Technion - Israel Institute of Technology, Haifa, Israel.
Cephalalgia. 2010 Aug;30(8):910-8. doi: 10.1177/0333102409357249. Epub 2010 Mar 12.
This study aimed to identify the cortical mechanisms underlying the processes of interictal dishabituation to experimental pain in subjects suffering from migraine with aura (MWA). In 21 subjects with MWA and 22 healthy controls, cortical responses to two successive trials of noxious contact-heat stimuli were analyzed using EEG-tomography software. When compared with controls, MWA patients showed significantly increased pain-evoked potential amplitudes accompanied by reduced activity in the orbitofrontal cortex (OFC) and increased activity in the pain matrix regions, including the primary somatosensory cortex (SI) (p < .05). Similarly to controls, MWA subjects displayed an inverse correlation between the OFC and SI activities, and positive interrelations between other pain-specific regions. The activity changes in the OFC negatively correlated with lifetime headache duration and longevity (p < .05). Reduced inhibitory functioning of the prefrontal cortex is a possible cause for disinhibition of the pain-related sensory cortices in migraine. The finding of OFC hypofunction over the disease course is in keeping with current concepts of migraine as a progressive brain disorder.
本研究旨在确定偏头痛伴先兆（MWA）患者在经历实验性疼痛的间歇性脱敏过程中的皮质机制。在 21 名 MWA 患者和 22 名健康对照者中，使用 EEG 体绘制软件分析了对两个连续的有害接触热刺激试验的皮质反应。与对照组相比，MWA 患者的疼痛诱发电位幅度明显增加，同时眶额皮质（OFC）的活动减少，包括初级体感皮层（SI）在内的疼痛矩阵区域的活动增加（p <.05）。与对照组一样，MWA 患者的 OFC 和 SI 活动之间呈负相关，而其他与疼痛相关的区域之间呈正相关。OFC 的活动变化与终生头痛持续时间和寿命呈负相关（p <.05）。前额叶皮层抑制功能降低可能是偏头痛相关感觉皮层去抑制的原因。在疾病过程中发现 OFC 功能低下与偏头痛作为一种进行性脑疾病的现有概念一致。
