A PET study exploring the laterality of brainstem activation in migraine using glyceryl trinitrate
A PET study exploring the laterality of brainstem activation in migraine using glyceryl trinitrate
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DOI：
10.1093/brain/awh416
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发表时间：
2005-04-01
期刊：
影响因子：
14.5
通讯作者：
Goadsby, PJ
中科院分区：
文献类型：
--
作者：
Afridi, SK;Matharu, MS;Goadsby, PJ
偏头痛是一种常见的致残状态，可能与涉及疼痛和其他感觉方式的大脑通路功能障碍有关。这种疾病的一个主要特征，实际上是标志性的，导致了它的名字，那就是疼痛可能是偏侧的。用(H2O)-O-15标记的正电子发射计算机断层扫描(PET)对24例偏头痛患者和8例健康对照进行研究。根据头痛的部位，偏头痛患者被分为三组：右侧、左侧或双侧。在每组中，使用硝酸甘油(GTN)注射诱导偏头痛。受试者在预定的时间点进行扫描：输液前、GTN期间、偏头痛期间和偏头痛后。采用SPM99软件对数据进行统计分析。与无痛状态相比，偏头痛患者和对照组相比，在偏头痛状态和无痛状态下，脑干在背侧桥(小体积矫正后P<；0.05)被显著激活。当每组分别分析时，为了研究偏侧性，发现右侧和左侧组的脑桥背侧激活是同侧的，而在双侧头痛组中左侧占优势的双侧。与以前的工作一致，在舒马曲坦控制疼痛后，这种激活仍然存在。这些结果表明，偏头痛疼痛的偏侧化是由于偏侧化的脑功能障碍。
Migraine is a common disabling condition likely to be associated with dysfunction of brain pathways involved in pain and other sensory modalities. A cardinal, indeed signature, feature of the disorder that led to its name is that the pain may be lateralized. (H2O)-O-15-labelled PET was used to study 24 migraineurs and eight healthy controls. The migraineurs were divided into three groups according to the site of their headache: right, left or bilateral. In each group, a migraine was induced using a glyceryl trinitrate (GTN) infusion. The subjects were scanned at predefined points: pre-infusion, during GTN, during migraine and post-migraine. SPM99 software was used to analyse the data. Significant brainstem activation was seen in the dorsal lateral pons (P < 0.05 after small volume correction) during the migraine state versus the pain-free state when comparing migraineurs with controls. When each group was analysed separately, to investigate laterality, it was found that the dorsal pontine activation was ipsilateral in the right-sided and left-sided groups and bilateral in the bilateral headache group with a left-sided preponderance. Consistent with previous work, the activation persisted after pain was controlled by sumatriptan. These results suggest that lateralization of pain in migraine is due to lateralized brain dysfunction.