Brain Markers of Low and High Frequency Episodic Migraine

描述(申请人提供)：偏头痛是一个巨大的临床问题，影响着超过2500万美国人，花费数十亿美元。发作性偏头痛是一种反复发作的头痛，每月发生1-14天。它可能有先兆，也可能没有先兆(通常会发展和缓解的局灶性神经症状)。大多数(80%-95%)偏头痛患者在一生中仍呈发作性发作，发作频率低(每月1-4次)，但也有一些(约5%)患者从低发作频率发展为高频发作，然后发展为日常头痛/偏头痛。这种疾病尚未解开的谜团之一是大脑在从低频(LF)发作表现到更频繁的高频(HF)或慢性日常头痛的过程中如何变化的本质。在这里，我们建议评估功能、形态计量(灰质体积和白质完整性)和化学(兴奋性和抑制性代谢物的测量)在不同的LF和HF急性发作期偏头痛队列中的变化。具体地说，我们将在(1)有或没有先兆的LF偏头痛患者与健康的年龄、性别、教育水平和匹配的对照组中进行比较；(2)有或没有先兆的HF偏头痛患者有健康的年龄、性别、教育水平和匹配的对照组；(3)LF有或没有先兆的HF偏头痛患者。我们希望验证这一假设，即随着偏头痛频率的增加，兴奋性氨基酸的增加和抑制性氨基酸的减少会导致大脑结构和功能的改变。我们在成像、偏头痛神经生物学和神经学方面拥有必要的专业知识，并为拟议研究的每个方面提供了初步数据。

DESCRIPTION (provided by applicant): Migraine is a huge clinical problem affecting over 25 million Americans and costing billions of dollars. Episodic migraine is a recurrent headache that occurs 1-14 days per month. It may occur with or without aura (focal neurological symptoms that usually develop and resolve). Most (80-95%) migraine patients remain episodic with low frequency attacks (1-4 attacks per month) throughout their lives whereas some (about 5%) progress from low to high frequency and then to daily headache/migraine. One of the unsolved mysteries of the disease is the nature of how the brain changes in progressing from the low frequency (LF) episodic manifestation to the more frequent high frequency (HF) or chronic daily headache. Here we propose to evaluate functional, morphometric (gray matter volume and white matter integrity) and chemical (measures of excitatory and inhibitory metabolites) changes in the brains of separate cohorts of LF and HF acute episodic migraineurs. Specifically we will compare these three brain measures in (1) LF migraineurs with and without aura with healthy age, gender, education level, matched controls; (2) HF migraineurs with and without aura with healthy age, gender, education level, matched controls; and (3) LF with HF migraineurs with and with out aura. We wish to test the hypothesis that with increased migraine frequency, increased excitatory amino acids and decreased inhibitory amino acids lead to alterations in brain structure and function. We have the necessary expertise in imaging, migraine neurobiology and neurology, and preliminary data for each aspect of the proposed research.