Low-Frequency Short-Time Nociceptive Stimulation of the Greater Occipital Nerve does not Modulate the Trigeminal System

• Published in: Cephalalgia Vol. 28; no. 8; pp. 842 - 846
• Main Authors: Jürgens, TP, Busch, V, Opatz, O, Schulte-Mattler, WJ, May, A
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.08.2008; Blackwell Publishing Ltd
• Subjects: Adolescent; Adult; Blinking - physiology; Cervical Vertebrae; Electric Stimulation - methods; Electrical stimulation; Evoked Potentials, Somatosensory - physiology; Female; functional connectivity; greater occipital nerve; Humans; Male; nociceptive blink reflex; occipital nerve stimulation; Pain Threshold - physiology; Reaction Time - physiology; Spinal Nerves - physiology; trigeminal nerve; Trigeminal Nerve - physiology; Electrical stimulation; trigeminal nerve; occipital nerve stimulation; functional connectivity; greater occipital nerve; nociceptive blink reflex
• ISSN: 0333-1024; 1468-2982
• DOI: 10.1111/j.1468-2982.2008.01612.x

Occipital stimulation in a small group of refractory chronic migraine and cluster headache patients has been suggested as a novel therapeutic approach with promising results. In an earlier study we have shown that a drug-induced block of the greater occipital nerve (GON) inhibits the nociceptive blink reflex (nBR). Now, we sought to examine the effects of low-frequency (3 Hz) short-time nociceptive stimulation of the GON on the trigeminal system. We recorded the nBR responses before and after stimulation in 34 healthy subjects. Selectivity of GON stimulation was confirmed by eliciting somatosensory evoked potentials of the GON upon stimulation. In contrast to an anaesthetic block of the occipital nerve, no significant changes of the R2-latencies and R2-response areas of the nBR can be elicited following GON stimulation. Various modes of electrical stimulation exist with differences in frequency, stimulus intensity, duration of stimulation and pulse width. One explanation for a missing modulatory effect in our study is the relatively short duration of the stimulation.