Abstract
BackgroundMany human and animal studies have shown the influence of nicotine and caffeine on pain perception and processing. This study aims to investigate whether smoking or caffeine consumption influences trigeminal pain processing.MethodsSixty healthy subjects were investigated using simultaneous recordings of the nociceptive blink reflex (nBR) and pain related evoked potentials (PREP) following nociceptive electrical stimulation on both sides of the forehead (V1). Thirty subjects were investigated before and after smoking a cigarette, as well as before and after taking a tablet of 400 mg caffeine.ResultsAfter smoking PREP showed decreased N2 and P2 latencies indicating central facilitation at supraspinal (thalamic or cortical) level. PREP amplitudes were not changed. NBR showed a decreased area under the curve (AUC) indicating central inhibition at brainstem level. After caffeine intake no significant changes were observed comparing nBR and PREP results before consumption.ConclusionsSmoking influences trigeminal pain processing on supraspinal and brainstem level. In the investigated setting, caffeine consumption does not significantly alter trigeminal pain processing. This observation might help in the further understanding of the pathophysiology of pain disorders that are associated with excessive smoking habits such as cluster headache. Previous smoking has to be taken into account when performing electrophysiological studies to avoid bias of study results.
Highlights
Many human and animal studies have shown the influence of nicotine and caffeine on pain perception and processing
Smoking and caffeine consumption is quite common in the general population, and even more pronounced in some patient populations
Our results show inhibition at brainstem level and facilitation at supraspinal level of trigeminal pain processing after smoking a cigarette in healthy volunteers
Summary
Many human and animal studies have shown the influence of nicotine and caffeine on pain perception and processing. This study aims to investigate whether smoking or caffeine consumption influences trigeminal pain processing. The influence of caffeine and nicotine on pain processing is well described in the literature. Smoking and caffeine consumption is quite common in the general population, and even more pronounced in some patient populations Caffeine itself can induce or exacerbate some pain entities (e.g. migraine [2], caffeine-withdrawal headache [3]). Smokers are more prone to develop back pain, and general chronic pain conditions [4,5,6,7,8,9,10,11,12,13,14]. Higher pain intensity scores were reported in smokers [15]
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