Combined evaluation of pupillary and cardiovascular responses
to cold pressor test in cluster headache patients.
Tassorelli C, Micieli G, Osipova V, Marcheselli S, Rossi
F, Nappi G.
Headache Center and Autonomic Unit, Institute of Neurology IRCCS C. Mondino
Foundation, University of Pavia, Italy. tassorel@tin.it
Little is known about the structures and mechanisms involved in the
pathophysiology of cluster headache (CH). In this study, pupillary and
cardiovascular responses to the cold pressor test (CPT) were monitored in CH
patients during either an active phase of disease or a remission period in order
to evaluate the oculocephalic and cardiovascular functioning of the autonomic
nervous system in this form of idiopathic headache. CH patients showed a
specific pattern of pupillary response on both sides during both phases of the
disease. This response differed from that of controls because of an absent
miosis. The pressor response to CPT was more marked in CH patients than in
controls. Naloxone pretreatment caused specific and selective changes in both
the pupillary and cardiovascular responses of CH patients. These data suggest a
systemic sympathetic hyperactivation in response to CPT in CH patients. An
oculocephalic sympathetic hypofunction is possibly associated as well as an
altered opioid neuromodulation.
PMID: 9950623
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Page Last Updated: 03/25/2007