Can cortical spreading depression activate central trigeminovascular neurons without peripheral input? Pitfalls of a new concept.

The author discusses the role of cortical projections to the medullary dorsal horn in trigeminal nociception, based on a study by Lambert and colleagues published in this journal. The study considered the debate on whether the activation of the central trigeminovascular neurons by cortical spreading depression (CSD) depends on peripheral input. The study is questioned based on studies that emphasized the role of peripheral nociceptors in the activation of central trigeminovascular neurons.