Verroiopoulos George V, Nitoda Eirini, Ladas Ioannis D, Brouzas Dimitrios, Antonakaki Dimitra, Moschos Marilita M
*First Department of Ophthalmology, University of Athens, Athens, Greece; and †Laboratory of Electrophysiology, First Department of Ophthalmology, University of Athens, Athens, Greece.
J Clin Neurophysiol. 2016 Oct;33(5):431-442. doi: 10.1097/WNP.0000000000000256.
A cross-sectional study to investigate the morphological and functional changes of the visual pathway taking place in patients with migraine.
Fifteen patients (14 female, 1 male) diagnosed with migraine with aura and 23 patients (21 female, 2 male) diagnosed with migraine without aura were compared with 20 healthy volunteers (18 female, 2 male). All the participants underwent optical coherence tomography scan, electroretinogram (ERG), visual evoked potentials, and multifocal electroretinogram (mf-ERG) recording.
Assessing ERG recordings, no significant differences in mean N1-P1 amplitudes were measured among the groups. The mean visual evoked potentials N80-P100 amplitudes were not significantly different among the three groups (one way analysis of variance: P = 0.075, F = 2.718). No significant difference was found in P100 latency times among groups. The mean retinal response density of mf-ERG in ring 1 was higher in healthy individuals compared with migraineurs, with statistical significance (Kruskal-Wallis analysis of variance and Dunn multiple comparisons test; P < 0.001, mean rank difference = -24.857 and P < 0.001, mean rank difference = -20.9, for migraine with aura-control and migraine without aura-control comparisons, respectively). In migraine with aura subjects, retinal nerve fiber layer thickness in superior and inferior quadrants was significantly decreased compared with healthy individuals, whereas in migraine without aura group, only the superior quadrant was significantly thinner compared with the control group.
Retinal response density in mfERG of all migraineurs was significantly lessened compared with healthy individuals. There was no significant difference in visual evoked potentials N80-P100 amplitudes or P100 latencies among the groups. Moreover, retinal nerve fiber layer thinning observed in patients with migraine compared with control subjects, appeared statistically significant in some quadrants. The authors may be able to defend the retinal blood flow decrease theory in migraine. The results also indicate that several levels of the visual pathway seem to be affected in migraineurs.
一项横断面研究，旨在调查偏头痛患者视觉通路发生的形态学和功能变化。
将15例诊断为有先兆偏头痛的患者（14例女性，1例男性）和23例诊断为无先兆偏头痛的患者（21例女性，2例男性）与20名健康志愿者（18例女性，2例男性）进行比较。所有参与者均接受了光学相干断层扫描、视网膜电图（ERG）、视觉诱发电位和多焦视网膜电图（mf-ERG）记录。
评估ERG记录时，各组间平均N1-P1波幅未测得显著差异。三组间平均视觉诱发电位N80-P100波幅无显著差异（单因素方差分析：P = 0.075，F = 2.718）。组间P100潜伏期未发现显著差异。与偏头痛患者相比，健康个体mf-ERG第1环的平均视网膜反应密度更高，具有统计学意义（Kruskal-Wallis方差分析和Dunn多重比较检验；有先兆偏头痛与对照组比较，P < 0.001，平均秩次差异 = -24.857；无先兆偏头痛与对照组比较，P < 0.001，平均秩次差异 = -20.9）。在有先兆偏头痛患者中，与健康个体相比，上象限和下象限的视网膜神经纤维层厚度显著降低，而在无先兆偏头痛组中，仅上象限与对照组相比显著变薄。
与健康个体相比，所有偏头痛患者mfERG中的视网膜反应密度均显著降低。各组间视觉诱发电位N80-P100波幅或P100潜伏期无显著差异。此外，与对照组相比，偏头痛患者观察到的视网膜神经纤维层变薄在某些象限具有统计学意义。作者可能能够支持偏头痛的视网膜血流减少理论。结果还表明，偏头痛患者视觉通路的几个水平似乎受到影响。
