Cosentino Guiseppe, Brighina Filippo, Brancato Sara, Valentino Francesca, Indovino Serena, Fierro Brigida
Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Palermo, Italy.
Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Palermo, Italy.
J Pain. 2015 Jan;16(1):53-9. doi: 10.1016/j.jpain.2014.10.006. Epub 2014 Oct 31.
Evidence shows involvement of the cerebral cortex in the pathophysiology of cluster headache (CH). Here we investigated cortical excitability in episodic CH patients by using transcranial magnetic stimulation. In 25 patients with episodic CH and 13 healthy subjects we evaluated the motor cortical response to single-pulse (ie, motor threshold, input-output curves, cortical silent period) and paired-pulse (ie, intracortical facilitation, short intracortical inhibition) transcranial magnetic stimulation in both hemispheres. Thirteen patients were evaluated outside bout and the remaining 12 patients inside bout. Our results showed increased slope of the input-output curves after stimulation of both hemispheres in patients outside bout and in the hemisphere contralateral to the headache side in patients inside bout. Increased intracortical facilitation was observed in the hemisphere ipsilateral to the headache side in patients evaluated both outside and inside bout; reduced short intracortical inhibition was observed in patients inside bout ipsilateral to the side of pain. In conclusion, we provide evidence of increased cortical excitability in episodic CH both outside and inside bout, especially in the hemisphere ipsilateral to the side of headache attacks. Our results suggest that an abnormal regulation of cortical excitability could be involved in the pathophysiology of CH.
We investigated cortical excitability in episodic cluster headache by using transcranial magnetic stimulation, providing evidence of cortical hyperexcitability in patients both inside and outside bout. We suggest that an abnormal state of cortical excitability could be involved in the pathophysiology of the disease.
有证据表明大脑皮层参与丛集性头痛（CH）的病理生理学过程。在此，我们通过经颅磁刺激研究发作性CH患者的皮层兴奋性。对25例发作性CH患者和13名健康受试者，我们评估了双侧半球对单脉冲经颅磁刺激（即运动阈值、输入-输出曲线、皮层静息期）和双脉冲经颅磁刺激（即皮层内易化、短皮层内抑制）的运动皮层反应。13例患者在发作间期接受评估，其余12例患者在发作期接受评估。我们的结果显示，发作间期患者双侧半球以及发作期患者头痛侧对侧半球在刺激后输入-输出曲线的斜率增加。在发作间期和发作期接受评估的患者中，头痛侧同侧半球均观察到皮层内易化增加；在发作期疼痛侧同侧的患者中观察到短皮层内抑制减少。总之，我们提供了证据表明发作性CH在发作间期和发作期皮层兴奋性均增加，尤其是在头痛发作侧同侧半球。我们的结果提示皮层兴奋性的异常调节可能参与CH的病理生理学过程。
我们通过经颅磁刺激研究发作性丛集性头痛患者的皮层兴奋性，为发作期和发作间期患者的皮层兴奋性过高提供了证据。我们认为皮层兴奋性的异常状态可能参与该疾病的病理生理学过程。
