Brain Markers of Low and High Frequency Episodic Migraine

描述（由申请人提供）：偏头痛是一个巨大的临床问题，影响超过2500万美国人，耗资数十亿美元。发作性偏头痛是一种复发性头痛，每月发生1-14天。它可能会发生或没有先兆（局灶性神经症状，通常发展和解决）。大多数（80-95%）偏头痛患者在其一生中仍为发作性低频率发作（每月1-4次发作），而一些（约5%）患者从低频率发展到高频率，然后发展为每日头痛/偏头痛。该疾病的未解之谜之一是大脑如何从低频（LF）发作性表现发展为更频繁的高频（HF）或慢性每日头痛。在这里，我们建议评估功能，形态测量（灰质体积和白色物质的完整性）和化学（兴奋性和抑制性代谢产物的措施）的LF和HF急性发作性偏头痛患者的不同队列的大脑中的变化。具体来说，我们将比较以下三种大脑测量：（1）LF偏头痛患者（有和无先兆），健康年龄，性别，教育水平，匹配对照组;（2）HF偏头痛患者（有和无先兆），健康年龄，性别，教育水平，匹配对照组;（3）LF偏头痛患者（有和无先兆）。我们希望测试的假设，增加偏头痛的频率，增加兴奋性氨基酸和减少抑制性氨基酸导致大脑结构和功能的改变。我们在影像学、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.