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Sphenopalatine ganglion stimulation induces changes in cardiac autonomic regulation in cluster headache

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@article{b4787c423e184a1ca768567ff7d5de1f,
title = "Sphenopalatine ganglion stimulation induces changes in cardiac autonomic regulation in cluster headache",
abstract = "INTRODUCTION: Cluster headache is characterized by attacks of severe unilateral pain accompanied by cranial and systemic autonomic changes. Our knowledge of the latter is imperfect. This study aimed to investigate the effect of low-frequency sphenopalatine ganglion stimulation on cardiac autonomic regulation.MATERIALS AND METHODS: In a double-blind, randomized, sham-controlled crossover design, patients received low-frequency and sham stimulation. RR intervals were recorded, and heart rate variability was analysed (time-domain, frequency-domain, nonlinear parameters). Headache characteristics, including cranial autonomic symptoms, were recorded at baseline and every 10 min for 60 min.RESULTS: Sixteen patients were included. Changes in heart rate variability from baseline in the analysed parameters differed significantly between low-frequency and sham stimulation. Initially, during low-frequency stimulation, there was a greater increase in heart rate compared to sham (P<0·05) and changes in the frequency, nonlinear and time domain (P<0·05) reflecting a higher sympathetic tone. These preceded the observed cranial autonomic symptoms. Ten episodes of cluster-like attacks were reported (six following low-frequency stimulation, four following sham). During these, parasympathetic tone (P<0·05) was higher compared to baseline.CONCLUSIONS: In cluster headache patients subjected to low-frequency and sham stimulation of the sphenopalatine ganglion, we found changes indicating higher sympathetic tone during low-frequency stimulation preceding cranial autonomic symptoms or cluster pain. During cluster pain, regardless of stimulation parameters, we saw increased parasympathetic activity, congruent with previous reports. The results indicate involvement of cardiac autonomic regulation before and during cluster headache attacks.",
keywords = "Journal Article",
author = "Mads Barloese and Petersen, {Anja S} and Song Guo and Messoud Ashina and Jesper Mehlsen and Jensen, {Rigmor H}",
note = "{\textcopyright} 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.",
year = "2018",
doi = "10.1111/cpf.12484",
language = "English",
volume = "38",
pages = "808--815",
journal = "Clinical Physiology and Functional Imaging",
issn = "1475-0961",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "5",

}

RIS

TY - JOUR

T1 - Sphenopalatine ganglion stimulation induces changes in cardiac autonomic regulation in cluster headache

AU - Barloese, Mads

AU - Petersen, Anja S

AU - Guo, Song

AU - Ashina, Messoud

AU - Mehlsen, Jesper

AU - Jensen, Rigmor H

N1 - © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

PY - 2018

Y1 - 2018

N2 - INTRODUCTION: Cluster headache is characterized by attacks of severe unilateral pain accompanied by cranial and systemic autonomic changes. Our knowledge of the latter is imperfect. This study aimed to investigate the effect of low-frequency sphenopalatine ganglion stimulation on cardiac autonomic regulation.MATERIALS AND METHODS: In a double-blind, randomized, sham-controlled crossover design, patients received low-frequency and sham stimulation. RR intervals were recorded, and heart rate variability was analysed (time-domain, frequency-domain, nonlinear parameters). Headache characteristics, including cranial autonomic symptoms, were recorded at baseline and every 10 min for 60 min.RESULTS: Sixteen patients were included. Changes in heart rate variability from baseline in the analysed parameters differed significantly between low-frequency and sham stimulation. Initially, during low-frequency stimulation, there was a greater increase in heart rate compared to sham (P<0·05) and changes in the frequency, nonlinear and time domain (P<0·05) reflecting a higher sympathetic tone. These preceded the observed cranial autonomic symptoms. Ten episodes of cluster-like attacks were reported (six following low-frequency stimulation, four following sham). During these, parasympathetic tone (P<0·05) was higher compared to baseline.CONCLUSIONS: In cluster headache patients subjected to low-frequency and sham stimulation of the sphenopalatine ganglion, we found changes indicating higher sympathetic tone during low-frequency stimulation preceding cranial autonomic symptoms or cluster pain. During cluster pain, regardless of stimulation parameters, we saw increased parasympathetic activity, congruent with previous reports. The results indicate involvement of cardiac autonomic regulation before and during cluster headache attacks.

AB - INTRODUCTION: Cluster headache is characterized by attacks of severe unilateral pain accompanied by cranial and systemic autonomic changes. Our knowledge of the latter is imperfect. This study aimed to investigate the effect of low-frequency sphenopalatine ganglion stimulation on cardiac autonomic regulation.MATERIALS AND METHODS: In a double-blind, randomized, sham-controlled crossover design, patients received low-frequency and sham stimulation. RR intervals were recorded, and heart rate variability was analysed (time-domain, frequency-domain, nonlinear parameters). Headache characteristics, including cranial autonomic symptoms, were recorded at baseline and every 10 min for 60 min.RESULTS: Sixteen patients were included. Changes in heart rate variability from baseline in the analysed parameters differed significantly between low-frequency and sham stimulation. Initially, during low-frequency stimulation, there was a greater increase in heart rate compared to sham (P<0·05) and changes in the frequency, nonlinear and time domain (P<0·05) reflecting a higher sympathetic tone. These preceded the observed cranial autonomic symptoms. Ten episodes of cluster-like attacks were reported (six following low-frequency stimulation, four following sham). During these, parasympathetic tone (P<0·05) was higher compared to baseline.CONCLUSIONS: In cluster headache patients subjected to low-frequency and sham stimulation of the sphenopalatine ganglion, we found changes indicating higher sympathetic tone during low-frequency stimulation preceding cranial autonomic symptoms or cluster pain. During cluster pain, regardless of stimulation parameters, we saw increased parasympathetic activity, congruent with previous reports. The results indicate involvement of cardiac autonomic regulation before and during cluster headache attacks.

KW - Journal Article

U2 - 10.1111/cpf.12484

DO - 10.1111/cpf.12484

M3 - Journal article

C2 - 29105279

VL - 38

SP - 808

EP - 815

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

SN - 1475-0961

IS - 5

ER -

ID: 52009293