Occipital afferent activation of second order neurons in the trigeminocervical complex in rat

Doaré, K Le; Akerman, Simon; Holland, Philip R.; Lasalandra, Michele P; Bergerot, A; Classey, John; Knight, Yvonne; Goadsby, PJ

doi:10.1016/j.neulet.2006.04.049

Cited by 69 publications

(42 citation statements)

References 27 publications

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“…In a study of ONS in drCCH we found no significant change in pain thresholds, which argues against a diffuse analgesic effect [8]. It was speculated that ONS might exert its action by decreasing excitability of second order nociceptors in trigeminal nucleus caudalis on which converge cervical, somatic trigeminal and visceral trigeminovascular afferents [10,11]. Yet, the nociception-specific blink reflex, mediated by spinal trigeminal nucleus interneurons, was increased rather than decreased in our study of ONS in drCCH [8] and it remained unchanged in healthy subjects after short low frequency transcutaneous stimulation of the greater occipital nerve [12].…”

Section: Introductionmentioning

confidence: 99%

Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study

et al. 2011

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BackgroundOccipital nerve stimulation (ONS) has raised new hope for drug-resistant chronic cluster headache (drCCH), a devastating condition. However its mode of action remains elusive. Since the long delay to meaningful effect suggests that ONS induces slow neuromodulation, we have searched for changes in central pain-control areas using metabolic neuroimaging.MethodsTen drCCH patients underwent an 18FDG-PET scan after ONS, at delays varying between 0 and 30 months. All were scanned with ongoing ONS (ON) and with the stimulator switched OFF.ResultsAfter 6-30 months of ONS, 3 patients were pain free and 4 had a ≥ 90% reduction of attack frequency (responders). In all patients compared to controls, several areas of the pain matrix showed hypermetabolism: ipsilateral hypothalamus, midbrain and ipsilateral lower pons. All normalized after ONS, except for the hypothalamus. Switching the stimulator ON or OFF had little influence on brain glucose metabolism. The perigenual anterior cingulate cortex (PACC) was hyperactive in ONS responders compared to non-responders.ConclusionsMetabolic normalization in the pain neuromatrix and lack of short-term changes induced by the stimulation might support the hypothesis that ONS acts in drCCH through slow neuromodulatory processes. Selective activation in responders of PACC, a pivotal structure in the endogenous opioid system, suggests that ONS could restore balance within dysfunctioning pain control centres. That ONS is nothing but a symptomatic treatment might be illustrated by the persistent hypothalamic hypermetabolism, which could explain why autonomic attacks may persist despite pain relief and why cluster attacks recur shortly after stimulator arrest. PET studies on larger samples are warranted to confirm these first results.

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Section: Introductionmentioning

confidence: 99%

Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study

et al. 2011

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“…Le Doaré et al [33] revealed this connection in a rat model by measuring the FOS expression at the dorsal horn and the nucleus caudalis after infiltrating the cervical musculature with a nociceptive agent. This connection has been shown in cats and humans as well [34,35].…”

Section: Greater Occipital Nerve Stimulationmentioning

confidence: 96%

“…The nucleus caudalis projects to the thalamus, which relays sensory input to the cortex [33,34,39,40]. Furthermore, animal studies have shown connections between neurons of the C2 spinal cord and the hypothalamus [41], the thalamus [42,43], the periaqueductal grey (PAG) [42], the caudate nuclei [44], the amygdala and orbitofrontal cortex [43] as well as the cerebellum [45].…”

Section: Greater Occipital Nerve Stimulation In Fibromyalgiamentioning

confidence: 99%

Peripheral Nerve Stimulation for Fibromyalgia

Plazier¹,

Vanneste

Dekelver

et al. 2011

Progress in Neurological Surgery

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Fibromyalgia is a condition marked by widespread chronic pain, accompanied by a variety of other symptoms, including sleep and fatigue disorders, headaches, disorders of the autonomic nervous system, as well as cognitive and psychiatric symptoms. It occurs predominantly in women and is often associated with other systemic or autoimmune diseases. Despite its serious socio economical burden, the treatment options remain poor. In this chapter, the authors discuss the possibilities of using greater occipital nerve stimulation as a treatment for fibromyalgia, based on available clinical studies. Greater occipital nerve stimulation has already been used successfully to treat occipital neuralgia and various primary headache syndromes. Testable hypothetical working mechanisms are proposed to explain the surprising effect of this treatment on widespread bodily pain.

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“…Cette approche s'est depuis quelques années centrée sur la stimulation du nerf grand occipital dont l'objectif est de moduler l'intégration des afférences convergentes se projetant au niveau du complexe trigeminocervical [30]. Le prérequis est plus précisément une modulation de l'intégration des afférences durales, telle qu'elle a pu être démontrée dans une approche expérimentale [3], d'autant que des travaux d'imagerie fonctionnelle ont mis en évidence une modification de l'activation thalamique induite par la stimulation du nerf grand occipital chez des sujets souffrant de migraine chronique [34].…”

Section: Stimulation Du Nerf Grand Occipitalunclassified

New developments and prospects in the treatment of migraine

Lantéri-Minet

2010

Douleur analg

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Les nouveautés et les perspectives du traitement de la migraine concernent le traitement de la crise migraineuse, le traitement prophylactique de la migraine épisodique et le traitement prophylactique de la migraine chronique. Les avancées les plus prometteuses concernent des approches pharmacologiques et des approches instrumentales. Pour le traitement de la crise migraineuse, ces avancées concernent les antagonistes des récepteurs du CGRP, les agonistes des récepteurs 5-HT1F et la stimulation magnétique transcrâ-nienne. Pour le traitement prophylactique de la migraine épisodique, ces avancées concernent les inhibiteurs de la dépression corticale envahissante et la fermeture chirurgicale du foramen ovale perméable. Enfin, pour le traitement de la migraine chronique, ces avancées concernent la toxine botulinique de type A et la neuromodulation par stimulation du nerf grand occipital. Mots clés Migraine sans aura · Migraine avec aura · Abus médicamenteux · Migraine chronique · TraitementAbstract Innovations and prospects for the migraine treatment relate to the treatment of the migraine attack, the prophylactic treatment of episodic migraine and the prophylactic treatment of chronic migraine. These innovations are pharmacological approaches and instrumental approaches. For the treatment of the migraine attack, these innovations relate to CGRP antagonists, 5-HT1F agonists and transcranial magnetic stimulation. For the prophylactic treatment of the episodic migraine, these innovations relate to cortical spreading depression inhibitors and persistent foramen ovale closure. Lastly, for the treatment of the chronic migraine, these projections relate to botulinum toxin type A and the neuromodulation by greater occipital nerve stimulation.

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Occipital afferent activation of second order neurons in the trigeminocervical complex in rat

Cited by 69 publications

References 27 publications

Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study

Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study

Peripheral Nerve Stimulation for Fibromyalgia

New developments and prospects in the treatment of migraine

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