Mulleners W M, Chronicle E P, Palmer J E, Koehler P J, Vredeveld J W
Departments of Neurology, Atrium Medical Center, Heerlen, The Netherlands.
Headache. 2001 Jun;41(6):565-72. doi: 10.1046/j.1526-4610.2001.041006565.x.
Previous research using transcranial magnetic stimulation has produced equivocal findings concerning thresholds for the generation of visual phosphenes in migraine with aura. These studies were methodologically varied and did not systematically address cortical excitability in migraine without aura. We therefore studied magnetophosphene thresholds in both migraine with aura and migraine without aura compared with headache-free controls.
Sixteen subjects with migraine with aura and 12 subjects with migraine without aura were studied and compared with 16 sex- and age-matched controls. Using a standardized transcranial magnetic stimulation protocol of the occipital cortex, we assessed the threshold stimulation intensity at which subjects just perceived phosphenes via a method of alternating course and fine-tuning of stimulator output.
There were no significant differences across groups in the proportion of subjects seeing phosphenes. However, the mean threshold at which phosphenes were reported was significantly lower in both migraine groups (migraine with aura=47%, migraine without aura=46%) than in controls (66%). Moreover, there was no significant correlation between individual phosphene threshold and the time interval to the closest migraine attack.
Our findings confirm that the occipital cortex is hyperexcitable in the migraine interictum, both in migraine with and without aura.
以往使用经颅磁刺激的研究对于伴先兆偏头痛患者视觉光幻视产生阈值的研究结果并不一致。这些研究在方法上存在差异，且未系统地探讨无先兆偏头痛患者的皮质兴奋性。因此，我们对伴先兆偏头痛和无先兆偏头痛患者的磁光幻视阈值进行了研究，并与无头痛的对照组进行比较。
对16例伴先兆偏头痛患者和12例无先兆偏头痛患者进行了研究，并与16例年龄和性别匹配的对照组进行比较。采用标准化的枕叶经颅磁刺激方案，通过交替调整刺激器输出的方法，评估受试者刚能感知到光幻视时的阈值刺激强度。
各组中能看到光幻视的受试者比例无显著差异。然而，两个偏头痛组（伴先兆偏头痛组为47%，无先兆偏头痛组为46%）报告出现光幻视的平均阈值均显著低于对照组（66%）。此外，个体光幻视阈值与距最近一次偏头痛发作的时间间隔之间无显著相关性。
我们的研究结果证实，在偏头痛发作间期，枕叶皮质在伴先兆和无先兆偏头痛患者中均呈兴奋性增高状态。
