Skip to main content


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

Article metrics

  • 248 Accesses

  • 32 Citations


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.


  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, 10805332

  2. 2.

    Fields HL IHS Special Lecture (2001). Pain modulating networks in headache pathogenesis Cephalalgia 21:273, 10.1046/j.1468-2982.2001.00008.x

  3. 3.

    Welch KMA. (2003) Contemporary concepts of migraine pathogenesis Neurology 61:S2–S8, 1:CAS:528:DC%2BD3sXptlais70%3D, 14581652

  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, 12507697

  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, 7417817

  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, 9303250

  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.2005.08.019

  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, 16776692

  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, 14678845

  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, 14499420

  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%3D

  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, 1735413

  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, 7807168

  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, 8926499

  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, 12098634

  16. 16.

    Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders. Cephalalgia 24[Suppl 1]:9–160

  17. 17.

    American Psychiatric Association. (1994) Diagnostic and statistical manual of mental disorders (DSM-IV), 4th ed. Washington DC: American Psychiatric Association; 19

  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%3D

  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.

  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, 14499749

  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, 14678844

  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, 460935

  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, 10.1097/00001756-199712010-00026

Download references

Author information

Correspondence to Marina de Tommaso.

Rights and permissions

Reprints and Permissions

About this article


  • Migraine
  • Laser-evoked potentials
  • Diffuse noxious inhibiting control


By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Please note that comments may be removed without notice if they are flagged by another user or do not comply with our community guidelines.