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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Exteroceptive suppression (ES) of temporalis muscle activity, particularly the multisynaptic ES2, has been reported to be significantly reduced in tension type headache, but not in migraine. We re-evaluated the methods of optimally analysing the single shock technique and its intra- and inter-individual variability in 26 normal subjects. These data were compared with the results in patients with migraine, post-lumbar puncture headache, headache due to meningitis, tension-type headaches in HIV infection and patients with symptomatic headache of various etiologies. ES2 was absent in about 50% of tension-type headache patients, but only in one normal subject. With the methods used here and when patients with absent ES2 were excluded, mean duration of ES2 was not significantly different between the various groups. It seems therefore necessary, in spite of increased discomfort for patients, to use complementary methods, such as averaging 16-32 responses and applying various stimulation sets, if one wants to increase the potency of temporalis ES2 as a diagnostic and pathophysiologic tool in headache.
Headache 1992 Jan
PMID:Exteroceptive suppression of temporalis muscle activity in various types of headache. 155 31

The exteroceptive suppression (ES) of electrical activity in the temporal muscle is an inhibitory antinociceptive brain-stem reflex. We investigated whether aspirin can significantly modulate latencies or durations of the early (ES1) and late (ES2) exteroceptive suppression periods of electrical activity in the temporal muscle. Participating in the randomized double-blind crossover study were 20 patients with migraine without aura, 20 patients with tension-type headache, and 20 healthy subjects. ES1 and ES2 elicited by an electrical stimulus of 20 mA lasting 0.2 msec were recorded during maximal voluntary contraction of the mastication muscles before and 30 min after medication. In a randomized and double-blind fashion half of the subjects were given 1200 mg of aspirin in the form of an effervescent solution and the other half were given an identically tasting solution without aspirin. One week later the experiment was repeated with the substances exchanged in crossover fashion. The administration of placebo as well as aspirin caused a highly significant increase in ES1 duration (P less than or equal to 0.001). While aspirin caused a highly significant increase in ES2 duration (P less than or equal to 0.001) the taking of placebo showed no significant effect on ES2 duration. In giving aspirin as opposed to the placebo, there was a significant interaction between groups and drug effect on the latency of ES1; whereas in migraine patients and in patients with tension-type headache the latency of ES1 was reduced by administration of aspirin, it was increased in healthy subjects (P less than or equal to 0.05). Neither aspirin nor placebo significantly varied the ES2 latency.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acetylsalicylic acid activates antinociceptive brain-stem reflex activity in headache patients and in healthy subjects. 158 37

EMG analysis of the late exteroceptive suppression period of the temporal muscle activity is discussed as comparative methodology in the assessment of patients suffering from chronic tension-type headache and from migraineurs. After electrical perioral trigeminal nerve stimulation during maximum voluntary jaw occlusion, early (ES1) and late (ES2) exteroceptive suppression periods can be registered above the temples using surface EMG recordings. In patients suffering from chronic tension-type headache the duration of the late suppression period is shortened (p less than 0.001) compared to migraineurs or controls. However, patients suffering from episodic tension-type headache display late suppression periods of temporal muscle activity of differing lengths.
Cephalalgia 1991 May
PMID:EMG analysis of the late exteroceptive suppression period of temporal muscle activity in episodic and chronic tension-type headaches. 186 Jan 31

The second exteroceptive silent period (ES2) of temporalis muscle was recorded on days 1 and 15 of the menstrual cycle in 17 women, 9 of whom suffered regularly from tension-type headaches during menstruation. Mean duration of temporalis ES2 was significantly shorter on day 1 of the cycle than on day 15. This difference was due to a marked menstrual reduction of ES2 in the headache subgroup. A positive correlation was found between ES2 durations and oestradiol/progesterone ratios. We hypothesize that the variations of ES2 during the ovarian cycle result from the modulatory effects of oestrogens on descending aminergic pathways that control excitability of inhibitory brainstem interneurons mediating exteroceptive suppression of jaw-closing motoneurons.
Cephalalgia 1991 May
PMID:Exteroceptive silent period of temporalis muscle in menstrual headaches. 186 Jan 34

In 18 normal subjects and 36 patients with chronic headache (3 cluster headache, 18 maigraine and 15 muscle contraction headache), exteroceptive suppression in the temporalis, masseter and trapezius muscles was examined. In the temporalis and masseter muscles, early and late phases (ES1 and ES2) were observed. In the present study, late response (ES2) was examined. Patients with muscle contraction headache showed an obvious decrease of exteroceptive suppression in duration and degree. Patients with common migraine showed slight reduction of exteroceptive suppression in duration and amount, when compared with normal subjects. Patients with classic migraine or cluster headache elicited almost normal exteroceptive suppression. Exteroceptive suppression in the trapezius muscle consisted of one or two suppressive phase(s). Early phase was small and unstable. In the present study, late response with latency of about 45 ms was examined. In the trapezius muscle, migraine and patients with muscle contraction headache elicited the reduction of the exteroceptive suppression in degree. There might be the failure of the inhibitory interneuron mediating the pathway of exteroceptive suppression not only in patients with muscle contraction headache, but also in patients with migraine, especially in patients with common migraine.
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PMID:[Exteroceptive suppression after mental nerve stimulation in patients with chronic headache]. 235 Sep 23

Early (ES1) and late (ES2) exteroceptive suppression periods elicited by electrical stimulation of the labial commissure during teeth-clenching were recorded over the temporalis muscle in 45 headache patients (25 tension headaches and 20 migraines) and 22 controls. Mean duration of ES2 for single shocks was significantly reduced in tension headache when compared with migraine or controls. At a stimulation rate of 2 Hz, ES2 was abolished in 40% of tension headache sufferers, but in none of the migraineurs. EMG analysis of temporalis late exteroceptive suppression might be a helpful diagnostic tool in functional headaches. Reduction of ES2 suggests that there is deficient activation or excessive inhibition of pontobulbar inhibitory interneurons which receive a strong input from limbic structures. ES2 might thus represent an interface between psychogenic and myogenic factors putatively involved in the pathogenesis of tension headache.
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PMID:Exteroceptive suppression of temporalis muscle activity in chronic headache. 368 73

Exteroceptive suppression of temporalis muscle activity (ES2 duration) has been reported to be reduced in chronic tension-type headache in previous open studies (with varying stimulus and analysis methods). We studied ES2 duration and latency in 11 patients with chronic tension-type headache, 10 patients with cervicogenic headache, 11 migraine patients, and 9 headache-free control subjects. The investigator was blinded as to the diagnostic category. Electrical stimuli of 0.5 ms duration and at least three times sensory threshold (median 9.6 mA) were used. ES2 was obtained in all but one (control) subject and the control ES2 duration mean was 33.5 (SD 8.5) ms (80% EMG amplitude reduction criterion). Mean ES2 duration differences were not found between the four groups. None of the headache patients had ES2 durations below the control group range. ES2 duration tended to decrease with increasing duration of headache history. Consistent asymmetries of ES2 latency and duration were not found among patients with (unilateral) cervicogenic headache. Thus, the role of ES2 in headache diagnosis still seems to be unsettled.
Headache 1995 Jun
PMID:Exteroceptive suppression of temporalis muscle activity: a blind study of tension-type headache, migraine, and cervicogenic headache. 763 19

Inhibition of the second exteroceptive suppression of temporalis muscle activity (ES2) produced by a preceding electrical stimulus applied at the index was studied in patients suffering from migraine without aura (MO), chronic (CTH) or episodic (ETH) tension-type headache. Each patient group comprised of 12 subjects was compared to a group of healthy controls. Mean duration of unconditioned ES2, measured on 10 averaged rectified responses after labial stimulation at a 0.1 Hz frequency, was reduced in CTH only. From stimulation intensities of 20 mA onward, peripheral-induced inhibition of temporalis ES2 was significantly more pronounced in both subtypes of tension-type headache compared to migraineurs or controls. After an index finger stimulus of 20 mA, temporalis ES2 was abolished in 83% of CTH, 67% of ETH, 25% of MO patients and 8% of controls, whereas unconditioned ES2 was present in all patients. Among 9 ETH patients with normal (> or = 32 msec) unconditioned ES2, 5 had total disappearance of ES2 after a 20 mA index stimulation. These results demonstrate that peripheral conditioning at 20 mA increases the diagnostic sensitivity of ES2 studies. They suggest that the changes observed in tension-type headache are due to hyperexcitability of the reticular nuclei which inhibit the medullary inhibitory interneurons mediating ES2.
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PMID:Reduction of temporalis exteroceptive suppression by peripheral electrical stimulation in migraine and tension-type headaches. 770 6

We have evaluated the specificity and sensitivity of temporalis ES2 measurements for the diagnosis of primary headaches. Ninety-four outpatients diagnosed according to IHS criteria were prospectively included: 25 had chronic tension-type headache (code 2.2.), 15 episodic tension-type headache (code 2.1.), 20 migraine without aura (code 1.1.) and 34 chronic daily headaches with daily analgesics/ergotamine abuse (code 8.2.). In chronic tension-type, the sensitivity of the ES2 test was 84% at the 0.1 and the 0.5 Hz, but only 56% at the 2Hz stimulation rates. Its specificity was 100% at 0.1Hz, 90% at 0.5Hz and 95% at 2Hz compared to migraine; positive predictive values were at similar levels. Sensitivity of ES2 at 0.1 Hz was 67% in episodic tension-type headache, but its positive predictive value versus migraine was excellent. Comparing chronic tension-type headache and analgesic abusers, the specificity and positive predictive value of the ES2 test for diagnosing chronic tension-type headache were less satisfactory (60%) while the negative predictive values, however, remained good (83% at 0.1Hz). The results confirm that the temporalis ES2 test has a higher diagnostic sensitivity in chronic and episodic tension-type headache, but that it has a high negative predictive value for both types of tension-type headache compared to other primary headaches. For diagnostic purposes, the 0.1Hz stimulation rate seems optimal. The 2Hz stimulation rate is the least sensitive, although it may induce total disappearance of ES2 in up to 40% of patients. ES2 is of limited usefulness for separating chronic tension-type headache and chronic drug-abuse headache, possibly because the latter group comprises both tension-type headache and migraine patients.
Headache 1995 Feb
PMID:Specificity and sensitivity of temporalis ES2 measurements in the diagnosis of chronic primary headaches. 773 67

The aim of this study was to clarify the changes of inhibitory interneuronal activity in patients with chronic tension-type headache with disorder of pericranial muscle after treatment, and the pharmacological mechanisms of tizanidine--an alpha 2 adrenergic agonist. The effects of tizanidine on exteroceptive suppression (ES) of the temporalis muscle were examined in eighteen patients with chronic tension-type headache with disorder of pericranial muscles, before and two weeks after the administration of tizanidine. The left mental nerve was stimulated, under the maximal voluntary contraction of the temporalis muscles. Two types of stimulation were used: weak stimulation with four times the sensory threshold, and strong stimulation with 10 times the sensory threshold. The rectified electromyographic activity was recorded from the right temporalis muscle. ES2 produced by four times the sensory threshold was lengthened after tizanidine administration. This fact suggests that tizanidine improves the inhibitory function in the central nervous system, and then relieves headache. However, ES produced by 10 times the sensory threshold did not change. This suggests that the effect of tizanidine may be relatively mild. The interneurones mediating ES2 may be modified by the alpha 2 agonist.
Headache 1994 Sep
PMID:Effects of tizanidine administration on exteroceptive suppression of the temporalis muscle in patients with chronic tension-type headache. 796 Jul 28


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