A positron emission tomographic study in spontaneous migraine
A positron emission tomographic study in spontaneous migraine
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DOI：
10.1001/archneur.62.8.1270
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发表时间：
2005-08-01
影响因子：
--
通讯作者：
Goadsby, PJ
中科院分区：
文献类型：
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作者：
Afridi, SK;Giffin, NJ;Goadsby, PJ
背景：急性偏头痛的脑功能成像已被证明是具有挑战性的，因为与发作性疾病相关的逻辑问题。自从对偏头痛脑干激活的开创性观察以来，只有一个病例证实了这一发现。目的：检验偏头痛脑干激活可以检测到的假设，并使用比以前使用的更高分辨率的正电子发射断层扫描来细化解剖定位。设计：使用正电子发射断层扫描与放射性水（（H2O）-O-15），我们研究了急性偏头痛发作自发发生。5例患者在发作期和发作间期进行了成像，并通过统计参数图分析了差异。设置：三级转诊中心。患者：6名发作性偏头痛的志愿者是从偏头痛通讯的广告中招募的。一名患者被排除，因为使用预防性medication.Main结果测量：脑干激活偏头痛状态与发作间期states.Results：两名患者有一个典型的偏头痛的先兆发作前的头痛。所有研究的发作都符合偏头痛的标准诊断标准。比较偏头痛扫描与发作间期扫描，有显着激活的背侧脑桥脑，偏左（小容量校正，P = 0.003）。在右侧前扣带回、后扣带回、小脑、丘脑、丘脑、前额叶皮质和颞叶中也观察到激活。有一个区域的失活偏头痛阶段也位于脑桥，偏侧的right.Conclusions：我们的研究结果提供了明确的证据，背侧脑桥激活偏头痛和加强认为，偏头痛是一种皮质下疾病调制传入神经交通。
Background: Functional brain imaging in acute migraine has proved challenging because of the logistic problems associated with an episodic condition. Since the seminal observation of brainstern activation in migraine, there has been only a single case substantiating this finding.Objective: To test the hypothesis that brainstem activation could be detected in migraine and to refine the anatomic localization with higher-resolution positron emission tomography than previously used.Design: Using positron emission tomography with radioactive water ((H2O)-O-15), we studied acute migraine attacks occurring spontaneously. Five patients underwent imaging in ictal and interictal states, and the differences were analyzed by means of statistical parametric mapping. Setting: Tertiary referral center.Patients: Six volunteers with episodic migraine were recruited from advertisements in migraine newsletters. One patient was excluded because of use of preventive medication.Main Outcome Measure: Brainstem activation during migraine state vs interictal state.Results: Two patients had a typical migrainous aura before the onset of the headache. All of the attacks studied fulfilled standard diagnostic criteria for migraine. Comparing the migraine scans with interictal scans, there was significant activation in the dorsal pons, lateralized to the left (small volume correction, P =.003). Activation was also seen in the right anterior cingulate, posterior cingulate, cerebellum, thalamus, insula, prefrontal cortex, and temporal lobes. There was an area of deactivation in the migraine phase also located in the pons, lateralized to the right.Conclusions: Our findings provide clear evidence of dorsal pontine activation in migraine and reinforce the view that migraine is a subcortical disorder modulating afferent neural traffic.