Judit A, Sándor P S, Schoenen J
Department of Neurology, Semmelweis University of Medicine, Budapest, Hungary.
Cephalalgia. 2000 Oct;20(8):714-9. doi: 10.1111/j.1468-2982.2000.00122.x.
Between attacks, migraine with (MO) or without aura (MA) patients show deficient habituation of pattern-reversal visual evoked potentials (PR-VEP) and a strong intensity dependence of auditory evoked cortical potentials (IDAP). Clinical observations of migraine prodromes and previously published electrophysiological studies suggest that cortical information processing may vary in close temporal relationship to the attack. We studied PR-VEP and IDAP just before (11 MO pts), during (23 MO, 3 MA), 1 day following (27 MO, 1 MA) and 2 days following (14 MO) a migraine attack. The results were compared with a large group of MO patients recorded at a distance of at least 3 days from an attack (n = 66 for IDAP; n = 39 for VEP). Patients recorded the day before the attack had on average an habituation of -13.6+/-20.5% (mean +/- SD) between the 5th and 1st block of 100 averaged VEP responses and a flat (0.38+/-1.06 microV/10 dB) amplitude-stimulus intensity function (ASF) slope of the auditory evoked cortical potential. Both values were significantly different from those obtained in the attack interval (P=0.003; P=0.020). During the attack, VEP habituation was less pronounced (-0.17+/-26.2%) and ASF slopes remained flat (0.32+/-1.44 microV/10 dB; P=0.002 compared to interval). During the 2 days following the attack, VEP habituation was replaced by potentiation (+0.09+/-29.1% the 1st day; 19.5+/-45.7% the 2nd day) and ASF slopes increased markedly (0.87+/-1.39 and 1.14+/-1.12 microV/10 dB). The normalization of evoked cortical responses just before and during the attack, might reflect an increase in the cortical preactivation level due to enhanced activity in raphe-cortical serotonergic pathways.
在发作间期，伴（MO）或不伴先兆（MA）的偏头痛患者表现出图形翻转视觉诱发电位（PR-VEP）的习惯化缺陷以及听觉诱发性皮质电位（IDAP）对强度的强烈依赖性。偏头痛前驱症状的临床观察以及先前发表的电生理研究表明，皮质信息处理可能在与发作紧密的时间关系中发生变化。我们在偏头痛发作前（11例MO患者）、发作期间（23例MO，3例MA）、发作后1天（27例MO，1例MA）以及发作后2天（14例MO）研究了PR-VEP和IDAP。将结果与一大组距离发作至少3天记录的MO患者进行比较（IDAP为n = 66；VEP为n = 39）。发作前一天记录的患者在100次平均VEP反应的第5个和第1个组块之间平均习惯化率为-13.6±20.5%（平均值±标准差），听觉诱发性皮质电位的幅度-刺激强度函数（ASF）斜率平坦（0.38±1.06 μV/10 dB）。这两个值与发作间期获得的值均有显著差异（P = 0.003；P = 0.020）。发作期间，VEP习惯化不太明显（-0.17±26.2%），ASF斜率仍保持平坦（0.32±1.44 μV/10 dB；与发作间期相比P = 0.002）。在发作后的2天内，VEP习惯化被增强所取代（第1天为+0.09±29.1%；第2天为19.5±45.7%），ASF斜率显著增加（0.87±1.39和1.14±1.12 μV/10 dB）。发作前和发作期间诱发性皮质反应的正常化，可能反映了由于中缝-皮质5-羟色胺能通路活动增强导致的皮质预激活水平增加。
