| The most revealing aspect of the article was the observation of the trigeminal
nerve, a complex network of nerve fibers that ferries sensory signals from
the face, jaws and top of the forehead to the brain. During the course of
a migraine, scientists discovered, the trigeminal nerve practically floods
the brain with pain signals. The more researchers learn about the trigeminal
nerve, the more they believe that it is involved in all types of primary
headaches, including tension and cluster headaches. The differences in the
headache types seem to stem from what activates the trigeminal nerve and
how it responds.
The hypothesis
for the method of action of the NTI device for headache and migraine prevention
involves both the trigeminal nerve and the sympathetic nervous system.
Specifically, when hyperactive spindle fibers (which are innervated by
the sympathetic nervous system) reside within a trigeminally innervated
muscle (like the temporalis, for example), a sympathetic input (that is,
a "trigger"), may cause the intrafusal fibers of the spindle
to contort or spasm. One of the effect of the NTI device is described
by it's name, NTI: Nociceptive Trigeminal Inhibition (meaning inhibitory
signals are sent to disrupt trigeminal activity). Currently, the only
known method of disrupting hyper-trigeminal activity is with the NTI device.
As the TIME article describes, What seems clear, however, is that the
brain of a migraineur (as sufferers are called) is primed to overreact
to all sorts of stimuli that most people can easily tolerate. "The
brain receives input from a wide variety of triggers—stress, hormones,
falling barometric pressure, food, drink, sleep disturbances," says
Dr. David Buchholz, a neurologist at the Johns Hopkins University School
of Medicine in Baltimore, Md. "Each of us has his own stack of triggers
and his own personal threshold at which the migraine mechanism activates.
The higher the trigger level climbs above the threshold, the more fully
activated the migraine system—and the more pain", which perfectly
describes a heightened sympathetic tone, as is seen in the spindle fibers
of migraine and headache sufferers.
There was no mention of the NTI device, the only non-drug, non-surgical
method approved for marketing by the FDA for the prevention of medically
diagnosed migraine pain. However, Botox was mentioned, but curiously,
as a "surprise": One of the surprises of the past couple of
years is the effectiveness of Botox, which is now being injected into
facial muscles to temporarily erase wrinkles. Migraineurs have reported
that botox seems to banish their headaches as well. Studies are under
way to see if those observations hold up. Botox studies continue to show
efficacy in migraine prevention (results vary greatly, due mostly to an
unstandardized protocol of injection placement). One of the leading hypotheses
of the efficacy of Botox involves "re-normalization
of excessive muscle spindle activity".
As more is learned and accepted by the pharmaceutically supported migraine
and headache management industry about the trigeminal and sympathetic
nervous system, "alternative" modalities such as the NTI may
become more widely accepted.
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