Volume 15 Supplement 1

Abstracts from the 4th European Headache and Migraine Trust International Congress: EHMTIC 2014

Open Access

EHMTI-0387. Characterization of peripheral and central sensitization in patients undergoing occipital nerve stimulator implant for intractable migraine

  • V Mehta1,
  • A Bahra2,
  • L Casey1,
  • A Alamgir1,
  • R VanGroningen3 and
  • T Wodehouse1
The Journal of Headache and Pain201415(Suppl 1):M8


Published: 18 September 2014


Trigemino-spinal sensitization and impaired descending inhibitory control (DNIC) has been reported in chronic migraine.1 Further mechanism behind occipital nerve stimulation (ONS) remains speculative.


This observational study characterises peripheral and central sensitization in patients undergoing ONS for intractable chronic migraine


Quantitative Sensory testing (QST) measurements were carried out in patients before and after ONS (n=6).
  1. 1.

    Measurement of pressure pain thresholds (PPT): Computer-controlled pressure algometer (SomedicAB, Sweden, diameter contact tip 10mm; standardised speed 0.3kg/s) measured PPTs at standardized three points (temple, cheek bone and cervical).

  2. 2.

    DNIC: DNIC response was measured using PPT on cheekbone with an inflated cuff insitu on one arm.



Patients with chronic migraine demonstrated loss of DNIC, (PPTs 56.0 KPa vs 46.2kPA cuff inflated). A “normal’ DNIC response was observed two weeks following ONS (58.4 kPA vs 100.4kPA cuff inflated) continuing positively over next three months. In contrast the PPTs remained same before and after the ONS.


This case series reports sustained reversal of the loss of DNIC response in patients undergoing ONS for intractable headache whilst having no effect on peripheral pain thresholds.

No conflict of interest.

Authors’ Affiliations

Pain & Anesthesia Research Centre St Bartholomew's Hospital, Bart's Health NHS Trust
Department of Neurology Whipps Cross Hospital, Bart's Health NHS Trust
Department of Neurosurgery Royal London Hospital, Bart's Health NHS Trust


  1. Boyer N: Pain. 2014, 155: 1196–205. 10.1016/j.pain.2014.03.001PubMedView ArticleGoogle Scholar


© Mehta et al; licensee Springer. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.