Abstract
Comparative studies on the second exteroceptive suppression period (ES2) of the masseter or temporalis muscle in migraineurs and controls have provided conflicting results. As the interneurons responsible for ES2 are probably close to the trigeminal nucleus caudalis and receive afferents also from the anti-nociceptive system, the study of ES2 could provide information on neural circuits involved in migraine pathophysiology. The aim of this observational, pilot study was to assess whether erenumab treatment may affect the exteroceptive suppression reflex of the temporalis muscle activity in migraineurs. The exteroceptive suppression reflex of the temporalis muscle activity was previously studied in a small case series of three chronic female migraineurs and after 4 months of beneficial erenumab treatment, administered according to current clinical indications. There was a statistically significant decrease in ES2 latency (p-value 0.039) and duration (p-value 0.030) after treatment. The change observed in the temporalis ES2 during erenumab treatment indicates that ES2 may play some kind of role as a neurophysiological marker and that this monoclonal antibody can modulate the brainstem circuits involved in migraine pathophysiology, at least indirectly. Further studies are required to confirm this intriguing hypothesis.
Data availability
The data are held on file and may be available.
References
Cruccu G, Deuschl G (2000) The clinical use of brainstem reflex and hand-muscle reflexes. Clin Neurophysiol 111:371–387
Cruccu G, Iannetti GD, Marx JJ et al (2005) Brainstem reflex circuits revisited. Brain 128(Pt 2):386–394
de Tommaso M, Losito L, Difruscolo O et al (2005) Changes in cortical processing of pain in chronic migraine. Headache 45:1208–1218
Dodick DW (2018) Migraine. Lancet 391(10127):1315–1330
Ebinger F (2006) Exteroceptive suppression of masseter muscle activity in juvenile migraineurs. Cephalalgia 26(6):722–730
Göbel H, Schoenen J (1993) Exteroceptive suppression in headache research. Discussion summary. Cephalalgia 13:20
Haanes K, Edvinsson L (2019) Pathophysiological mechanisms in migraine and the identification of new therapeutic targets. CNS Drug 33:525–537
Headache Classification Committee of the International Headache Society (IHS) (2018) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 38(1):1–211
Knight YE, Goadsby PJ (2001) The periaqueductal grey matter modulates trigeminovascular input: a role in migraine? Neuroscience 106:793–800
Lipton RB, Silberstein SD (2015) Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention. Headache 55(Suppl 2):103–122
Noseda R, Burstein R (2013) Migraine pathophysiology: anatomy of the trigeminovascular pathway and associated neurological symptoms, cortical spreading depression, sensitization, and modulation of pain. Pain 154(Suppl 1):S44–S53
Schoenen J (1993) Exteroceptive suppression of temporalis muscle activity: methodological and physiological aspects. Cephalalgia 13(1):3–10
Tataroglu C, Kanik A, Sahin G et al (2002) Exteroceptive suppression patterns of masseter and temporalis muscles in central and peripheral headache disorders. Cephalalgia 22:444–452
Zhu Y, Liu Y, Zhao J et al (2018) The efficacy and safety of calcitonin gene-related peptide monoclonal antibody for episodic migraine: a meta-analysis. Neurol Sci 39:2097–2106
Acknowledgements
The authors thank Barbara Wade, contract professor at the University of Torino, for her linguistic advice.
Author information
Authors and Affiliations
Contributions
E.R. conceived the study; E.R., D.R., and M.A. collected the data; P.I. performed the statistical analysis; E.R. wrote the manuscript and tables; all authors revised the manuscript and tables. All authors read and approved the manuscript and all data were generated in-house and that no paper mill was used.
Corresponding author
Ethics declarations
Ethics approval
The Local Authorities approved the study.
Consent to participate
All patients gave informed consent to participate in the study.
Consent for publication
All patients gave informed consent to having their data published.
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Rota, E., Aguggia, M., Immovilli, P. et al. Change in the second exteroceptive suppression period of the temporalis muscle during erenumab treatment. Naunyn-Schmiedeberg's Arch Pharmacol 395, 607–611 (2022). https://doi.org/10.1007/s00210-022-02216-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00210-022-02216-4