Does Greater Occipital Nerve Block Modulate Brainstem Excitability? Insights From a Randomized Controlled Study in Migraine
Abstract
Objectives: Greater occipital nerve block (GONb) is widely used in the treatment of migraine; however, its effects on brainstem excitability remain unclear. This study aimed to assess whether GONb alters brainstem excitability in patients with migraine by evaluating blink reflex (BR) and masseter inhibitory reflex (MIR) parameters.
Materials and methods: This randomized, placebo-controlled, double-blind study included 34 patients with migraine who received either GONb (n = 17) or placebo (n = 17). BR and MIR responses were recorded before and after treatment. The primary outcome was the change in BR R2 response latency, whereas secondary outcomes included BR inhibition, MIR parameters, and pain reduction (visual analog scale [VAS] scores).
Results: GONb significantly reduced BR R2 response latency (p = 0.002), indicating altered brainstem excitability. However, no significant changes were observed in BR inhibition (p > 0.05) or MIR parameters (p > 0.05). GONb led to a significant reduction in migraine frequency (-84.6%, p < 0.0001) and pain severity (VAS: 7.2 ± 1.1 to 2.3 ± 1.6, p < 0.0001), but these improvements did not correlate with neurophysiologic findings.
Conclusions: This study reveals that GONb modifies brainstem excitability by affecting BR R2 latency but does not significantly affect BR inhibition or MIR responses. The findings suggest that GONb selectively influences trigeminal nociceptive pathways rather than global brainstem inhibitory circuits. Further…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 34 participants or records.
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.