The Journal of Headache and Pain

, Volume 8, Issue 3, pp 167–174 | Cite as

Effects of remote cutaneous pain on trigeminal laser-evoked potentials in migraine patients

  • Marina de Tommaso
  • Olimpia Difruscolo
  • Michele Sardaro
  • Giuseppe Libro
  • Carla Pecoraro
  • Claudia Serpino
  • Paolo Lamberti
  • Paolo Livrea
Open Access


The present study aimed to evaluate heat pain thresholds and evoked potentials following CO2 laser thermal stimulation (laser-evoked potentials, LEPs), during remote application of capsaicin, in migraine patients vs. non-migraine healthy controls. Twelve outpatients suffering from migraine without aura were compared with 10 healthy controls. The LEPs were recorded by 6 scalp electrodes, stimulating the dorsum of the right hand and the right supraorbital zone in basal condition, during the application of 3% capsaicin on the dorsum of the left hand and after capsaicin removal. In normal subjects, the laser pain and the N2-P2 vertex complex obtained by the hand and face stimulation were significantly reduced during remote capsaicin application, with respect to pre-and post-capsaicin conditions, while in migraine LEPs and laser pain were not significantly modified during remote painful stimulation. In migraine a defective brainstem inhibiting control may coexist with cognitive factors of focalised attention to facial pain, less sensitive to distraction by a second pain.


Migraine Laser-evoked potentials Diffuse noxious inhibiting control 


  1. 1.
    Burstein R, Yarnitsky D, Goor-Aryeh I, Ransil BJ, Baiwa ZH (2000) An association between migraine and cutaneous allodynia. Ann Neurol 47:614–624., 10.1002/1531-8249(200005)47:5<614::AID-ANA9>3.0.CO;2-N, 1:STN:280:DC%2BD3c3mtlSrsA%3D%3D, 10805332CrossRefPubMedGoogle Scholar
  2. 2.
    Fields HL IHS Special Lecture (2001). Pain modulating networks in headache pathogenesis Cephalalgia 21:273, 10.1046/j.1468-2982.2001.00008.xCrossRefGoogle Scholar
  3. 3.
    Welch KMA. (2003) Contemporary concepts of migraine pathogenesis Neurology 61:S2–S8, 1:CAS:528:DC%2BD3sXptlais70%3D, 14581652CrossRefPubMedGoogle Scholar
  4. 4.
    de Tommaso M, Valeriani M, Guido M et al (2003) Abnormal brain processing of cutaneous pain in patients with chronic migraine. Pain 101:25–32, 10.1016/S0304-3959(02)00299-3, 12507697CrossRefPubMedGoogle Scholar
  5. 5.
    Dickenson AH, Le Bars D, Besson JM (1980) Diffuse noxious inhibitory controls (DNIC). Effects on trigeminal nucleus caudalis neurones in the rat Brain Res. 200:293–305, 10.1016/0006-8993(80)90921-X, 1:STN:280:DyaL3M%2Fit1eisg%3D%3D, 7417817CrossRefPubMedGoogle Scholar
  6. 6.
    Lautenbacher S, Rollman GB (1997) Possible deficiencies of pain modulation in fibromyalgia. Clin J Pain 13:189–96, 10.1097/00002508-199709000-00003, 1:STN:280:DyaK2svkvV2htA%3D%3D, 9303250CrossRefPubMedGoogle Scholar
  7. 7.
    Pielstickera A, Haage G, Zaudig M, Lautenbacher S (2005) Impairment of pain inhibition in chronic tension-type headache. Pain 118:215–223, 10.1016/j.pain.2005.08.019CrossRefGoogle Scholar
  8. 8.
    Sandrini G, Rossi P, Milanov I, Serrao M, Cecchini AP, Nappi G (2006) Abnormal modulatory influence of diffuse noxious inhibitory controls in migraine and chronic tension-type headache patients. Cephalalgia 26:782–789, 10.1111/j.1468-2982.2006.01130.x, 1:STN:280:DC%2BD28vlslOlsA%3D%3D, 16776692CrossRefPubMedGoogle Scholar
  9. 9.
    Romaniello A, Iannetti GD, Truini A, Cruccu G (2003) Trigeminal responses to laser stimuli. Neurophysiol Clin 33:315–324, 10.1016/j.neucli.2003.10.010, 1:STN:280:DC%2BD3srpslGksw%3D%3D, 14678845CrossRefPubMedGoogle Scholar
  10. 10.
    Valeriani M, de Tommaso M, Restuccia D et al (2003) Reduced habituation to experimental pain in migraine patients: a CO(2) laser evoked potential study. Pain 105:57–64, 10.1016/S0304-3959(03)00137-4, 1:STN:280:DC%2BD3svktFOruw%3D%3D, 14499420CrossRefPubMedGoogle Scholar
  11. 11.
    de Tommaso M, Losito L, Difruscolo O et al (2005) Capsaicin failed in suppressing cortical processing of CO2 laser pain in migraine patients. Neurosci Lett 384:150–5., 10.1016/j.neulet.2005.04.086, 15927376, 1:CAS:528:DC%2BD2MXlt1KitLg%3DCrossRefPubMedGoogle Scholar
  12. 12.
    Arendt-Nielsen L, Gotliebsen K (1992) Segmental inhibition of laser-evoked brain potentials by ipsi-and contralaterally applied cold pressor pain. Eur J Appl Physiol Occup Physiol 64:56–61, 10.1007/BF00376441, 1:STN:280:DyaK387jslajtQ%3D%3D, 1735413CrossRefPubMedGoogle Scholar
  13. 13.
    Kakigi R (1994) Diffuse noxious inhibitory control. Reappraisal by pain-related somatosensory evoked potentials following CO2 laser stimulation. J Neurol Sci 125:198–205, 10.1016/0022-510X(94)90036-1, 1:STN:280:DyaK2M7gsFyrug%3D%3D, 7807168CrossRefPubMedGoogle Scholar
  14. 14.
    Watanabe S, Kakigi R, Hoshiyama M, Kitamura Y, Koyama S, Shimojo M (1996) Effects of noxious cooling of the skin on pain perception in man. J Neurol Sci 135:68–73, 10.1016/0022-510X(95)00253-X, 1:STN:280:DyaK28vgt1Ggug%3D%3D, 8926499CrossRefPubMedGoogle Scholar
  15. 15.
    Romaniello A, Arendt-Nielsen L, Cruccu G, Svensson P (2002) Modulation of trigeminal laser evoked potentials and laser silent periods by homotopical experimental pain. Pain 98:217–28, 10.1016/S0304-3959(02)00049-0, 12098634CrossRefPubMedGoogle Scholar
  16. 16.
    Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders. Cephalalgia 24[Suppl 1]:9–160Google Scholar
  17. 17.
    American Psychiatric Association. (1994) Diagnostic and statistical manual of mental disorders (DSM-IV), 4th ed. Washington DC: American Psychiatric Association; 19Google Scholar
  18. 18.
    Valeriani M, Rambaud L, Mauguie`re F (1996) Scalp topography and dipolar source modelling of potentials evoked by CO2 laser stimulation of the hand. Electroencephalog Clin Neurophysiol 100:343–53, 10.1016/0168-5597(96)95625-7, 1:STN:280:DC%2BD2s3jtlSqtQ%3D%3DCrossRefGoogle Scholar
  19. 19.
    Biehl R, Treede R-D, Bromm B (1984) Pain ratings of short radiant heat pulses. In: Bromm B, ed. Pain measurement in man Neurophysiological correlates of pain. Amsterdam: Elsevier. 397–408.Google Scholar
  20. 20.
    Valeriani M, Arendt-Nielsen L, Le Pera D et al (2003) Short-term plastic changes of the human nociceptive system following acute pain induced by capsaicin. Clin Neurophysiol 114:1879–1890, 10.1016/S1388-2457(03)00180-9, 14499749CrossRefPubMedGoogle Scholar
  21. 21.
    Treede R-D, Lorenz J, Baumgartner U (2003) Clinical usefulness of laser-evoked potentials Neurophysiol Clin 33:303–314, 10.1016/j.neucli.2003.10.009, 14678844CrossRefPubMedGoogle Scholar
  22. 22.
    Le Bars D, Dickenson AH, Besson JM (1979) Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurons in the rat. Pain 6:283–305, 10.1016/0304-3959(79)90049-6, 460935CrossRefPubMedGoogle Scholar
  23. 23.
    Garcia-Larrea L, Peyron R, Laurent B, Mauguière F (1997) Association and dissociation between laser-evoked potentials and pain perception. NeuroReport 8:3785–9, 1:STN:280:DyaK1c%2FoslansQ%3D%3D, 9427371, 10.1097/00001756-199712010-00026CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Marina de Tommaso
    • 1
  • Olimpia Difruscolo
    • 1
  • Michele Sardaro
    • 1
  • Giuseppe Libro
    • 1
  • Carla Pecoraro
    • 1
  • Claudia Serpino
    • 1
  • Paolo Lamberti
    • 1
  • Paolo Livrea
    • 1
  1. 1.Neurophysiopathology of Chronic Pain Unit, Neurological and Psychiatric Sciences DepartmentUniversity of Bari, Clinica Neurologica, PoliclinicoBariItaly

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