Electrophysiological correlates of episodic migraine chronification: evidence for thalamic involvement.
Electrophysiological correlates of episodic migraine chronification: evidence for thalamic involvement.
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DOI：
10.1186/1129-2377-14-76
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发表时间：
2013-09-09
期刊：
影响因子：
--
通讯作者：
Pierelli F
中科院分区：
文献类型：
--
作者：
Coppola G;Iacovelli E;Bracaglia M;Serrao M;Di Lorenzo C;Pierelli F
发作性偏头痛的特征是高频体感振荡（HFO）减少，反映了丘脑-皮层活动，以及低频（LF-）体感诱发电位（SSEP）对发作之间重复感觉刺激的适应性不足。在这里，我们研究了传统的LF-SSEP和HFO在发作性偏头痛谁发展为慢性偏头痛（CM）。34例发作性（15例发作间期[MOii]，19例发作期[MOi]）和19例CM患者接受了右侧正中神经SSEP。将患者组与年龄和性别分布相当的20名健康志愿者（HV）组进行比较。我们测量了N20-P25 LF-SSEP第一振幅阻滞和习惯化，并在应用带通滤波器（450-750 Hz）后，测量了最大峰-峰潜伏期以及早期和晚期HFO的振幅。早期HFO减少、第一阻滞LF-SSEP降低和习惯性不足表征MOii。最初较高的SSEP振幅和晚期正常习惯化表征CM和MOi患者。数字滤波后，两组患者均显示潜伏期峰值缩短，早期HFO振幅正常化，晚期HFO增加。当合并MO和CM患者的数据时，每月头痛天数与LF-SSEP斜率呈负相关（r =-0.385，p = 0.006），而LF-SSEP斜率又与第一振幅阻滞呈负相关（r = 0.568，p < 0.001）。我们的研究结果表明，在发作期偏头痛发作期间也报告了慢性偏头痛的异常，即早期反应敏感化和晚期习惯化。HFO分析表明，与发作之间的阵发性偏头痛相比，这种感觉敏感化可能是由于丘脑和皮质之间的连接强度增加而解释的。这种电功能行为是否是日常头痛的原发性或继发性，从而反映了躯体感觉系统中枢敏化过程的电生理指纹，仍有待确定。
Episodic migraine is characterized by decreased high-frequency somatosensory oscillations (HFOs), reflecting thalamo-cortical activity, and deficient habituation of low-frequency (LF-) somatosensory evoked potentials (SSEPs) to repetitive sensory stimulation between attacks. Here, we study conventional LF-SSEPs and HFOs in episodic migraineurs who developed chronic migraine (CM). Thirty-four episodic (15 interictally [MOii], 19 ictally [MOi]) and 19 CM patients underwent right median nerve SSEPs. The patient groups were compared to a group of 20 healthy volunteers (HV) of comparable age and gender distribution. We measured the N20-P25 LF-SSEP 1st amplitude block and habituation, and, after applying a band-pass filter (450–750 Hz), maximal peak-to-peak latency and the amplitudes of the early and late HFOs. Reduced early HFOs, lower 1st block LF-SSEPs and deficient habituation characterize MOii. Initially higher SSEP amplitudes and late normal habituation characterize both CM and MOi patients. After the digital filtration, both patient groups showed shortened latency peaks and normalization of early HFO amplitudes with increased late HFOs. When data of MO and CM patients were combined, the monthly number of days with headache negatively correlated with the LF-SSEP slope (r = −0.385, p = 0.006), which in turn negatively correlated with the 1st amplitude block (r = 0.568, p < 0.001). Our results show abnormalities in chronic migraine that are also reported during attacks in episodic migraineurs, namely early response sensitization and late habituation. The HFO analysis suggests that this sensory sensitization may be explained by an increase in the strength of the connections between the thalamus and cortex compared to episodic migraine between attacks. Whether this electro-functional behaviour is primary or secondary to daily headache, thus reflecting an electrophysiological fingerprint of the somatosensory system central sensitization process, remains to be determined.
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作者：
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通讯作者：
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