Email this article Botulinum neurotoxin and chronic migraine: muscle fiber chemodenervation or nociceptic system modulation?
- Authors: Artemenko A.R.1, Kurenkov A.L.2, Nikitin S.S.3, Belomestova K.B.1
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Affiliations:
- I.M. Sechenov First Moscow State Medical University
- Research Center of Child Health, Russian Academy of Medical Sciences
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow
- Issue: Vol 3, No 4 (2013)
- Pages: 6-12
- Section: LECTURES AND REVIEWS
- Published: 20.12.2013
- URL: https://nmb.abvpress.ru/jour/article/view/61
- DOI: https://doi.org/10.17650/2222-8721-2013-0-4-6-12
- ID: 61
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Abstract
The results of controlled investigations suggest that botulinumtoxin type A (BTA) leads to decrease headache intensity and prevent migraine attacks. The antinociceptive mechanisms of BTA action remain unclear. Modern and previous hypothesis of antinociceptive action BTA in chronic migraine (CM) are discussed in details. Recent experimental and clinical evidence strongly suggest that BTA has a
specific antinociceptive effect realized through inhibition of proinflammatory neurotransmitters release not only from the sensory terminals but from muscle nociceptors. The mechanism of the action of BTA in CM has more than one target and is considered to involve different pathophysiological levels CM: neurogenic inflammation, peripheral and central sensitization. The administration of BTA on the PREEMPT principle (paradigm) ensures optimal neurotoxin distribution in the anatomic areas in accordance with their sensory innervation by cervical segments and sensory fibers in the trigeminal system, the terminal branches which are the major target of BTA in the treatment of CM.
About the authors
A. R. Artemenko
I.M. Sechenov First Moscow State Medical University
Author for correspondence.
Email: aartemenko@gmail.com
Russian Federation
A. L. Kurenkov
Research Center of Child Health, Russian Academy of Medical Sciences
Email: fake@neicon.ru
Russian Federation
S. S. Nikitin
Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow
Email: fake@neicon.ru
Russian Federation
K. B. Belomestova
I.M. Sechenov First Moscow State Medical University
Email: fake@neicon.ru
Russian Federation
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