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偏头痛患者大脑中动脉的动态脑自动调节功能得以保留。

Preserved dynamic cerebral autoregulation in the middle cerebral artery among persons with migraine.

作者信息

Reinhard M, Wehrle-Wieland E, Roth M, Niesen W D, Timmer J, Weiller C, Hetzel A

机构信息

Department of Neurology and Clinical Neurophysiology, University of Freiburg, Neurocenter, Breisacherstr. 64, 79106 Freiburg, Germany.

出版信息

Exp Brain Res. 2007 Jul;180(3):517-23. doi: 10.1007/s00221-007-0879-2. Epub 2007 Feb 6.

Abstract

Migraine affects the autonomous nervous system and a recent investigation has also proposed a severe disturbance of dynamic cerebral blood flow regulation in the middle cerebral artery during spontaneous blood pressure oscillations. This study investigates whether dynamic cerebral autoregulation is impaired in persons with migraine among a normal cohort. Out of 94 adults studied to establish normal values for dynamic autoregulation, 19 suffered from migraine according to IHS criteria (10 of them with aura). Transcranial Doppler sonography and fingerplethysmography were used to determine dynamic autoregulation of both middle cerebral arteries following spontaneous low frequency (0.06-0.12 Hz) blood pressure fluctuations (phase and gain of transfer function, correlation coefficient indices Dx and Mx). No significant differences were found for the low frequency variability of blood pressure (power spectral density) and various indices of dynamic cerebral autoregulation between persons with and without migraine. Moreover, no differences were observed between persons with migraine, with and without aura. This study based on a normal cohort does not support the presence of generally impaired cerebral autoregulation dynamics in persons with migraine. Future studies should focus on posterior circulation and particular cerebellar autoregulation.

摘要

偏头痛会影响自主神经系统,最近一项调查还提出,在自发性血压波动期间,大脑中动脉的动态脑血流调节存在严重紊乱。本研究调查了在正常队列中偏头痛患者的动态脑自动调节功能是否受损。在94名接受研究以确定动态自动调节正常值的成年人中,根据国际头痛协会(IHS)标准,有19人患有偏头痛(其中10人有先兆)。采用经颅多普勒超声和手指体积描记法,在自发性低频(0.06 - 0.12 Hz)血压波动后,测定双侧大脑中动脉的动态自动调节功能(传递函数的相位和增益、相关系数指数Dx和Mx)。在有偏头痛和无偏头痛的人群之间,血压的低频变异性(功率谱密度)和动态脑自动调节的各种指标均未发现显著差异。此外,有先兆和无先兆的偏头痛患者之间也未观察到差异。这项基于正常队列的研究不支持偏头痛患者普遍存在脑自动调节动力学受损的观点。未来的研究应关注后循环以及特定的小脑自动调节功能。

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