Cranial parasympathetic activation induces autonomic symptoms but no cluster headache attacks

Cephalalgia : an International Journal of Headache
Song GuoMessoud Ashina

Abstract

Background Low frequency (LF) stimulation of the sphenopalatine ganglion (SPG) may increase parasympathetic outflow and provoke cluster headache (CH) attacks in CH patients implanted with an SPG neurostimulator. Methods In a double-blind randomized sham-controlled crossover study, 20 CH patients received LF or sham stimulation for 30 min on two separate days. We recorded headache characteristics, cephalic autonomic symptoms (CAS), plasma levels of parasympathetic markers such as pituitary adenylate cyclase-activating polypeptide-38 (PACAP38) and vasoactive intestinal peptide (VIP), and mechanical detection and pain thresholds as a marker of sensory modulation. Results In the immediate phase (0-60 min), 16 (80%) patients experienced CAS after LF stimulation, while nine patients (45%) reported CAS after sham ( p = 0.046). We found no difference in induction of cluster-like attacks between LF stimulation (n = 7) and sham stimulation (n = 5) ( p = 0.724). There was no difference in mechanical detection and pain thresholds, and in PACAP and VIP plasma concentrations between LF and sham stimulation ( p ≥ 0.162). Conclusion LF stimulation of the SPG induced autonomic symptoms, but no CH attacks. These data suggest that increased paras...Continue Reading

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References

Jan 27, 1990·BMJ : British Medical Journal·J N MatthewsP Royston
Nov 1, 1968·Archives of Neurology·K Ekbom
Feb 1, 1997·Brain : a Journal of Neurology·M FanciullacciS Marabini
Aug 5, 1998·Lancet·A MayP J Goadsby
Apr 19, 2002·Brain : a Journal of Neurology·Manjit S Matharu, Peter J Goadsby
Jul 10, 2003·Lancet Neurology·Peter J Goadsby
Nov 18, 2005·European Journal of Pain : EJP·R RolkeR-D Treede
Feb 27, 2007·Regulatory Peptides·Steffen BirkJes Olesen
Feb 8, 2008·Cephalalgia : an International Journal of Headache·A RahmannM Ashina
Dec 5, 2008·Brain : a Journal of Neurology·Henrik Winther SchytzMessoud Ashina
Jul 6, 2010·Journal of Neurosurgery·Masataka TakahashiR Loch Macdonald
Jan 11, 2011·Cephalalgia : an International Journal of Headache·Dimos D MitsikostasNikolaos G Chalarakis
Jun 22, 2012·Cephalalgia : an International Journal of Headache·Maria AntonovaMessoud Ashina
Jul 21, 2012·Lancet Neurology·Delphine Magis, Jean Schoenen
Oct 16, 2012·Brain : a Journal of Neurology·Simon AkermanPeter J Goadsby
Jan 15, 2013·Cephalalgia : an International Journal of Headache·Jean SchoenenArne May
Feb 6, 2013·Cephalalgia : an International Journal of Headache·Henrik W SchytzMessoud Ashina
May 15, 2013·Cephalalgia : an International Journal of Headache·Tim P Jürgens, Massimo Leone
Aug 28, 2014·Brain : a Journal of Neurology·Song GuoMessoud Ashina
Mar 5, 2015·Cephalalgia : an International Journal of Headache·Anna AmbrosiniJean Schoenen
Aug 1, 2016·The Journal of Headache and Pain·Bernadett TukaJános Tajti

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Citations

Mar 2, 2018·Nature Reviews. Disease Primers·Arne MayShuu-Jiun Wang
Feb 18, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Z T LazzariG Lambru
Mar 15, 2018·The Journal of Headache and Pain·James A WaschekSimon Akerman
Aug 28, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Luca GianiMassimo Leone
Mar 14, 2019·Current Opinion in Neurology·Maike Möller, Arne May
Apr 24, 2020·Cephalalgia : an International Journal of Headache·Song GuoMessoud Ashina
Sep 24, 2020·Cephalalgia : an International Journal of Headache·Anne Luise H VollesenMessoud Ashina
Dec 9, 2020·Fundamental & Clinical Pharmacology·Pierre CouraultSophie Lancelot
Mar 31, 2021·Nature Reviews. Neurology·Diana Y Wei, Peter J Goadsby
Dec 12, 2021·Current Pain and Headache Reports·Stefan Evers, Oliver Summ
Mar 6, 2019·Journal of Neurosurgery·Sérgio A F DantasClement Hamani

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Clinical Trials Mentioned

NCT02510729

Software Mentioned

SPSS Statistics
GraphPad Prism

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