The blink reflex in "chronic migraine"
The blink reflex in "chronic migraine"
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DOI：
10.1016/j.clinph.2006.10.011
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发表时间：
2007-02-01
影响因子：
4.7
通讯作者：
Accornero, Neri
中科院分区：
文献类型：
--
作者：
De Marinis, Milena;Pujia, Anna;Accornero, Neri
目的：三叉神经血管系统的激活和脑干三叉神经核的敏化被认为在偏头痛中起重要作用。本研究的目的是探讨瞬目反射和习惯化的患者与“慢性偏头痛”。方法：我们研究了35例患者患有“慢性偏头痛”（IHS分类标准）外，并在自发性发作，和35名对照组。使用具有特定习惯化测试程序的EMG装置来诱发和记录眨眼反射反应，并在不同的时间间隔随机重复刺激以诱导习惯化。基础瞬目反射的R-1和R-2潜伏期、幅度和面积在研究的患者和对照受试者中是相似的，而在发作期以外的患者中，眨眼反射习惯性反应显著降低。当以10、5、4、3、2和1秒的时间间隔给予刺激时，获得的R-2区域相对于基线值的百分比变化与在偏头痛发作期间研究的相同患者和对照受试者的百分比变化具有统计学差异（p < 0.01-p < 0.001）。眨眼反射的习惯性下降与更高的发作频率之间存在显着相关性。眨眼反射的刺激强度（检测阈值强度的倍数）显着降低（p < 0.001）的一侧受影响或更严重的影响，头痛的患者研究在偏头痛attack.Conclusions：下降的习惯性眨眼反射外的攻击反映异常兴奋性的“慢性偏头痛”，正常化的攻击。攻击频率与习惯化反应之间的负相关性证实了高频率攻击引起的异常兴奋性。中枢敏感机制（异常性疼痛）可以解释较低的检测阈值上观察到的一侧受头痛患者在attacks.Significance：眨眼反射和它的习惯化可能有助于阐明微妙的神经生理变化，发生在偏头痛患者之间和期间的攻击。(c)2006年国际临床神经生理学联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objectives: Activation of the trigeminovascular system and sensitisation of brainstem trigeminal nuclei are thought to play an important role in migraine. The aim of this study was to investigate the blink reflex and its habituation in patients with "chronic migraine".Methods: We studied 35 patients suffering from "chronic migraine" (IHS classification criteria) outside and during a spontaneous attack, and 35 control subjects. An EMG device with a specific habituation test program was used to elicit and record blink reflex responses and to randomly repeat stimulations at different time intervals so as to induce habituation.Results: The R-1 and R-2 latencies, amplitudes and areas of the basal blink reflex were similar in patients studied both outside and during an attack as well as in control subjects, whereas the blink reflex habituation responses were markedly reduced in patients studied outside an attack. The percent changes in the R-2 areas from the baseline values, obtained when stimuli were delivered at time intervals of 10, 5, 4, 3, 2 and 1 s, were statistically different (p < 0.01-p < 0.001) from those of the same patients studied during a migraine attack and of those of control subjects. There was a significant correlation between decreased habituation of the blink reflex and a higher frequency of attacks. The stimulus intensities of the blink reflex (multiples of the detection threshold intensities) were significantly lower (p < 0.001) on the side affected or more severely affected, by headache in patients studied during a migraine attack.Conclusions: The decreased habituation of the blink reflex outside an attack reflects abnormal excitability in "chronic migraine", which normalizes during the attacks. The inverse correlation between the frequency of attacks and habituation responses confirms the abnormal excitability induced by the high frequency of attacks. Central sensitisation mechanisms (allodynia) may explain the lower detection thresholds observed on the side affected by headache in patients during the attacks.Significance: The blink reflex and its habituation may help shed light on the subtle neurophysiological changes that occur in migraine patients between and during attacks. (c) 2006 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.