Wang S-J, Lirng J-F, Fuh J-L, Chen J-J
Neurological Institute, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, 112.
J Neurol Neurosurg Psychiatry. 2006 May;77(5):622-5. doi: 10.1136/jnnp.2005.081836.
To determine the 1H-MR spectroscopic (MRS) findings in the hypothalamus in patients with episodic cluster headache.
47 patients were recruited with episodic cluster headache (35 in cluster period and 12 in remission), 21 normal controls, and 16 patients with chronic migraine. The hypothalamic 1H-MRS metabolite ratio changes in patients with cluster headache were evaluated and compared with results in the normal controls as well as patients with chronic migraine. Seven patients in the cluster period group underwent a follow up hypothalamic MRS study five to six months after remission.
In patients with cluster headache, the hypothalamic N-acetylaspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios were similar between those in cluster period and in remission. As a group, both NAA/Cr and Cho/Cr levels were significantly lower in patients with cluster headache in comparison with either the control or chronic migraine groups. In those with a follow up MRS study, the levels of metabolite ratios did not differ between the cluster and remission periods.
This study provides evidence of persistent biochemical change of the hypothalamus in patients with episodic cluster headache. Low levels of NAA/Cr and Cho/Cr suggest that cluster headache might be related to both neuronal dysfunction and changes in the membrane lipids in the hypothalamus.
确定发作性丛集性头痛患者下丘脑的氢质子磁共振波谱（MRS）表现。
招募了47例发作性丛集性头痛患者（35例处于丛集期，12例处于缓解期）、21例正常对照者以及16例慢性偏头痛患者。评估丛集性头痛患者下丘脑的氢质子磁共振波谱代谢物比率变化，并与正常对照者以及慢性偏头痛患者的结果进行比较。丛集期组的7例患者在缓解后5至6个月接受了下丘脑MRS随访研究。
丛集性头痛患者中，丛集期和缓解期患者的下丘脑N-乙酰天门冬氨酸（NAA）/肌酸（Cr）和胆碱（Cho）/Cr比率相似。总体而言，与对照组或慢性偏头痛组相比，丛集性头痛患者的NAA/Cr和Cho/Cr水平均显著降低。在接受MRS随访研究的患者中，丛集期和缓解期的代谢物比率水平没有差异。
本研究提供了发作性丛集性头痛患者下丘脑持续生化改变的证据。NAA/Cr和Cho/Cr水平较低表明丛集性头痛可能与下丘脑的神经元功能障碍和膜脂质变化均有关。
