Brainstem dysfunction in chronic migraine as evidenced by neurophysiological and positron emission tomography studies
Brainstem dysfunction in chronic migraine as evidenced by neurophysiological and positron emission tomography studies
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DOI：
10.1111/j.1526-4610.2007.00853.x
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发表时间：
2007-07-01
期刊：
影响因子：
5
通讯作者：
Khodavirdi, Ani
中科院分区：
文献类型：
--
作者：
Aurora, Sheena K.;Barrodale, Patricia M.;Khodavirdi, Ani
背景：慢性偏头痛 (CM) 的病理生理学尚未完全了解。我们的目的是检查 CM 患者皮层兴奋性的经颅磁刺激 (TMS) 指数，并进行 PET 研究，以确定是否存在任何可能存在相关性的激活和抑制区域。方法。-对 25 名 CM 患者使用经颅磁刺激，通过感知准确性磁抑制 (MSPA) 曲线的可靠参数来评估皮层的兴奋性。还对这 10 名患者进行了 (F-18-FDG PET) 扫描研究。结果-与正常对照和阵发性偏头痛相比，MSPA 表现出对 CM 的抑制作用降低。 CM 在 100 毫秒时报告正确的字母百分比为 84.37，而正常对照组为 19.14，阵发性偏头痛为 57.41。 10 名受试者的 PET 评估表明，与整体血流相比，脑干区域的脑代谢有所增加。内侧额叶、顶叶以及体感皮层的脑代谢区域也减少。结论：CM 患者的特征似乎是与高皮质兴奋性相关的视觉抑制减少。在这些受试者的队列中，大脑皮层某些区域存在脑干激活和抑制，表明抑制途径存在潜在功能障碍。
Background.-The pathophysiology of chronic migraine (CM) is not fully understood. We aimed to examine transcranial magnetic stimulation (TMS) indices of cortical excitability in patients with CM and also performed PET studies to ascertain if there were any areas of activation and inhibition for possible correlation.Methods.-Excitability of the cortex was assessed by a reliable parameter of magnetic suppression of perceptual accuracy (MSPA) profiles using transcranial magnetic stimulation in 25 patients with CM. Of these 10 patients were also studied with (F-18-FDG PET) scans.Results.-MSPA demonstrated decreased inhibition in CM compared to normal controls and episodic migraine. The percentage of letters reported correct at 100 ms was 84.37 for CM compared to 19.14 for normal controls and 57.41 for episodic migraine. The PET evaluation in 10 subjects demonstrated increased cerebral metabolism in areas of in the brainstem compared to the global flow. There were also decreased areas of cerebral metabolism in the medial frontal and parietal as well as the somatosensory cortex.Conclusions.-Patients with CM appear to be characterized by reduced visual suppression correlating with high cortical excitability. In a cohort of these subjects there was brainstem activation and inhibition in certain areas of the cortex suggesting a potential dysfunction in the inhibitory pathways.