Neuromuscular DiseasesNeuromuscular DiseasesНервно-мышечные болезни2222-87212413-0443Publishing House ABV Press6110.17650/2222-8721-2013-0-4-6-12LECTURES AND REVIEWSЛЕКЦИИ И ОБЗОРЫBotulinum neurotoxin and chronic migraine: muscle fiber chemodenervation or nociceptic system modulation?Ботулинический нейротоксин и хроническая мигрень: хемоденервация мышечных волокон или модуляция ноцицептивной системы?ArtemenkoA. R.АртеменкоА. Р.
Russian Federation
aartemenko@gmail.comKurenkovA. L.КуренковА. Л.
Russian Federation
NikitinS. S.НикитинС. С.
Russian Federation
BelomestovaK. B.БеломестоваК. В.
Russian Federation
I.M. Sechenov First Moscow State Medical UniversityГБОУ ВПО «Первый МГМУ им. И.М. Сеченова»Research Center of Child Health, Russian Academy of Medical SciencesФГБУ «Научный центр здоровья детей» РАМНInstitute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, MoscowНИИ общей патологии и патофизиологии РАМН, Москва20122013346122002201520022015Copyright ©; 2013, Artemenko A.R., Kurenkov A.L., Nikitin S.S., Belomestova K.B.Copyright ©; 2013, Артеменко А.Р., Куренков А.Л., Никитин С.С., Беломестова К.В.2013Artemenko A.R., Kurenkov A.L., Nikitin S.S., Belomestova K.B.Артеменко А.Р., Куренков А.Л., Никитин С.С., Беломестова К.В.https://creativecommons.org/licenses/by/4.0https://nmb.abvpress.ru/jour/article/view/61

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 aspecific 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.

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