Aberrant Neuromagnetic Signatures with Chronic Migraine

慢性偏头痛的异常神经磁特征

• 批准号: 8635429
• 负责人: Jing Xiang
• 金额: $ 18.09万
• 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 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8635429
• 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

ABSTRACT: 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.

摘要：慢性偏头痛是偏头痛的一种致残性并发症，头痛发生 15 次或以上。 每月天数。慢性偏头痛患者经常会出现药物过度使用性头痛，这可能会导致 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。自从痛苦一 慢性偏头痛患者通常会随着体力活动而恶化，并且往往难以达到标准 慢性偏头痛患者的生活质量非常低，这对社会产生了很大的影响。 偏头痛研究最重要的进展之一是确认皮质高和低 使用脑磁图 (MEG) 等非侵入性神经影像技术进行激活。脑磁图研究 偏头痛的研究表明，皮质激活正常化可以降低偏头痛的发病率 攻击。抗癫痫药物 (AED) 可能会改变皮质激活，通常对以下情况有效： 预防偏头痛。然而，慢性头痛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。潜在的大脑机制尚不清楚 并且很少对儿童慢性偏头痛进行研究。我们假设小儿慢性偏头痛是 与一组大脑区域的皮质过度激活和低激活有关。这个假设是基于 急性偏头痛皮质兴奋性的位置和程度的观察已被定量和 使用先进的 MEG 方法（例如波束成形和小波）进行无创测定。建立在我们的 根据偏头痛和 MEG 的研究经验，我们建议解决以下具体目标：（1）量化 慢性偏头痛儿童异常大脑激活的时空和光谱特征 MEG 引起头痛； (2) 确定大脑激活的时空和光谱变化 患有慢性偏头痛的儿童在临床治疗之前、期间和之后。本研究的创新点在于 慢性偏头痛中甚高频神经磁信号（高达 2884 Hz）的测量，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，我们可以精确地确定 拟议研究中的高频 MEG 数据皮质激活发生变化的位置和程度 慢性偏头痛。更清楚地了解异常皮质激活的位置和类型 发生时，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——可以指定， 改进，结果显着改善。鉴于高频神经磁信号是一种新的 生物标志物，使用先进的 MEG 方法对慢性偏头痛进行更深入的研究是我们下一步的关键步骤 了解偏头痛的病理生理学以及我们开发更好的治疗和预防的能力 策略。