Reduced Cerebellar Inhibition in Migraine with Aura: A TMS Study
Reduced Cerebellar Inhibition in Migraine with Aura: A TMS Study
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DOI：
10.1007/s12311-008-0090-4
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发表时间：
2009-09-01
期刊：
影响因子：
3.5
通讯作者：
Fierro, Brigida
中科院分区：
文献类型：
--
作者：
Brighina, Filippo;Palermo, Antonio;Fierro, Brigida
在偏头痛中发现了细微的临床小脑改变。此外，在偏头痛中已经描述了与缺乏抑制效率一致的视觉和运动皮层兴奋性的异常，并且已知小脑对大脑皮层施加抑制控制。在这里，我们调查了运动皮层小脑活动的损害，即抑制控制减少，可以在偏头痛中发现。10名有先兆的偏头痛患者和7名健康对照者接受了经颅磁刺激（TMS）方案，以研究小脑对运动皮层的抑制驱动：在对侧运动皮层进行测试刺激（TS）之前，在右侧小脑皮层上施加条件脉冲5，7，10，15 ms。小脑条件刺激抑制由TS单独产生的运动诱发电位（MEP）的大小约30- 50%。MEP对TS的振幅在患者和对照组之间无显著差异。与对照组相比，偏头痛患者的小脑条件性TMS在所有测试的刺激间隔（5-15 ms）显示出小脑抑制的显著缺陷。偏头痛患者的小脑抑制减少。这可以解释，至少部分地，以前在这些患者的大脑皮层中显示的抑制效率降低。
Subtle clinical cerebellar alterations have been found in migraine. Moreover, abnormalities in visual and motor cortex excitability consistent with a lack of inhibitory efficiency have been described in migraine, and it is known that cerebellum exerts an inhibitory control on cerebral cortex. Here, we investigated if impairment of cerebellar activity on motor cortex, i.e. reduced inhibitory control, can be found in migraine. Ten migraineurs with aura and seven healthy controls underwent a transcranial magnetic stimulation (TMS) protocol to investigate the cerebellar inhibitory drive on motor cortex: a conditioning pulse on right cerebellar cortex was delivered 5, 7, 10, 15 ms before a test stimulus (TS) on contralateral motor cortex. The cerebellar conditioning stimulus inhibits the size of the motor-evoked potential (MEP) produced by the TS alone by approximately 30-50%. Amplitude of MEP to TS alone showed no significant difference between patients and controls. Cerebellar conditioning TMS showed a significant deficit of cerebellar inhibition in migraine patients as compared to controls at all interstimulus intervals (5-15 ms) tested. Cerebellar inhibition is reduced in migraineurs. This could account, at least in part, for the reduced inhibitory efficiency previously showed in cerebral cortex of these patients.