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Reduced habituation of trigeminal reflexes in patients with episodic cluster headache during cluster period

Authors

  • A Perrotta,

    Corresponding author
    1. University Centre for Adaptive Disorders and Headache, IRCCS ‘C. Mondino Institute of Neurology’ Foundation, University of Pavia, Pavia,
    2. IRCCS ‘Neuromed’, ‘La Sapienza University’, Pozzilli, Isernia and
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  • M Serrao,

    1. University Centre for Adaptive Disorders and Headache, Polo Pontino-ICOT, ‘La Sapienza’ University and
    2. IRCCS ‘Neuromed’, ‘La Sapienza University’, Pozzilli, Isernia and
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  • G Sandrini,

    1. University Centre for Adaptive Disorders and Headache, IRCCS ‘C. Mondino Institute of Neurology’ Foundation, University of Pavia, Pavia,
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  • D Bogdanova,

    1. Department of Clinical Neurophysiology, University Hospital of Neurology and Psychiatry ‘St Naum’, Sofia, Bulgaria
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  • C Tassorelli,

    1. University Centre for Adaptive Disorders and Headache, IRCCS ‘C. Mondino Institute of Neurology’ Foundation, University of Pavia, Pavia,
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  • M Bartolo,

    1. University Centre for Adaptive Disorders and Headache, IRCCS ‘C. Mondino Institute of Neurology’ Foundation, University of Pavia, Pavia,
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  • G Coppola,

    1. G.B. Bietti Eye Foundation-IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome,
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  • F Pierelli,

    1. University Centre for Adaptive Disorders and Headache, Polo Pontino-ICOT, ‘La Sapienza’ University and
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  • G Nappi

    1. University Centre for Adaptive Disorders and Headache, IRCCS ‘C. Mondino Institute of Neurology’ Foundation, University of Pavia, Pavia,
    2. Chair of Neurology, University of Rome ‘La Sapienza’, Rome, Italy, and
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Armando Perrotta, MD, University Centre for Adaptive Disorders and Headaches, IRCCS ‘C. Mondino Institute of Neurology’ Foundation, Via Mondino 2, 27100 Pavia, Italy. Tel. + 39 03 8238 0435, fax + 39 03 8238 0448, e-mail armando.perrotta@mondino.it

Abstract

A growing body of evidence supports the pivotal role of the hypothalamus in the pathophysiology of cluster headache (CH). On the basis of animal studies, it has been suggested that a hypothalamic dysfunction can lead to a habituation deficit of brainstem reflex responses, as result of a stress-like condition. Taking into account these findings, we tested the hypothesis that habituation of brainstem reflexes may be impaired in CH patients. The habituation phenomenon of the late components (R2 and R3) of the blink reflex was studied in 27 CH patients during the cluster period, in 22 migraine patients interictally and in 20 control subjects. A significant habituation deficit in the R2 and R3 components was found in CH compared with both controls and migraineurs. The lack of habituation in CH, more pronounced than in migraine, points to abnormal processing of sensory stimuli at the trigeminal level that could be driven by hypothalamic dysfunction during the cluster period.

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