Aberrant Neuromagnetic Signatures with Chronic Migraine

慢性偏头痛的异常神经磁特征

• 批准号: 8742008
• 负责人: Jing Xiang
• 金额: $ 21.7万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8742008
• 关键词: Acupuncture procedure; Acute; Address; Adult; Affect; Aftercare; Analgesic Overuse Headaches; Anti-Inflammatory Agents; Anti-inflammatory; Antiepileptic Agents; Area; Biological Markers; Brain; Brain region; Cerebrum; Child; Childhood; Chronic; Chronic Headaches; Clinical; Clinical Treatment; Complication; Data; Development; Diagnosis; Disease; Disease Progression; Electroencephalography; Fingers; Frequencies; Functional disorder; Future; General Population; Goals; Headache; Incidence; Lead; Life; Location; Magnetoencephalography; Measurement; Measures; Methodology; Methods; Migraine; Modality; Motor Cortex; Outcome; Pain; Pathologic; Pathology; Patients; Pediatrics; Pharmaceutical Preparations; Physical activity; Play; Prevalence; Prevention; Prevention strategy; Process; Quality of life; Refractory; Reporting; Research; Research Personnel; Resolution; Role; Severities; Signal Transduction; Societies; Solutions; Specific qualifier value; Technology; Transcranial magnetic stimulation; base; effective therapy; experience; improved; innovation; neuroimaging; neurophysiology; prevent; public health relevance; response; spatiotemporal; standard care; treatment response; treatment strategy; triptans

DESCRIPTION (provided by applicant): Chronic migraine is a disabling complication of migraine with headaches that occurs 15 or more days per month. Patients with chronic migraine frequently experience medication overuse headaches that may further complicate this disorder and cause more problems for clinically treating headaches. Since the pain of a patient with chronic migraine typically worsens with physical activity and is often refractory to standard treatment, patients with chronic migraine have very low qualities of life which in term greatly impacts society. One of the most important advances in migraine research is the confirmation of cortical hyper- and hypo- activation with non-invasive neuroimaging technologies such as magnetoencephalography (MEG). MEG study of migraine has shown that the normalization of cortical activation can reduce the incidence of migraine attacks. Antiepileptic drugs (AED), which may change cortical activation, are frequently effective in the prevention of migraine. However, cortical dysfunction in chronic headaches can be hyper- or hypo-activation which depends on the pathology and brain regions. The underlying cerebral mechanism is poorly understood and has rarely been studied in pediatric chronic migraine. We hypothesize that pediatric chronic migraine is associated with cortical hyper- and hypo-activation in a set of brain areas. This hypothesis is based on the observations that the location and degree of cortical excitability in acute migraine have been quantitatively and noninvasively determined with advanced MEG methods such as beamforming and wavelet. Building on our research experience in migraine and MEG, we propose to address the following specific aims: (1) quantify the spatiotemporal and spectral signatures of aberrant brain activation in children with chronic migraine during headache attacks with MEG; (2) determine the spatiotemporal and spectral changes of brain activation in children with chronic migraine before, during and after clinical treatment. The innovation of the present study is the measurements of very high-frequency neuromagnetic signals (up to 2884 Hz) in chronic migraine because MEG study of migraine is conventionally limited to a low-frequency range (< 70 Hz). Since high-frequency neuromagnetic signals are well localized to focal brain areas, if successful, we can precisely determine with high-frequency MEG data in the proposed study where and to what degree cortical activation changed in chronic migraine. With a clearer understanding of the location and types of aberrant cortical activation occurring, all of the treatments targeted at cortical excitability (e.g. AED, transcranial magnetic stimulation, transcranial direct current stimulation, acupuncture) - which currently show great promise -could be specified, refined and their outcomes significantly improved. Given that high-frequency neuromagnetic signals are a new biomarker, a more in-depth study of chronic migraine with advanced MEG methods is a critical next step in our understanding of migraine pathophysiology and our ability to develop better treatment and prevention strategies.

描述（由申请人提供）：慢性偏头痛是偏头痛的一种致残性并发症，伴有每月发生 15 天或以上的头痛。慢性偏头痛患者经常会出现药物过度使用性头痛，这可能会使这种疾病进一步复杂化，并给临床治疗头痛带来更多问题。由于慢性偏头痛患者的疼痛通常会随着体力活动而加剧，并且通常难以接受标准治疗，因此慢性偏头痛患者的生活质量非常低，这对社会产生了很大影响。偏头痛研究最重要的进展之一是通过脑磁图 (MEG) 等非侵入性神经影像技术确认皮质过度激活和低激活。偏头痛的 MEG 研究表明，皮质激活正常化可以减少偏头痛发作的发生率。抗癫痫药物 (AED) 可能会改变皮质激活，通常可以有效预防偏头痛。然而，慢性头痛中的皮质功能障碍可能是过度激活或低激活，这取决于病理学和大脑区域。人们对儿童慢性偏头痛的潜在大脑机制知之甚少，也很少进行研究。我们假设小儿慢性偏头痛与一组大脑中的皮质过度激活和低激活有关 地区。这一假设基于以下观察：急性偏头痛中皮质兴奋性的位置和程度已通过先进的 MEG 方法（例如波束形成和小波）定量且无创地确定。基于我们在偏头痛和 MEG 方面的研究经验，我们建议解决以下具体目标：（1）量化 MEG 头痛发作期间慢性偏头痛儿童异常大脑激活的时空和光谱特征； (2)测定慢性偏头痛患儿临床治疗前、治疗中、治疗后大脑激活的时空和光谱变化。本研究的创新之处在于测量慢性偏头痛的甚高频神经磁信号（高达 2884 Hz），因为偏头痛的 MEG 研究传统上仅限于低频范围（< 70 Hz）。由于高频神经磁信号很好地定位于大脑的焦点区域，如果成功，我们可以在拟议的研究中使用高频脑磁图数据精确确定慢性偏头痛中皮质激活的变化位置和程度。随着对异常皮质激活发生的位置和类型有了更清晰的了解，所有针对皮质兴奋性的治疗（例如 AED、经颅磁刺激、经颅直流电刺激、 针灸）——目前显示出巨大的前景——可以被具体化、完善，并且其结果将得到显着改善。鉴于高频神经磁信号是一种新的生物标志物，利用先进的 MEG 方法对慢性偏头痛进行更深入的研究是我们了解偏头痛病理生理学以及开发更好的治疗和预防策略的能力的关键下一步。