chronic Migraine—A Prospective, Randomized, Interventional Study

Göbel, Carl; Heinze, Axel; Karstedt, Sarah; Clasen, Svenja; Göbel, Hartmut

doi:10.1007/s40122-021-00242-3

Cited by 3 publications

(3 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They have been shown to have enhanced corneal discomfort, especially on the affected side [59] . The winking reflex induced by corneal air oscillations was increased in patients with chronic migraines [60] . Morphological changes in the corneal basal plexus, Langerhans cell aggregation, nerve regeneration and inflammation, and changes in the corneal nerve from the ocular branch of the trigeminal nerve observed in patients with migraines support the possible involvement of the peripheral system of the trigeminal nerve in migraine pathogenesis [61] .…”

Section: Corneal Pain and Trigeminal Nerve Sensitizationmentioning

confidence: 85%

Calcitonin gene‐related peptide and persistent corneal pain: A trigeminal nerve sensitization perspective

Hong,

Ding,

Xiong

et al. 2023

Brain-X

View full text Add to dashboard Cite

Persistent corneal pain (PCP) has excellent research prospects, especially the central sensitization mechanism of the trigeminal nerve, which is involved in migraine, corneal pain, and trigeminal neuralgia. The cornea has dense sensory innervation, and repeated corneal neuropathic pain has been associated with trigeminal nerve central sensitization, which is induced in PCP. The calcitonin gene‐related peptide (CGRP) is involved in corneal pain conduction, injury protection, and immune homeostasis. A high CGRP level maintains corneal pain perception and protects corneal epithelial cells. However, a persistently high CGRP level causes hypersensitivity of the corneal and trigeminal nerves, resulting in PCP. CGRP‐related drugs can effectively improve trigeminal nerve sensitization and relieve central sensitization‐related pain (PCP, migraine, and trigeminal neuralgia). Exploring the role of CGRP in PCP's pain sensitization mechanism is vital in the pain perception field, with the potential to improve the quality of life of patients with PCP and strengthen the understanding of CGRP's dual role in corneal pain.

show abstract

Section: Corneal Pain and Trigeminal Nerve Sensitizationmentioning

confidence: 85%

Calcitonin gene‐related peptide and persistent corneal pain: A trigeminal nerve sensitization perspective

Hong,

Ding,

Xiong

et al. 2023

Brain-X

View full text Add to dashboard Cite

show abstract

“…Notably, in patients with CM, occipital nerve stimulation was demonstrated to markedly reduce the orbicularis oculi reflex. This finding indicates that direct counteraction of trigeminally mediated central sensitisation mitigates the effects of aversive peripheral stimulation [ 35 ]. We suggest that heightened lid tightener intensity may reduce light input triggering the trigeminal nociceptive pathway.…”

Section: Discussionmentioning

confidence: 99%

Decoding pain through facial expressions: a study of patients with migraine

Chen,

Hsiao,

Coppola

et al. 2024

J Headache Pain

View full text Add to dashboard Cite

Background The present study used the Facial Action Coding System (FACS) to analyse changes in facial activities in individuals with migraine during resting conditions to determine the potential of facial expressions to convey information about pain during headache episodes. Methods Facial activity was recorded in calm and resting conditions by using a camera for both healthy controls (HC) and patients with episodic migraine (EM) and chronic migraine (CM). The FACS was employed to analyse the collected facial images, and intensity scores for each of the 20 action units (AUs) representing expressions were generated. The groups and headache pain conditions were then examined for each AU. Results The study involved 304 participants, that is, 46 HCs, 174 patients with EM, and 84 patients with CM. Elevated headache pain levels were associated with increased lid tightener activity and reduced mouth stretch. In the CM group, moderate to severe headache attacks exhibited decreased activation in the mouth stretch, alongside increased activation in the lid tightener, nose wrinkle, and cheek raiser, compared to mild headache attacks (all corrected p < 0.05). Notably, lid tightener activation was positively correlated with the Numeric Rating Scale (NRS) level of headache (p = 0.012). Moreover, the lip corner depressor was identified to be indicative of emotional depression severity (p < 0.001). Conclusion Facial expressions, particularly lid tightener actions, served as inherent indicators of headache intensity in individuals with migraine, even during resting conditions. This indicates that the proposed approach holds promise for providing a subjective evaluation of headaches, offering the benefits of real-time assessment and convenience for patients with migraine.

show abstract

“…Occipital nerve stimulation (ONS) devices, with implantable electrodes fixated near the occipital nerves and a pulse generator in the chest, have been studied for occipital neuralgia and refractory CM for many years. ONS may normalize the loss of condition pain modulation or directly counteract the trigeminally mediated central sensitization in these patients [42,43]. Several multi-center randomized sham-controlled trials demonstrated improvement in headache frequency, intensity, or disability [44][45][46][47]; all were published more than 5 years ago.…”

Section: Occipital Nerve Stimulationmentioning

confidence: 99%