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Effects of Distraction Versus Spatial Discrimination on Laser-Evoked Potentials in Migraine

Authors

  • Marina de Tommaso MD,

    1. From the University of Bari – Neurologic and Psychiatric Sciences, Bari, Italy (Drs. Tommaso, Sardaro, and Difruscolo); Johannes-Gutenberg-University, Institute of Physiology and Pathophysiology, Mainz, Germany (Drs. Baumgartner and Treede).
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  • Ulf Baumgartner MD,

    1. From the University of Bari – Neurologic and Psychiatric Sciences, Bari, Italy (Drs. Tommaso, Sardaro, and Difruscolo); Johannes-Gutenberg-University, Institute of Physiology and Pathophysiology, Mainz, Germany (Drs. Baumgartner and Treede).
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  • Michele Sardaro MD,

    1. From the University of Bari – Neurologic and Psychiatric Sciences, Bari, Italy (Drs. Tommaso, Sardaro, and Difruscolo); Johannes-Gutenberg-University, Institute of Physiology and Pathophysiology, Mainz, Germany (Drs. Baumgartner and Treede).
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  • Olimpia Difruscolo MD,

    1. From the University of Bari – Neurologic and Psychiatric Sciences, Bari, Italy (Drs. Tommaso, Sardaro, and Difruscolo); Johannes-Gutenberg-University, Institute of Physiology and Pathophysiology, Mainz, Germany (Drs. Baumgartner and Treede).
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  • Claudia Serpino MD,

    1. From the University of Bari – Neurologic and Psychiatric Sciences, Bari, Italy (Drs. Tommaso, Sardaro, and Difruscolo); Johannes-Gutenberg-University, Institute of Physiology and Pathophysiology, Mainz, Germany (Drs. Baumgartner and Treede).
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  • Rolf-Detlef Treede MD

    1. From the University of Bari – Neurologic and Psychiatric Sciences, Bari, Italy (Drs. Tommaso, Sardaro, and Difruscolo); Johannes-Gutenberg-University, Institute of Physiology and Pathophysiology, Mainz, Germany (Drs. Baumgartner and Treede).
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Dr. Marina de Tommaso, University of Bari (Italy) – Neurologic and Psychiatric Sciences, Clinica Neurologica, Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.

Abstract

Objectives.— To evaluate whether migraine patients exhibit less inhibition to painful stimuli when distracted from pain as compared to healthy subjects, testing the spatial discrimination of painful stimuli, the performance during the mental arithmetic task used to contrast the discrimination performance and the behavior of N1 and N2-P2 laser-evoked potentials (LEPs) amplitudes during spatial discrimination and during distraction.

Methods.— Eight migraine patients and 8 healthy controls were examined. During repetitive series of painful laser stimulation of the hand, they had to (1) perform a spatial discrimination task, contrasted by (2) a mental arithmetic task that served as distraction.

Results.— Patients made 50% to 100% more mistakes than controls in the spatial discrimination task (P < .001) as well as during mental arithmetic (P < .05). Whereas healthy subjects showed a marked decrease of the LEP vertex potential amplitudes during distraction compared to the discrimination task, no such attenuation of LEPs was seen in migraine patients (group × task interaction, P < .05). N1 amplitude exhibited a left-hemisphere dominance in both groups, significantly smaller amplitude in migraine patients, but no significant task modulation.

Conclusion.— Migraine patients exhibited reduced inhibition by attentional modulation of pain processing, accompanied by impaired spatial discrimination of painful stimuli.

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