Altiokka Ozlem, Mutluay Belgin, Koksal Ayhan, Ciftci-Kavaklioglu Beyza, Ozturk Musa, Altunkaynak Yavuz, Baybas Sevim, Soysal Aysun
Department of Neurology, Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Turkey.
Department of Neurology, Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Turkey
Cephalalgia. 2016 Jan;36(1):37-43. doi: 10.1177/0333102415580112. Epub 2015 Apr 2.
To investigate which part of the autonomic system is mainly involved and assess the sensitivity of face sympathetic skin response in cluster headache.
The study sample consisted of 19 drug-free cluster headache patients (16 males, three females) and 19 healthy volunteers. Demographic features and pain characteristics were thoroughly identified. Dysautonomic symptoms were evaluated during attack and remission periods of cluster headache patients. Orthostatic hypotension, R-R interval variation and sympathetic skin responses obtained from the face and four extremities were evaluated and the sensitivity of face sympathetic skin responses was assessed in contrast to extremity sympathetic skin responses.
All sympathetic skin responses of face and extremities could be obtained during attack and remission periods. On the symptomatic side, mean latency of face sympathetic skin responses was longer compared to the asymptomatic side and controls (p = 0.02, p = 0.004). There were no differences in latency or amplitude of extremity sympathetic skin responses between symptomatic and asymptomatic sides and controls. No significant relationship was determined between sympathetic skin responses, R-R interval variation, orthostatic hypotension and cluster headache clinical features.
Sympathetic hypoactivity of the face seems to predominate the pathophysiology of cluster headache. Face sympathetic skin responses might be more sensitive compared to extremity sympathetic skin response in demonstrating dysautonomic symptoms in cluster headache patients.
研究自主神经系统的哪一部分主要受累，并评估丛集性头痛患者面部交感神经皮肤反应的敏感性。
研究样本包括19例未服用药物的丛集性头痛患者（16例男性，3例女性）和19名健康志愿者。详细确定人口统计学特征和疼痛特征。在丛集性头痛患者的发作期和缓解期评估自主神经功能障碍症状。评估直立性低血压、R-R间期变化以及从面部和四肢获得的交感神经皮肤反应，并与肢体交感神经皮肤反应对比评估面部交感神经皮肤反应的敏感性。
在发作期和缓解期均可获得面部和四肢的所有交感神经皮肤反应。在有症状的一侧，与无症状一侧及对照组相比，面部交感神经皮肤反应的平均潜伏期更长（p = 0.02，p = 0.004）。有症状一侧与无症状一侧及对照组之间，肢体交感神经皮肤反应的潜伏期或波幅无差异。交感神经皮肤反应、R-R间期变化、直立性低血压与丛集性头痛临床特征之间未确定显著关系。
面部交感神经功能减退似乎在丛集性头痛的病理生理学中占主导地位。在显示丛集性头痛患者的自主神经功能障碍症状方面，面部交感神经皮肤反应可能比肢体交感神经皮肤反应更敏感。
