Bramanti Placido, Grugno Rosario, Vitetta Antongiulio, Di Bella Paolo, Muscarà Nunzio, Nappi Giuseppe
Centro Studi Neurolesi", University of Messina, Italy.
Funct Neurol. 2005 Jan-Mar;20(1):29-32.
The neuropathological processes believed to underlie migraine with and without aura are still widely debated in the literature. In order to arrive at a more detailed and comprehensive picture of the altered processes present in migraineurs, electrophysiological data obtained through transcranial magnetic stimulation (TMS) and electroencephalography (EEG) were combined with haemodynamic data obtained through functional magnetic resonance imaging (fMRI). Ten subjects affected by migraine (with or without aura) underwent TMS and EEG investigation prior to a visual stimulation task, studied in fMRI. Our preliminary results showed a reduced cortical silent period especially in subjects affected by migraine with aura. The fMRI BOLD response was found to be weaker in occipital areas proportionally to the frequency and severity of migraine attacks. The data obtained from our study seem to support the theory of cortical spreading depression recently observed in human subjects. Moreover, the electrophysiological data were also correlated to migraine attack frequency, thus pointing to elevated cortical excitability between attacks. Better understanding of the neuropathological processes that trigger migraine attacks will help in the selection of more adequate prophylactic therapies. The results of this preliminary study need to be confirmed in a a large sample of subjects.
据信，有无先兆偏头痛背后的神经病理过程在文献中仍存在广泛争议。为了更详细、全面地了解偏头痛患者体内发生改变的过程，将经颅磁刺激（TMS）和脑电图（EEG）获得的电生理数据与功能磁共振成像（fMRI）获得的血流动力学数据相结合。10名患有偏头痛（有或无先兆）的受试者在进行fMRI研究的视觉刺激任务之前接受了TMS和EEG检查。我们的初步结果显示，尤其是有先兆偏头痛患者的皮质静息期缩短。发现枕叶区域的fMRI血氧水平依赖（BOLD）反应与偏头痛发作的频率和严重程度成比例地减弱。我们研究获得的数据似乎支持最近在人类受试者中观察到的皮质扩散性抑制理论。此外，电生理数据也与偏头痛发作频率相关，从而表明发作间期皮质兴奋性升高。更好地理解引发偏头痛发作的神经病理过程将有助于选择更合适的预防性治疗方法。这项初步研究的结果需要在大量受试者中得到证实。
