Department of Radiology and Nuclear Medicine, MR-department (-1K12B), Ghent University Hospital, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
J Headache Pain. 2011 Jun;12(3):295-302. doi: 10.1007/s10194-011-0295-7. Epub 2011 Feb 8.
Proton magnetic resonance spectroscopy ((1)H-MRS) has been used in a number of studies to assess noninvasively the temporal changes of lactate (Lac) in the activated human brain. Migraine neurobiology involves lack of cortical habituation to repetitive stimuli and a mitochondrial component has been put forward. Our group has recently demonstrated a reduction in the high-energy phosphates adenosine triphosphate (ATP) and phosphocreatine (PCr) in the occipital lobe of migraine without aura (MwoA) patients, at least in a subgroup, in a phosphorus MRS ((31)P-MRS) study. In previous studies, basal Lac levels or photic stimulation (PS)-induced Lac levels were found to be increased in patients with migraine with aura (MwA) and migraine patients with visual symptoms and paraesthesia, paresia and/or dysphasia, respectively. The aim of this study was to perform functional (1)H-MRS at 3 T in 20 MwoA patients and 20 control subjects. Repetitive visual stimulation was applied using MR-compatible goggles with 8 Hz checkerboard stimulation during 12 min. We did not observe any significant differences in signal integrals, ratios and absolute metabolite concentrations, including Lac, between MwoA patients and controls before PS. Lac also did not increase significantly during and following PS, both for MwoA patients and controls. Subtle Lac changes, smaller than the sensitivity threshold (i.e. estimated at 0.1-0.2 μmol/g at 3 T), cannot be detected by MRS. Our study does, however, argue against a significant switch to non-aerobic glucose metabolism during long-lasting PS of the visual cortex in MwoA patients.
质子磁共振波谱((1)H-MRS)已被用于多项研究中，以无创评估激活人脑中乳酸盐(Lac)的时间变化。偏头痛的神经生物学涉及到皮质对重复刺激的习惯化缺失，并且提出了线粒体成分的作用。我们的研究小组最近在一项磷磁共振波谱((31)P-MRS)研究中发现，至少在偏头痛无先兆（MwoA）患者的亚组中，偏头痛伴先兆（MwA）和偏头痛伴视觉症状和感觉异常、轻偏瘫和/或构音障碍患者的枕叶高能磷酸化合物三磷酸腺苷（ATP）和磷酸肌酸（PCr）减少。在以前的研究中，发现有先兆偏头痛（MwA）和偏头痛伴视觉症状及感觉异常、轻偏瘫和/或构音障碍的患者基底 Lac 水平或光刺激（PS）诱导的 Lac 水平升高。本研究旨在对 20 名 MwoA 患者和 20 名对照受试者进行 3T 功能((1)H-MRS。使用与 MR 兼容的护目镜进行重复视觉刺激，8Hz 棋盘刺激 12 分钟。在 PS 之前，我们未观察到 MwoA 患者和对照组之间信号积分、比值和绝对代谢物浓度（包括 Lac）有任何显著差异。PS 期间和之后 Lac 也没有显著增加，无论是 MwoA 患者还是对照组。MRS 无法检测到 Lac 变化较小的情况（即在 3T 时估计为 0.1-0.2μmol/g）。然而，我们的研究结果并不支持在 MwoA 患者视觉皮层长时间 PS 期间，向非有氧葡萄糖代谢的显著转换。
