Supraspinal inhibition of trigeminal input into subnucleus caudalis by dorsal column stimulation

Atweh, Samir; Dajani, Badr M.; Saadé, Nayef E.; Jabbur, Suhayl J.

doi:10.1016/0006-8993(85)90466-4

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…Mecanismos de inibição central e periférica aparecerão em diferentes sítios cerebrais na tentativa de restabelecer este equilíbrio [13][14][15][16][17][18][19][20][21] . O tempo necessário para que isto ocorra, corresponde a duração média das crises de migrânea.…”

Section: Discussionunclassified

Bloqueio anestésico do nervo occipital maior na profilaxia da migrânea

Piovesan

Werneck

Kowacs

et al. 2001

Arq. Neuro-Psiquiatr.

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RESUMO -Na fisiopatologia da enxaqueca muitas estruturas estão envolvidas, sendo que o nervo trigêmeo pode ser considerado a estrutura principal. Com o objetivo de determinar a influência do nervo occipital maior (NOM) sobre o comportamento da enxaqueca, estudamos 37 pacientes que apresentavam crises de enxaqueca. Utilizando-se de um estudo duplo cego cruzado os pacientes foram submetidos a infiltração do NOM com bupivacaína 0,5% (BP) e soro fisiológicos 0,9% (S.), os efeitos clínicos após os bloqueios anestésicos foram avaliados: subjetivamente através da escala visual analítica para dor e objetivamente determinou-se os limiares de percepção dolorosa. A comparação entre os dois grupos (BP-S.) e (S.-BP) mostrou que: o número e a duração das crises em todos os momentos do estudo não mudaram; a intensidade das crises no grupo (BP-S.) foi menor somente depois da segunda infiltração (P=0,020), em todos os outros momentos não se observaram alterações significativas. Concluímos que o bloqueio anestésico com BP sobre o NOM não altera o número e a duração das crises de migrânea, porém promove uma redução média na intensidade das crises 60 dias após a sua infiltração. Os resultados mostrados sugerem que o NOM participa ativamente sobre a modulação nociceptiva durante as crises de enxaqueca sem aura.PALAVRAS-CHAVE: bloqueio anestésico, nervo occipital maior, enxaqueca, profilaxia. Anesthetic blockade of the greater occipital nerve in migraine prophylaxisABSTRACT -Migraine comprises a great many encephalic structures in its pathophysiology with the trigeminal nerve (TN) type being one of the main ones. .or the purpose of determining a possible influence of the greater occipital nerve (GON) on migraine behavior, 37 patients who showed this pathology were studied. Using a double blind cross over group and submitting those patients to a GON infiltration with bupivacaina 0.5% (BP) and physiological serum 0.9% (PS), the clinical effects were evaluated: subjectively, through a pain analytical visual scale; objectively, by determining the threshold of pain perception (algometry). The comparison between the two groups (BP-PS) and (PS-BP) has shown that the number and duration of the attacks did not show significant statistical differences during the study. The intensity of the attacks was lower in group (BP-PS) only after the second infiltration (p=0.020), in the other moments no differences have been observed between the groups. The conclusion is that the anesthetic blockage with BP on the GON does not change the number of crises and their duration, but it does provokes an intensity reduction after 60 days from the infiltration. The results shown here suggest that GON participates in the cranial nociceptive modulation during crises of migraine without aura.KEY WORDS: blockade, greather occipital nerve, migraine, prophylaxis. O nervo occipital maior (NOM) é um dos responsáveis pela inervação sensorial cutânea da região occipital e suboccipital 1 . Pesquisas recentes mostraram que ele também participa ativamente na modulação nocice...

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Section: Discussionunclassified

Bloqueio anestésico do nervo occipital maior na profilaxia da migrânea

Piovesan

Werneck

Kowacs

et al. 2001

Arq. Neuro-Psiquiatr.

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“…Several studies denoted the influence of SCS on brainstem loops and brainstem key regions [49], with contributions of the nucleus raphe magnus [25,31], the nucleus caudalis [19], rostroventromedial medulla [32] and locus coeruleus [33]. In relation to the descending pathways, changes in several supraspinal regions were found, namely in the orbitofrontal cortex [68] and anterior cingulate gyrus/cortex [46,68].…”

Section: Scientific Support For This Hypothesismentioning

confidence: 99%

Exploration of the Supraspinal Hypotheses about Spinal Cord Stimulation and Dorsal Root Ganglion Stimulation: A Systematic Review

Goudman

Groote

Linderoth

et al. 2021

JCM

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Despite the established efficacy and effectiveness of Spinal Cord Stimulation (SCS), there is still no consensus on the supraspinal mechanisms of action of this therapy. The purpose of this study was to systematically review previously raised hypotheses concerning supraspinal mechanisms of action of SCS based on human, animal and computational studies. Searches were conducted using four electronic databases (PubMed, EMBASE, SCOPUS and Web of Science), backward reference searching and consultation with experts. The study protocol was registered prior to initiation of the review process (PROSPERO CRD42020161531). A total of 54 publications were included, 21 of which were animal studies, and 33 were human studies. The supraspinal hypotheses (n = 69) identified from the included studies could be categorized into six groups concerning the proposed supraspinal hypothesis, namely descending pathways (n = 24); ascending medial pathway (n = 13); ascending lateral pathway (n = 10); affective/motivational influences (n = 8); spinal–cerebral (thalamic)-loop (n = 3) and miscellaneous (n = 11). Scientific support is provided for the hypotheses identified. Modulation of the descending nociceptive inhibitory pathways, medial and lateral pathways were the most frequently reported hypotheses about the supraspinal mechanisms of action of SCS. These hypotheses were mainly supported by studies with a high or moderate confidence in the body of evidence.

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