Rauschel Veronika, Straube Andreas, Süß Frank, Ruscheweyh Ruth
University of Munich, Department of Neurology, Feodor-Lynen-Straße 19 Marchioninistr 15, 81377, Munich, Germany.
University of Dresden, Institute and Policlinic of Occupational and Social Medicine, Fetscherstr, 74 01307, Dresden, Germany.
J Headache Pain. 2015;16:82. doi: 10.1186/s10194-015-0567-8. Epub 2015 Sep 16.
BACKGROUND: Migraine is a stress-related disorder, suggesting that there may be sympathetic hyperactivity in migraine patients. However, there are contradictory results concerning general sympathetic activation in migraine patients. To shed more light on the involvement of the autonomic nervous system (ANS) in migraine pathophysiology, we investigated cardiac and cardiovascular reactions during vagal (paced breathing) and sympathetic activation (mental stress test). METHODS: Heart rate variability parameters and skin conductance responses were recorded interictally in 22 episodic migraine patients without aura and 25 matched controls during two different test conditions. The paced breathing test consisted of a five-minute baseline, followed by two minutes of paced breathing (6 breathing cycles per minute) and a five-minute recovery phase. The mental stress test consisted of a five-minute baseline, followed by one minute of stress anticipation, three and a half minutes of mental stress and a five-minute recovery phase. Furthermore we measured blood pressure and heart rate once daily over 2 weeks. Subjects rated their individual current stress level and their stress level during paced breathing and during the mental stress test. RESULTS: There were no significant differences between migraine patients and controls in any of the heart rate variability parameters in either time domain or frequency domain analysis. However, all parameters showed a non-significant tendency for larger sympathetic activation in migraine patients. Also, no significant differences could be observed in skin conductance responses and average blood pressure. Only heart rates during the 2-week period and stress ratings showed significantly higher values in migraine patients compared to controls. CONCLUSIONS: Generally there were no significant differences between migraine patients and controls concerning the measured autonomic parameters. There was a slight but not significant tendency in the migraine patients to react with less vagal and more sympathetic activation in all these tests, indicating a slightly changed set point of the autonomic system. Heart rate variability and blood pressure in migraine patients should be investigated for longer periods and during more demanding sympathetic activation.
背景：偏头痛是一种与压力相关的疾病，这表明偏头痛患者可能存在交感神经过度活跃的情况。然而，关于偏头痛患者的总体交感神经激活情况，研究结果相互矛盾。为了更深入了解自主神经系统（ANS）在偏头痛病理生理学中的作用，我们研究了在迷走神经（有节奏呼吸）和交感神经激活（心理应激测试）过程中的心脏和心血管反应。 方法：在两种不同的测试条件下，对22名无先兆发作性偏头痛患者和25名匹配的对照者进行发作间期心率变异性参数和皮肤电导率反应的记录。有节奏呼吸测试包括5分钟的基线期，随后是2分钟的有节奏呼吸（每分钟6个呼吸周期）和5分钟的恢复期。心理应激测试包括5分钟的基线期，随后是1分钟的应激预期期、3分半钟的心理应激期和5分钟的恢复期。此外，我们在2周内每天测量一次血压和心率。受试者对他们当前的个体应激水平以及在有节奏呼吸和心理应激测试期间的应激水平进行评分。 结果：在时域或频域分析中，偏头痛患者和对照者在任何心率变异性参数上均无显著差异。然而，所有参数均显示偏头痛患者交感神经激活程度有更大的趋势，但不显著。此外，在皮肤电导率反应和平均血压方面也未观察到显著差异。与对照者相比，仅偏头痛患者在2周期间的心率和应激评分显著更高。 结论：总体而言，偏头痛患者和对照者在测量的自主神经参数方面没有显著差异。在所有这些测试中，偏头痛患者有轻微但不显著的趋势，即迷走神经激活较少，交感神经激活较多，这表明自主神经系统的设定点略有变化。应在更长时间内以及在更强烈的交感神经激活期间对偏头痛患者的心率变异性和血压进行研究。
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