Lara Ahmad (Italy)

IRCCS Mondino Foundation Headache Science and Neurorehabilitation Centre

Author Of 1 Presentation

Free Communication

SPINAL NOCICEPTIVE SENSITIZATION AND PLASMA PALMITOYLETHANOLAMIDE LEVELS DURING EXPERIMENTALLY-INDUCED MIGRAINE ATTACKS

Session Type
Free Communication
Date
04.10.2021, Monday
Session Time
11:30 - 13:00
Room
Free Communication B
Lecture Time
12:30 - 12:40
Presenter
  • Roberto De Icco (Italy)

Abstract

Background and Aims:

Migraine subjects experience a derangement of the nociceptive system control as the disease progresses. The endocannabinoid system may modulate the nociceptive pathways. We evaluated the nociceptive spinal modulation together with anandamide (AEA) and palmitoylethanolamide (PEA) circulating levels in patients with episodic migraine exposed to nitroglycerin (NTG - 0.9 mg, sublingual).

Methods:

We enrolled 24 patients (MiG - 33.0±8.1 years, 22 female) and 19 healthy controls (HC - 29.5±9.3, 15 female). Nociceptive withdrawal reflex and plasma AEA and PEA levels were recorded at baseline and at 30 (T30), 60 (T-60) and 120 (T-120) minutes after NTG administration. In subjects with a positive provocation test (NTG+) during the hospital observation period (180 minutes), the evaluations were repeated at migraine onset (T-MIG) and after 1 hour (T-MIG-1h).

Results:

Sixteen MiG patients (66.7%) and 0 HCs had an NTG+ response. NTG induced spinal sensitization in both NTG+ and NTG- patients, detectable as a decrease in temporal summation threshold (p=0.001 and 0.016, respectively). AEA levels significantly increased in all subjects until T-120 (p=0.035), without differences between MiG and HC groups. PEA levels significantly increased only in MiG patients at T-120 (p=0.001).

In 13 patients with NTG+ response before 180 minutes, we detected spinal nociceptive facilitation at T-MIG and at T-MIG-1h (p=0.001), and PEA increase at T-MIG-1h (p=0.031).

We did not find any correlations between neurophysiological parameters and levels of endocannabinoid mediators.

Conclusions:

NTG facilitates spinal nociceptive modulation and is associated to increased circulating PEA levels in subjects who develop a migraine. This response likely represents a compensatory anti-inflammatory/analgesic mechanism.

Hide