Painful Heat Reveals Hyperexcitability of the Temporal Pole in Interictal and Ictal Migraine States
Painful Heat Reveals Hyperexcitability of the Temporal Pole in Interictal and Ictal Migraine States
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DOI：
10.1093/cercor/bhq109
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发表时间：
2011-02-01
期刊：
影响因子：
3.7
通讯作者：
Borsook, D.
中科院分区：
文献类型：
--
作者：
Moulton, E. A.;Becerra, L.;Borsook, D.
在偏头痛发作期间，伴随头痛的感觉改变可能表现为异常性疼痛和对光、声音和气味的敏感性增强。我们的目的是确定偏头痛患者的皮质区域的生理变化，使用疼痛热和功能性磁共振成像（fMRI）和这种变化的结构基础，使用扩散张量成像（DTI）。在11名发作间期患者中，在fMRI扫描期间将疼痛热阈值+1 ℃单侧应用于前额。与健康受试者相比，患者内侧颞叶的激活明显更大，特别是前颞极（TP）。在患者中，TP显示出显着增加的功能连接在几个大脑区域相对于控制，这表明TP过度兴奋可能有助于偏头痛的功能异常。在9名健康受试者中，DTI鉴定了TP与枕核之间的白色连接，这与偏头痛有关。在8例患者中，偏头痛期间TP伴疼痛性发热的fMRI激活加剧，表明反复偏头痛可能使TP敏感。本文探讨了TP在偏头痛中的非经典作用。观察到的颞叶异常可能为偏头痛患者的许多感知变化提供基础，并可能作为药物疗效的潜在发作间期生物标志物。
During migraine attacks, alterations in sensation accompanying headache may manifest as allodynia and enhanced sensitivity to light, sound, and odors. Our objective was to identify physiological changes in cortical regions in migraine patients using painful heat and functional magnetic resonance imaging (fMRI) and the structural basis for such changes using diffusion tensor imaging (DTI). In 11 interictal patients, painful heat threshold + 1 degrees C was applied unilaterally to the forehead during fMRI scanning. Significantly greater activation was identified in the medial temporal lobe in patients relative to healthy subjects, specifically in the anterior temporal pole (TP). In patients, TP showed significantly increased functional connectivity in several brain regions relative to controls, suggesting that TP hyperexcitability may contribute to functional abnormalities in migraine. In 9 healthy subjects, DTI identified white matter connectivity between TP and pulvinar nucleus, which has been related to migraine. In 8 patients, fMRI activation in TP with painful heat was exacerbated during migraine, suggesting that repeated migraines may sensitize TP. This article investigates a nonclassical role of TP in migraineurs. Observed temporal lobe abnormalities may provide a basis for many of the perceptual changes in migraineurs and may serve as a potential interictal biomarker for drug efficacy.