痛觉眨眼反射习惯的标准值

Q4 Medicine Confinia Cephalalgica Pub Date : 2024-05-07 DOI:10.4081/cc.2024.15730
Michele Corrado, Elena Mazzotta, Gloria Vaghi, Francescantonio Cammarota, Federico Bighiani, Alessandro Antoniazzi, D. Martinelli, M. Pocora, Luca Martinis, Valentina Grillo, Sara Bottiroli, Armando Perrotta, Giuseppe Cosentino, Grazia Sances, C. Tassorelli, R. De Icco
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引用次数: 0

摘要

简介习惯化是一种生理现象,其特点是对重复刺激的反应减弱。在头痛疾病中,习惯化研究涉及多种刺激参数和感觉模式的不同范式,并一致显示原发性头痛在发作间期的习惯化受损。痛觉眨眼反射(nBR)及其相关的 R2 反应由三叉神经颈复合体的多突触网络调节,是该领域研究最多的反应之一。由于缺乏 nBR 习惯性常态数据,因此无法就个别患者的功能状态得出结论。本研究旨在确定无偏头痛或其他头痛疾病个人诊断和家族史的健康受试者的 nBR 习惯化过程的标准值:我们招募了 40 名健康受试者(24 名女性,32.7±11.6 岁)进行 nBR 记录和 nBR 习惯化评估。为了评估 nBR 的习惯化,我们以三种不同的随机刺激频率(0.2、0.3、0.5 Hz)连续施加了 26 次刺激。剔除第一个反应后,将剩余的 25 个曲线下面积(AUC)分成 5 个区块,计算每个区块的 AUC 平均值。第五个区块的 AUC 与第一个区块相比减少的百分比代表习惯化指数(HI)值。我们将单尾第 10 百分位数阈值视为 nBR HI 的正常值下限:所有研究频率的习惯化现象均得到证实。在 0.5 赫兹(p=0.021)和 0.2 赫兹(p=0.007)的五个刺激区块中,女性受试者的 R2 分量绝对 AUC 比男性高。我们发现了一种频率依赖性习惯模式,与 0.5 赫兹(p=0.001)和 0.3 赫兹(p=0.008)相比,0.2 赫兹刺激下的频率依赖性较低。0.5 Hz 时的平均 HI 为 73.1±13.6,0.3 Hz 时为 69.2±15.0,0.2 Hz 时为 61.1±21.4。男女受试者的 HI 值相当,与年龄、刺激强度和 R2 分量的潜伏期无关。0.5赫兹时,HIs的第10百分位数为43.5%,0.3赫兹时为55.8%,0.2赫兹时为28.6%:我们对健康受试者的 nBR 习惯性进行了调查,以收集标准数据。我们描述了与频率相关的习惯化程度,频率越高的刺激越明显。此外,我们还描述了反应行为的性别相关特征,这在偏头痛领域极为重要。我们的研究进一步描述了暴露于痛觉刺激的健康对照组的生理习惯化现象。标准习惯值的定义将为偏头痛以及其他头痛和疼痛疾病的研究提供新的可能性。
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Normative values of the nociceptive blink reflex habituation
Introduction: Habituation is a physiological phenomenon, characterized by response reduction to repeated stimulus presentation. In headache disorders, habituation studies have involved different paradigms with several stimulation parameters and sensory modalities, and consistently showed impaired habituation in primary headaches in the interictal phase. The nociceptive blink reflex (nBR) and its related R2 response, modulated by a polysynaptic network in the trigeminocervical complex, is one of the most studied in the field. The lack of nBR habituation normative data hampered the possibility to draw conclusions regarding the functional status of individual patients. The present study aims to define normative values for the nBR habituation process in healthy subjects without a personal diagnosis and family history of migraine, or other headache disorders.Methods: We enrolled 40 healthy subjects (24 females, 32.7±11.6 years) for nBR recording and nBR habituation assessment. To assess the habituation of nBR, 26 consecutive stimuli were administered at three different and randomized stimulus frequencies (0.2, 0.3, 0.5 Hz). After excluding the first response, the remaining 25 area under the curve (AUC) were divided in 5 blocks, and the average values of the AUC was calculated for each block. The percentage reduction in the AUC of the fifth block, compared to the first, represents the habituation index (HI) value. We considered a one-tailed 10th percentile threshold as the lower threshold of normative values for nBR HI.Results: The habituation phenomenon was confirmed for all study frequencies. The absolute AUC of the R2 component across the five blocks of stimulation was higher in female subjects when compared to male for 0.5 Hz (p=0.021) and 0.2 Hz (p=0.007). We found a frequency-dependent habituation pattern, being lower at the 0.2 Hz stimulation when compared to 0.5 Hz (p=0.001), and 0.3 Hz (p=0.008). The average HIs were 73.1±13.6 at 0.5 Hz, 69.2±15.0 at 0.3 Hz, and 61.1±21.4 at 0.2 Hz. HIs were comparable between male and female subjects, without correlations with age, intensity of stimulation, and latency of the R2 component. The 10th percentile of the HIs was 43.5% for 0.5 Hz, 55.8% for 0.3 Hz, and 28.6% for 0.2 Hz.Conclusions: We investigated the nBR habituation in a population of healthy subjects for normative data collection. We described a frequency- dependent degree of habituation, being more pronounced at higher frequencies of stimulation. Moreover, we described gender-related features of response behaviour, which is extremely important in the migraine field. Our study further characterized the physiological habituation phenomenon in healthy controls exposed to a nociceptive stimulation. The definition of a normative habituation value will open novel possibilities in the study of migraine, as well as other headache and pain disorders.
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来源期刊
Confinia Cephalalgica
Confinia Cephalalgica Medicine-Neurology (clinical)
CiteScore
0.30
自引率
0.00%
发文量
4
期刊最新文献
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