Ayzenberg Ilya, Nastos Ilias, Strassburger-Krogias Katrin, Obermann Mark, Gold Ralf, Krogias Christos
Department of Neurology, St. Josef-Hospital, Medical Faculty, Ruhr-University Bochum, Germany.
Department of Neurology, St. Josef-Hospital, Medical Faculty, Ruhr-University Bochum, Germany Neurological practice, Bochum, Germany.
Cephalalgia. 2016 Jul;36(8):800-6. doi: 10.1177/0333102415617415. Epub 2015 Nov 12.
Reduced echogenicity of the brainstem raphe nuclei (BRN) was demonstrated in major depression, possibly indicating serotonergic dysfunction. Postulating that migraine may constitute a "chronic low serotonin syndrome," we aimed to evaluate the echogenicity of midbrain structures, including serotonergic BRN in episodic migraine.
Transcranial sonography was performed in 39 patients with episodic migraine (median age 35, interquartile range (IQR): 27-47 years; 27 women) and 35 controls (median age 31, IQR: 29-47 years; 19 women). Individuals with concomitant depression were excluded. Echogenicity of BRN, substantia nigra (SN) and third ventricle width was evaluated according to an internationally established examination protocol.
Hypoechogenicity of BRN was depicted in 23.1% of migraine patients and 20% of controls, showing no significant difference. Migraine patients with hypoechogenic BRN had significantly higher attack frequency (median 3, IQR 2-5 vs. 1.5, IQR 1-2 days/month; p = 0.029) and a trend toward earlier disease manifestation. The rate of hyperechogenic SN and width of the third ventricle were similar between both groups. We did not observe any differences between migraine patients with and without aura.
Sonographic findings did not differ between migraine patients and controls. Hypoechogenic BRN correlated to a higher migraine attack frequency, probably indicating more severe disease activity.
在重度抑郁症中已证实脑干中缝核（BRN）的回声性降低，这可能表明血清素能功能障碍。假设偏头痛可能构成一种“慢性低血清素综合征”，我们旨在评估发作性偏头痛患者中脑结构的回声性，包括血清素能BRN。
对39例发作性偏头痛患者（中位年龄35岁，四分位间距（IQR）：27 - 47岁；27名女性）和35名对照者（中位年龄31岁，IQR：29 - 47岁；19名女性）进行经颅超声检查。排除伴有抑郁症的个体。根据国际公认的检查方案评估BRN、黑质（SN）的回声性和第三脑室宽度。
23.1%的偏头痛患者和20%的对照者出现BRN低回声，差异无统计学意义。BRN低回声的偏头痛患者发作频率显著更高（中位值3次，IQR 2 - 5次/月 vs. 1.5次，IQR 1 - 2次/月；p = 0.029），且有疾病表现较早的趋势。两组间SN高回声率和第三脑室宽度相似。我们未观察到有先兆和无先兆偏头痛患者之间存在任何差异。
偏头痛患者和对照者的超声检查结果无差异。BRN低回声与更高的偏头痛发作频率相关，这可能表明疾病活动更严重。
