Central mechanisms of peripheral nerve stimulation in headache disorders.

摘要: The effect of peripheral neurostimulation has traditionally been attributed to the activation non-noxious afferent nerve fibers (Aβ-fibers) thought modulate Aδ and C-fiber-mediated nociceptive transmission in spinal cord, compatible with 'gate control theory pain'. concept extended since its initial description more recent experimental evidence suggests that analgesic effects stimulation pain states such as chronic headache require an interplay multiple influences. Besides segmental pain-modulating mechanisms cord involving various transmitter systems, also a contribution descending modulating pathways mediating stimulation. Beyond neuromodulation--decreasing excitation or increasing inhibition--a prerequisite this arrangement is convergence different types activity intact modulatory network. In review, we focus on functional anatomy, pathophysiological neurophysiological pharmacological findings elucidating central