Cerebellar and Cerebral Autoregulation in Migraine
Cerebellar and Cerebral Autoregulation in Migraine
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DOI：
10.1161/strokeaha.111.644674
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发表时间：
2012-04-01
期刊：
影响因子：
8.3
通讯作者：
Kaube, Holger
中科院分区：
文献类型：
--
作者：
Reinhard, Matthias;Schork, Joscha;Kaube, Holger
背景和目的：无症状缺血性脑损伤常发生在有先兆的偏头痛患者，且最常位于小脑边缘区。这可能意味着小脑血流自动调节功能受损。本研究探讨了发作间期小脑自动调节的特点偏头痛和无aire. Methods-34例患者（n = 17，偏头痛无先兆; n = 17，偏头痛有先兆）和35个年龄和性别匹配的对照进行了研究。对一条小脑后下动脉、右侧大脑后动脉和左侧大脑中动脉进行三重同时经颅多普勒监测。通过自发性血压波动评估自动调节动力学（相关系数指数Dx）和振荡诱导的0.1 Hz血压振荡（相位和增益）。结果-与对照组相比，自身调节指数Dx较高小脑后下动脉（表明自动调节较少）（P = 0.0062）和大脑中动脉（P = 0.0078），而无先兆偏头痛则无此差异。偏头痛患者和对照组之间的相位和增益没有显着差异。自动调节与临床因素没有显着的关联，包括偏头痛发作的频率和直立性intolerance. Conclusions，这是第一次分析偏头痛小脑自动调节没有表现出一个特定的小脑autoregulation在发作间期。然而，在小脑和前循环中有先兆的偏头痛患者中，更多的静态自动调节特性（指数Dx）受损。有先兆偏头痛患者小脑缺血性病变的好发可能是自身调节改变和其他因素（如终末动脉小脑血管结构）共同作用的结果。（中风。2012;43：987-993.）
Background and Purpose-Silent ischemic brain lesions frequently occur in migraine with aura and are most often located in cerebellar border zones. This may imply an impairment of cerebellar blood flow autoregulation. This study investigated the characteristics of interictal cerebellar autoregulation in migraine with and without aura.Methods-Thirty-four patients (n = 17, migraine without aura; n = 17, migraine with aura) and 35 age-and sex-matched controls were studied. Triple simultaneous transcranial Doppler monitoring of one posterior inferior cerebellar artery, right posterior cerebral artery, and left middle cerebral artery was performed. Autoregulation dynamics were assessed from spontaneous blood pressure fluctuations (correlation coefficient index Dx) and from respiratory-induced 0.1-Hz blood pressure oscillations (phase and gain).Results-Compared with controls, the autoregulatory index Dx was higher (indicating less autoregulation) in the posterior inferior cerebellar artery (P = 0.0062) and middle cerebral artery (P = 0.0078) in migraine with aura, but not in migraine without aura. Phase and gain did not significantly differ between migraine patients and controls. No significant associations of autoregulation with clinical factors were found, including frequency of migraine attacks and orthostatic intolerance.Conclusions-This first-time analysis of cerebellar autoregulation in migraine did not show a specific cerebellar dysautoregulation in the interictal period. More static autoregulatory properties (index Dx) are, however, impaired in persons with migraine with aura both in the cerebellar and anterior circulation. The cerebellar predilection of ischemic lesions in migraine with aura might be a combination of altered autoregulation and additional factors, such as the end artery cerebellar angioarchitecture. (Stroke. 2012;43:987-993.)