Spinal Reflexes in Migraine

In this chapter the contribution offered by the study of the spinal reflexes to the understanding of migraine physiopathology is discussed: how the spinal reflexes contributed to the insight that the abnormal pain processing at the basis of migraine pain is not just confined to the cranial structures but represents a widespread phenomenon involving the control of pain of the whole body. The most extensively studied spinal reflex response in migraine is the nociceptive flexion or withdrawal reflex (NWR) of the lower limb. The NWR represents an objective direct measure of the functional activity of the nociceptive system in humans and, as it is modulated by descending cortico-subcortical pathways, also reflects the activity of the supraspinal control pain systems.