Nedeltchev K, Arnold M, Schwerzmann M, Nirkko A, Lagger F, Mattle H P, Sturzenegger M
Department of Neurology, University Hospital of Bern, Bern, Switzerland.
Cephalalgia. 2004 Sep;24(9):700-6. doi: 10.1111/j.1468-2982.2004.00740.x.
Cortical hypersensitivity and absent habituation to different stimuli have been observed in migraine patients. These features might also be transmitted to the cerebral vasoreactivity, but results are conflicting so far. Transcranial Doppler ultrasound (TCD) was used to assess cerebral blood flow velocity (CBFV) changes in the middle (MCA) and posterior cerebral arteries (PCA) in relation to repetitive checkerboard visual stimulation. Stimulation consisted of 10 consecutive cycles, each comprising 10 s stimulation and 10 s rest. TCD recordings were analysed using stimulus-related averaging algorithm. Data of 19 interictal migraineurs with aura were compared to those of 19 headache-free healthy volunteers. The CBFV increase in PCA and in MCA during visual stimulation was significantly larger and steeper in migraineurs than in controls (P = 0.017 and P = 0.005). The response in PCA remained stable over the 10 stimulation cycles, both in migraineurs and in controls. The response in MCA was stable only in migraineurs. In controls it decreased over the last 5 stimulation cycles compared with the first 5 cycles (P = 0.04). Migraineurs with aura exhibit a larger cerebrovascular response to repetitive visual stimulation compared to headache-free subjects. A reduced adaptation to environmental stimuli in migraine is suggested, since there was no habituation in migraineurs in contrast to healthy controls.
在偏头痛患者中已观察到皮质超敏反应以及对不同刺激缺乏习惯化。这些特征可能也会传递至脑血管反应性，但目前结果存在矛盾。经颅多普勒超声（TCD）用于评估在重复性棋盘格视觉刺激下大脑中动脉（MCA）和大脑后动脉（PCA）的脑血流速度（CBFV）变化。刺激由10个连续周期组成，每个周期包括10秒刺激和10秒休息。使用与刺激相关的平均算法分析TCD记录。将19名有先兆的发作间期偏头痛患者的数据与19名无头痛的健康志愿者的数据进行比较。在视觉刺激期间，偏头痛患者的PCA和MCA中的CBFV增加显著大于且快于对照组（P = 0.017和P = 0.005）。在偏头痛患者和对照组中，PCA的反应在10个刺激周期内均保持稳定。只有偏头痛患者的MCA反应是稳定的。在对照组中，与前5个周期相比，后5个刺激周期的反应降低（P = 0.04）。与无头痛的受试者相比，有先兆的偏头痛患者对重复性视觉刺激表现出更大的脑血管反应。由于与健康对照组相比偏头痛患者没有习惯化，提示偏头痛患者对环境刺激的适应性降低。
