Interictal dysfunction of a brainstem descending modulatory center in migraine patients.
Interictal dysfunction of a brainstem descending modulatory center in migraine patients.
复制标题
偏头痛患者的脑干下降调节中心的间隔功能障碍。
DOI：
10.1371/journal.pone.0003799
复制
发表时间：
2008
期刊：
影响因子：
3.7
通讯作者：
Borsook, David
中科院分区：
文献类型：
--
作者：
Moulton, Eric A.;Burstein, Rami;Tully, Shannon;Hargreaves, Richard;Becerra, Lino;Borsook, David
脑干含有下行回路，可以调节脊髓背角和延髓背角的伤害性处理(与疼痛相关的神经信号)。偏头痛患者发作时脑干功能的异常提示下行调节功能障碍可能通过减少下行抑制或增加易化来促进偏头痛的发作。为了确定脑干功能障碍是否可以在促进偏头痛发作方面发挥作用，我们测量了偏头痛患者在没有发作(即发作间歇期)时的脑干功能。利用功能磁共振成像技术，我们对12例发作性偏头痛患者发作间期的脑干活动与热刺激进行了对比研究。收集单独的扫描来测量对41°C和有害高温(痛阈值+1°C)的反应。刺激要么施加在患侧的前额上(据报道在发作期间)，要么施加在手背上。这在12名年龄性别匹配的对照组受试者中重复，测试的一侧与匹配的偏头痛患者的一侧一致。楔状核(NCF)是脑干疼痛调制回路的一个组成部分，在偏头痛患者中似乎功能低下。在4种热刺激条件中，3种条件下对照组的NCF活性显著高于偏头痛患者。下行调制的改变被认为与偏头痛有关，导致抑制丧失或易化增强，从而导致三叉神经血管神经元的过度兴奋。NCF功能可以潜在地作为偏头痛患者的诊断指标，即使在没有发作的情况下也是如此。这对评估偏头痛的治疗方法具有重要意义。
The brainstem contains descending circuitry that can modulate nociceptive processing (neural signals associated with pain) in the dorsal horn of the spinal cord and the medullary dorsal horn. In migraineurs, abnormal brainstem function during attacks suggest that dysfunction of descending modulation may facilitate migraine attacks, either by reducing descending inhibition or increasing facilitation. To determine whether a brainstem dysfunction could play a role in facilitating migraine attacks, we measured brainstem function in migraineurs when they were not having an attack (i.e. the interictal phase). Using fMRI (functional magnetic resonance imaging), we mapped brainstem activity to heat stimuli in 12 episodic migraine patients during the interictal phase. Separate scans were collected to measure responses to 41°C and noxious heat (pain threshold+1°C). Stimuli were either applied to the forehead on the affected side (as reported during an attack) or the dorsum of the hand. This was repeated in 12 age-gender-matched control subjects, and the side tested corresponded to that in the matched migraine patients. Nucleus cuneiformis (NCF), a component of brainstem pain modulatory circuits, appears to be hypofunctional in migraineurs. 3 out of the 4 thermal stimulus conditions showed significantly greater NCF activation in control subjects than the migraine patients. Altered descending modulation has been postulated to contribute to migraine, leading to loss of inhibition or enhanced facilitation resulting in hyperexcitability of trigeminovascular neurons. NCF function could potentially serve as a diagnostic measure in migraine patients, even when not experiencing an attack. This has important implications for the evaluation of therapies for migraine.
登录
查看更多内容
影响因子：
2.5
作者：
Olausson, Hakan W.;Cole, Jonathan;Bushnell, M. Catherine
通讯作者：
Bushnell, M. Catherine
影响因子：
2.5
作者：
Ossipov, MH;Sun, H;Porreca, F
通讯作者：
Porreca, F
影响因子：
2.5
作者：
Haghparast, Abbas;Soltani-Hekmat, Ava;Komaki, Alireza
通讯作者：
Komaki, Alireza
影响因子：
5
作者：
Loder, E;Biondi, D
通讯作者：
Biondi, D
影响因子：
9.9
作者：
Kurth, T;Slomke, MA;Buring, JE
通讯作者：
Buring, JE