| Objective1. To investigate whether the values of trigemino-cervical reflex(TCR) parameters are relevant to the gender,age,electrical current and the stimulationg location (left or right) in healthy people.2. To study the clinical application of trigemino-cervical reflex in primary headache,then investigate the probable pathophysiology of migraine and chronic tension-type headache.Subjects and MethodsA short latency response was recorded in sternocleidomastoid muscle after the stimulation to the infraorbital branch of trigeminal nerve,called trigemino-cervical reflex(TCR). The brainstem reflex was investigated in 36 healthy subjects and 25 patients suffering from migraine without aura and 25 suffering from chronic tension-type headache in the pain-free time,from January 2009 to February 2010. Parameters of detection are value of PLP19,PLN31,amplitude and A.Results1. There were no significant difference in PLP19,PLN31,amplitude and A value between male and female in healthy subjects.2. There were no significant difference in PLP19,PLN31,amplitude and A value in various ages in healthy subjects.3.There were no significant difference in PLP19,PLN31,amplitude and A value between left side and right side in healthy subjects.4.In healthy subjects,there were no significant difference in PLP19,PLN31,and A value in various values of the electrical current, but the amplitude has a direct correlation with the value of electrical current. 5. The trigemino-cervical reflex were abnormal in patients suffering from migraine without aura and chronic tension-type headache. Compared with the healthy subjects ,the latency of P19 and N31 were shorten in the disease subjects,there was a statistically difference between them. In migraineurs, compared with the non-painful side,the latency of P19 and N31 were shorten statistically in the painful side,but there is no significant difference between them. Value of PLP19,PLN31 in patients with migraine without aura and chronic tension-type headache are no significant difference.ConclusionsIn healthy subjects,there were no significant difference in the values of trigemino-cervical reflex parameter(PLP19,PLN31,the amplitude and A value) in different ages,gender and the locations(left or right). The amplitude had a direct correlation with the value of electrical current,but PLP19,PLN31,and A value had not. The increase of trigeminal nerve system and the activition of the neuron in brainstem might participated in pathophysiology of migraine and pain transmission. Patients with chronic tension-type headache are hypersensitive to stimuli applied at cephalic and extracephalic,central sensitization participate in pathophysiology of chronic tension-type headache. Compared with the healthy subjects ,the latency of P19,N31 shorten in the disease subjects,because of central sensitization and dysfunction of the activation of neuron in central nervous system,which provide a neurological electrophysiologic examinaton to prove our theory above. There are no significant difference between patients with migraine without arua and chronic tension-type headache,which might collect with the similar abnormalities in the endogenous pain control mechanisms in both migraine and chronic tension-type headache. |
