The occipital cortex is hyperexcitable in migraine: Experimental evidence
The occipital cortex is hyperexcitable in migraine: Experimental evidence
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DOI：
10.1046/j.1526-4610.1999.3907469.x
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发表时间：
1999-07-01
期刊：
影响因子：
5
通讯作者：
Welch, KMA
中科院分区：
文献类型：
--
作者：
Aurora, SK;Cao, Y;Welch, KMA
目标。据报道，偏头痛患者产生磁磷吩的阈值较低。我们比较了阈值诱发光幻视经颅磁刺激和视觉触发头痛的能力在一组选择的个人偏头痛和无先兆正常对照。使用Cadwell MES-10刺激器进行经颅磁刺激。将直径为9.5 cm的圆形线圈应用于枕骨头皮（隆突上方7 cm）。刺激器强度以10%的增量增加，直到受试者报告视觉现象或达到100%强度。然后微调刺激器强度以确定看到光幻视的阈值。在相同的受试者中，在3.0 T MRI中给予视觉刺激，如果发生头痛，则记录反应。15名偏头痛患者与8名对照组进行了比较。与对照组（25%）相比，偏头痛患者（86.7%）的显著比例（P= 0.006）出现光幻视。偏头痛患者引发头痛的概率也更高（53%）;对照组没有引发头痛（P= 0.019）。经颅磁刺激光幻视阈值与视觉触发头痛之间存在显著相关性（P= 0.002）。当仅考虑偏头痛时，再次出现显著趋势（P=.084）。偏头痛患者和对照组枕叶皮层兴奋性阈值存在差异。偏头痛患者视觉皮层过度兴奋易诱发视觉性头痛。
Objectives.-Threshold for generation of magnetophosphenes has been reported to be lower in migraine. We compared the threshold for eliciting phosphenes by transcranial magnetic stimulation and the ability to visually trigger headache in a select group of individuals with migraine with and without aura to normal controls.Methods.-Transcranial magnetic stimulation was performed using the Cadwell MES-10 stimulator. A circular coil, 9.5 cm in diameter, was applied to the occipital scalp (7 cm above the inion). Stimulator intensity was increased in 10% increments until subjects reported visual phenomena or 100% intensity was reached. Stimulator intensity was then fine-tuned to determine the threshold at which phosphenes were seen. In the same subjects, visual stimulation was given in 3.0 T MRI and if a headache occurred the response was recorded.Results.-Fifteen subjects with migraine were compared to 8 controls. A significant proportion of the migraineurs (86.7%) developed phosphenes compared to the controls (25%) (P=.006). The probability of triggering a headache was also higher in the migraineurs (53%); no headache was triggered in the controls (P=.019). A significant correlation was found between the threshold for phosphenes on transcranial magnetic stimulation and visually triggered headache (P=.002). When only migraine was considered, there was again a significant trend (P=.084).Conclusions.-There is a difference in threshold for excitability of occipital cortex in migraineurs and controls. The hyperexcitable visual cortex in migraine is predisposed to visually triggered headache.