Functional MRI-BOLD of brainstem structures during visually triggered migraine
Functional MRI-BOLD of brainstem structures during visually triggered migraine
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DOI：
10.1212/wnl.59.1.72
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发表时间：
2002-07-09
期刊：
影响因子：
9.9
通讯作者：
Welch, KMA
中科院分区：
文献类型：
--
作者：
Cao, Y;Aurora, SK;Welch, KMA
背景资料：以前，在有先兆的自发性偏头痛期间，报告了红核和黑质中的高氧和血容量增加。目的：为了进一步了解这些中心的病理生理作用，在视觉触发偏头痛患者中研究了脑干结构的激活。研究方法：采用血氧水平依赖（BOLD）fMRI技术，对26例偏头痛患者（23例有先兆，3例无先兆）和10例正常对照者进行了重复棋盘格视觉刺激下的研究。覆盖枕叶皮质和脑干的三个轴向图像切片以3.5秒的时间分辨率采集224次。结果如下：重复的视觉刺激触发了12名患者的症状; 4名有先兆的偏头痛患者同时出现视觉症状和头痛，6名有先兆的偏头痛患者和2名无先兆的偏头痛患者仅出现头痛。四名有先兆偏头痛的患者在实验期间或实验后立即经历了他们通常的先兆发作或典型头痛的发作。在剩下的10名偏头痛患者和所有对照组中，视觉刺激在任何时候都没有引发症状。在刺激期间出现症状的75%的患者中，在枕叶皮质信号升高或视觉触发症状发作之前，红核和黑质的基线T2* 加权MR信号强度增加。结论：红核和黑质的激活（高氧和血容量增加）与偏头痛的视觉触发症状相关，表明这些脑干结构是发作期间激活的神经元网络的一部分。
Background: Previously, hyperoxia, and blood volume increase were reported in the red nucleus and substantia nigra during spontaneous migraine with aura. Objective: To further understand the pathophysiologic role of these centers, activation of brainstem structures was investigated in patients with visually triggered migraine. Methods: Twenty-six patients with migraine (23 with aura and 3 without aura), and 10 normal control subjects were studied with blood oxygen level-dependent (BOLD) fMRI during repeated checkerboard visual stimulation. Three axial image sections, which covered the occipital cortex and brainstem, were acquired 224 times with a temporal resolution of 3.5 seconds. Results: Repetitive visual stimulation triggered symptoms in 12 patients; four who had migraine with aura developed both visual symptoms and headaches, and six who had migraine with aura and two who had migraine without aura had headaches only. Four patients who had migraine with aura experienced the onset of their usual aura or onset of their typical headache either during the experiment or immediately after. In the remaining 10 patients with migraine, and all control subjects, visual stimulation failed to trigger symptoms at any time. In 75% of the patients who developed symptoms during stimulation, baseline T2*-weighted MR signal intensities increased in the red nucleus and substantia nigra before occipital cortex signal elevation or the onset of visually triggered symptoms. Conclusion: Activation (hyperoxia and blood volume increase) of the red nucleus and substantia nigra in association with visually triggered symptoms of migraine suggest that these brainstem structures are a part of a neuronal network activated during an attack.