光干扰期间偏头痛听觉诱发电位的强度依赖性。

Intensity dependence of auditory evoked potentials during light interference in migraine.

机构信息

Headache Clinic, IRCCS INM Neuromed, via Atinense, 18, I-86077 Pozzilli, Isernia, Italy.

出版信息

Neurosci Lett. 2011 Apr 1;492(2):80-3. doi: 10.1016/j.neulet.2011.01.060. Epub 2011 Jan 31.

Abstract

Migraine patients show interictally a strong intensity dependence of auditory evoked cortical potentials (IDAP) and a lack of habituation of evoked potentials. Photic drive on high-frequency flash stimulation is another well-known interictal feature in migraineurs, associated with alpha-rhythm hyper-synchronisation. We compared therefore the influence of light stimulation on IDAP in healthy volunteers (HV) and migraine patients. A continuous flash stimulation was delivered during the recording of auditory evoked potentials at suprathreshold increasing stimulation intensities. IDAP was measured as the amplitude/stimulus intensity function (ASF) slope. In HV, the ASF slope decreased during flash stimulation, whereas, on average, there was no significant change in migraineurs. A closer analysis of migraineurs disclosed two subgroups of patients with no detectable clinical differences: one, the largest, in which the ASF slope was normal at baseline, but increased during light stimulation, the other with an increased ASF slope at rest and a decrease during light interference. Visual sensory overload is able to increase IDAP in the majority of migraineurs, which contrasts with HV. We hypothesise that this could be due to hyper-synchronisation of the alpha rhythm because of photic drive and possibly thalamo-cortical dysfunction. A minority of migraineurs have, like HV, an IDAP reduction during light interference. They are, however, characterised, unlike most HV, by a high IDAP at baseline. Besides underscoring the pathophysiological heterogeneity of migraine, these results suggest that light interference might improve the phenotyping of migraine patients who have a normal IDAP in the resting condition.

摘要

偏头痛患者在间歇期表现出听觉诱发电位的强烈强度依赖性(IDAP)和诱发电位的缺乏习惯化。高频闪光刺激的光驱动是偏头痛患者另一种众所周知的间歇期特征,与 alpha 节律超同步化有关。因此,我们比较了健康志愿者(HV)和偏头痛患者在光刺激对 IDAP 的影响。在阈上递增刺激强度记录听觉诱发电位的同时,进行连续闪光刺激。IDAP 作为振幅/刺激强度函数(ASF)斜率进行测量。在 HV 中,ASF 斜率在闪光刺激期间降低,而偏头痛患者平均没有明显变化。对偏头痛患者的更仔细分析揭示了两个亚组,两组患者在临床方面没有可检测到的差异:一个亚组最大,其基线时 ASF 斜率正常,但在光刺激期间增加,另一个亚组在休息时 ASF 斜率增加,在光干扰时减少。视觉感官超负荷能够增加大多数偏头痛患者的 IDAP,这与 HV 形成对比。我们假设这可能是由于光驱动引起的 alpha 节律的超同步化,并且可能是丘脑-皮质功能障碍。少数偏头痛患者与 HV 一样,在光干扰期间 IDAP 减少。然而,与大多数 HV 不同的是,他们在基线时具有高 IDAP。除了强调偏头痛的病理生理异质性外,这些结果还表明,光干扰可能会改善在休息状态下 IDAP 正常的偏头痛患者的表型。

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