Hemodynamic and Metabolic Coupling in Migraine

项目摘要 这些研究的长期目标是了解大脑如何改变 血液动力学和氧代谢导致神经系统疾病，并且 确定它们在偏头痛的病理生理学中的作用。我们的总体假设是 偏头痛患者脑血流量(CBF)和氧代谢(CMRO2)异常， 这会影响局部脑组织氧合(PtO2)。此外，CBF/CMRO2 对视觉刺激作出反应的耦合在偏头痛中也是不正常的。在最近 在没有先兆的偏头痛期间，我们观察到低灌注量和低代谢， 但新陈代谢的较大下降导致局部组织的小幅增加。 头痛阶段的氧合作用。舒马曲坦治疗CBF和CMRO2 都归一化了。在视觉刺激后，我们观察到CBF反应增加， CBF/CMRO2偶联反应增强，可能与神经元有关 过度兴奋。这两种刺激引起的变化对舒马曲坦都没有反应。 我们的第一个具体目标是描述稳态CBF和CMRO2的变化 在基线期间，先兆症状、头痛症状和对 舒马曲坦，并确定这如何影响不同时期的组织氧合 偏头痛。我们的第二个目标是表征CBF/CMRO2耦合对 高对比度与低对比度视觉刺激，同样在偏头痛的不同阶段。一个 第三个目标是解决偏头痛期间休息状态大胆同步的变化，作为一种 偏头痛期间皮质同步性增强的迹象。还可以检查一个 无先兆传播波现象的大胆信号从休眠中衰减 陈述功能磁共振数据。这些研究将在10名患有月经性偏头痛的女性身上进行， 和10个对照。这些研究提供了一种解决基本机制的新方法 偏头痛病理生理学中的问题。这项探索性工作的终点是 CBF和CMRO2偶联的特征及其对脑组织的影响 氧合作用，以及BOLD同步化在疾病演变/治疗中的作用 月经期偏头痛的症状。这将为这些小说的应用奠定基础 MRI工具可更广泛地评估偏头痛的自然病史或治疗反应 精神错乱。

Project Summary The long-term goal of these studies is to understand how altered cerebral hemodynamics and oxygen metabolism contribute to neurological disease, and identify their role in the pathophysiology of migraine. Our overall hypothesis is that cerebral blood flow (CBF) and oxygen metabolism (CMRO2) are abnormal in migraine, and this affects local cerebral tissue oxygenation (PtO2). Further, that the CBF / CMRO2 coupling in response to a visual stimulus is also abnormal in migraine. During recent studies we observed hypoperfusion and hypometabolism during migraine without aura, but a greater decline in metabolism resulted in a small increase in local tissue oxygenation during the headache phase. Following sumatriptan both CBF and CMRO2 were normalized. Following a visual stimulus, we observed an increased CBF response, and increased CBF/CMRO2 coupling response, possibly related to neuronal hyperexcitability. Neither of these stimulus-induced changes responded to sumatriptan. Our first specific aim is to characterize the changes in steady-state CBF and CMRO2 during baseline, prodrome symptoms, headache symptoms and in response to sumatriptan, and determine how this affects tissue oxygenation at different phases of migraine. Our second aim is to characterize the CBF/CMRO2 coupling in response to a high contrast vs. a low contrast visual stimulus, again at different phases of migraine. A third aim is to address changes in resting state BOLD synchrony during migraine, as an indication of increased cortical synchrony during migraine. Also to examine a phenomenon of non-aura spreading waves of BOLD signal attenuation, from resting state fMRI data. These studies will be conducted in 10 women with menstrual migraine, and 10 controls. These studies present a new approach to address basic mechanistic questions in migraine pathophysiology. The endpoint of this exploratory work is the characterization of CBF and CMRO2 coupling and its impacts on cerebral tissue oxygenation, as well as the role of BOLD synchrony, during the evolution / treatment of symptoms in menstrual migraine. This will establish the basis for applying these novel MRI tools to evaluate the natural history or response to therapy more widely in migraine disorders.