Department of Neurological Sciences, Second University of Naples, Naples, Italy.
J Neurol. 2012 Sep;259(9):1903-12. doi: 10.1007/s00415-012-6438-1. Epub 2012 Feb 18.
We explored the functional pattern of the pain-processing network in patients with migraine, in the interictal periods, during trigeminal noxious stimulation. Contact heat evoked potential stimulation induced thermal pain and functional magnetic resonance imaging were used to measure whole-brain activation in 16 patients with episodic migraine without aura and 16 age- and gender-matched healthy controls in response to a severe (53°C) noxious, a moderate (51°C) noxious, and a control (41°C) stimulus applied to the maxillary skin. When comparing the fMRI activation over the entire brain, patients with migraine, with respect to healthy controls, showed a significantly greater activation in the perigenual part of anterior cingulate cortex at 51°C and less activation in the bilateral secondary somatosensory cortex at 53°C. A group-by-stimulus interaction analysis revealed a region in the pons showing a divergent response in patients and healthy controls. Correlation analyses demonstrated that the pons activation correlated with higher headache-related disability in patients. Our findings demonstrate increased antinociceptive activity in patients with migraine, which may represent a compensatory reorganization to modulate pain perception at the same intensity of healthy controls.
我们在间歇期内探索了偏头痛患者疼痛处理网络的功能模式，在三叉神经有害刺激期间。接触热诱发电位刺激诱导热痛，功能磁共振成像用于测量 16 例无先兆发作性偏头痛患者和 16 名年龄和性别匹配的健康对照者对强烈（53°C）有害、中度（51°C）有害和对照（41°C）刺激的全脑激活应用于上颌皮肤。当比较整个大脑的 fMRI 激活时，与健康对照组相比，偏头痛患者在 51°C 时前扣带回皮质的围生部分显示出明显更大的激活，而在 53°C 时双侧次级体感皮层的激活减少。组-刺激相互作用分析显示在桥脑中存在一个区域，患者和健康对照组的反应不同。相关性分析表明，桥脑激活与患者更高的头痛相关残疾相关。我们的研究结果表明偏头痛患者的抗伤害活性增加，这可能代表一种代偿性的重新组织，以调节与健康对照组相同强度的疼痛感知。
