Effects of Distraction Versus Spatial Discrimination on Laser‐Evoked Potentials in Migraine

Abstract

Migraine patients exhibited reduced inhibition by attentional modulation of pain processing, accompanied by impaired spatial discrimination of painful stimuli.

Effects of affective pictures on pain sensitivity and cortical responses induced by laser stimuli in healthy subjects and migraine patients

“…Previous studies, evaluating the distraction from experimental pain induced by the vision of positive, neutral, negative, and pain-related pictures in chronic syndromes, as fibromyalgia, somatoform pain disorder and back pain, found that affective modulation of pain was not specifically altered in these patients (Arnold et al, 2008). A reduced inhibitory effect induced by an alternative cognitive task was observed in migraine, especially in regard to laser evoked responses, with a similar trend for pain rating (de Tommaso et al, 2003(de Tommaso et al, , 2008a. It may be argued that emotional stimuli are able to distract migraine patients from pain, independently from their affective content, and probably due to a cognitive engagement connected with the content of the images, which contrast pain sensation.…”

“…In our previous studies on healthy volunteers, we have recently observed that images are able to distract from pain, on the basis of their aesthetic content (de Tommaso et al, 2008b). In fact, there is a cognitive-attentiveattraction toward beautiful images, also the geometric ones, demonstrated by the amplitude increase of the cognitive ERP P3 (de Tommaso et al, 2008a). In the case of emotional images, the effect on pain induced by emotive experience may be quite variable across people, depending upon picture content and modality of presentation (Mühlberger et al, 2007).…”

“…In previous studies, distraction induced by a mental arithmetic task suppressed LEPs amplitude in non-migraine subjects. However, in migraine patients, especially in chronic cases, the N2-P2 complex was not modified by engagement in mental computation (de Tommaso et al, 2003(de Tommaso et al, , 2008a. The lack of suppression of the later N2-P2 LEPs complex suggested a deficit in attentive modulation of pain, for a prevalence of cortical arousal and emotive reaction against nociceptive stimuli (de Tommaso et al, 2003(de Tommaso et al, , 2008a.…”

“…Considering the strong emotional involvement of migraine patients in pain processing, we can argue that affective stimuli may exert a significant effect on subjective pain rating and cortical elaboration of nociceptive inputs, differently from cognitive engagement (de Tommaso et al, 2008a). In line with this notion, we assessed the effect of affective images vision on laser evoked potentials and pain perception, in a cohort of healthy subjects and migraine patients.…”

Cortical Excitability in Chronic Migraine

“…However, LEPs are abnormally modulated by heterotopic conditioning stimuli such as remote capsaicin application [8] and by distraction [9,10].…”