• Armando Perrotta, Gianluca Coppola, Maria Grazia Anastasio, Roberto De Icco, Anna Ambrosini, Mariano Serrao, Vincenzo Parisi, Maurizio Evangelista, Giorgio Sandrini, and Francesco Pierelli.
• IRCCS Neuromed, Pozzilli, IS, Italy. Electronic address: arm.perrotta@gmail.com.
• J Pain. 2018 Sep 1; 19 (9): 1040-1048.

AbstractWe investigated whether the stimulation frequency (SF), the pain phases, and different diagnoses of trigeminal autonomic cephalalgias (TACs) may influence the habituation to pain. We studied the habituation of the nociceptive blink reflex R2 responses at different SFs (.05, .1, .2, .3, .5, and 1 Hz), in 28 episodic cluster headache (ECH) patients, 16 during and 12 outside the bout; they were compared with 16 episodic paroxysmal hemicrania (EPH) during the bout and 21 healthy subjects. We delivered 26 electrical stimuli and subdivided stimuli 2 to 26 in 5 blocks of 5 responses for each SF. Habituation values for each SF were expressed as the percentages of the mean area value of second through fifth blocks with respect to the first one. A significant lower mean percentage decrease of the R2 area across all blocks was found at .2 to 1 Hz SF during ECH, outside of the ECH, and EPH compared with healthy subjects. We showed a common frequency-dependent deficit of habituation of trigeminal nociceptive responses at higher SFs in ECH and EPH patients, independently from the disease phase. This abnormal temporal pattern of pain processing may suggest a trait-dependent dysfunction of some underlying pain-related subcortical structures, rather than a state-dependent functional abnormality due to the recurrence of the headache attacks during the active period.Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

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