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Changes in brainstem habituation during onabotulinumtoxinA treatment in chronic migraine: A prospective case–control study

Gerlinde Freimark, Sebastian Strauss, L. H. Overeem, M. Fitzek, K. S. Lange, Carolin L. Höhne, Uwe Reuter, Robert Fleischmann et al.

Headache, 2025

Abstract

Chronic migraine is a debilitating neurological disorder characterized by central sensitization and impaired brainstem habituation. OnabotulinumtoxinA is an established prophylactic treatment for chronic migraine, yet its effects on central trigeminal sensory processing remain incompletely understood. The nociceptive blink reflex (nBR) is a well‐established neurophysiological tool for assessing brainstem excitability and central sensory processing within the trigeminal system. This prospective case–control study investigated longitudinal changes in brainstem neurophysiology following onabotulinumtoxinA treatment using the nBR.

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