Department of Experimental Biomedicine and Clinical Neurosciences, Università di Palermo, Palermo, Italia.
Headache. 2011 May;51(5):726-33. doi: 10.1111/j.1526-4610.2011.01893.x.
An imbalance between activity of inhibitory and facilitatory intracortical circuits could play a central role in migraine etiology. We used input-output curves to achieve further information about intracortical excitability of motor cortex in migraine with aura.
Input-output curves were measured in the right abductor pollicis brevis muscle at rest in 12 patients suffering from migraine with aura and 8 healthy subjects. Stimuli were delivered at intensity ranging from 100% to 160% of resting motor threshold with 10-second inter-stimulus intervals. Seven patients were studied before and during treatment with levetiracetam.
Results showed a greater motor-evoked potential amplitude in response to increasing intensity of stimuli in patients compared to controls (P < .02). This increased facilitatory effect was abolished by levetiracetam (P < .005).
Our findings support the hypothesis of an interictal cortical hyper-responsivity in migraine patients that appears to be normalized by levetiracetam. This effect could support the potential therapeutic role of levetiracetam in migraine with aura prevention.
抑制性和易化性皮质内回路活动的失衡可能在偏头痛的发病机制中起核心作用。我们使用输入-输出曲线来进一步了解偏头痛伴先兆患者运动皮质的皮质内兴奋性。
在 12 例偏头痛伴先兆患者和 8 例健康受试者的右拇指外展短肌中，在休息时测量输入-输出曲线。刺激强度范围从静息运动阈值的 100%到 160%，刺激间隔为 10 秒。7 例患者在接受左乙拉西坦治疗前后进行了研究。
结果显示，与对照组相比，患者对刺激强度增加的运动诱发电位幅度更大（P <.02）。左乙拉西坦可消除这种增强的易化作用（P <.005）。
我们的发现支持偏头痛患者在发作间期皮质过度反应的假说，左乙拉西坦似乎使其正常化。这种作用可能支持左乙拉西坦在偏头痛预防性治疗中的潜在治疗作用。
