Meyer Bianca, Keller Armin, Wöhlbier Hans-Georg, Overath Claudia Helene, Müller Britta, Kropp Peter
Institute of Medical Psychology and Medical Sociology, University Medicine Rostock, Gehlsheimer Straße 20, 18246, Rostock, Germany.
Center of Integrative Psychiatry, University Clinic of Schleswig-Holstein, Niemannsweg 147, Haus 1, 24105, Kiel, Germany.
J Headache Pain. 2016;17:37. doi: 10.1186/s10194-016-0630-0. Epub 2016 Apr 18.
Central information processing, visible in evoked potentials like the contingent negative variation (CNV) is altered in migraine patients who exhibit higher CNV amplitudes and a reduced habituation. Both characteristics were shown to be normalized under different prophylactic migraine treatment options whereas Progressive Muscle Relaxation (PMR) has not yet been examined. We investigated the effect of PMR on clinical course and CNV in migraineurs in a quasi-randomized, controlled trial.
Thirty-five migraine patients and 46 healthy controls were examined. Sixteen migraineurs and 21 healthy participants conducted a 6-week PMR-training with CNV-measures before and after as well as three months after PMR-training completion. The remaining participants served as controls. The clinical course was analyzed with two-way analyses of variance (ANOVA) with repeated measures. Pre-treatment CNV differences between migraine patients and healthy controls were examined with t-tests for independent measures. The course of the CNV-parameters was examined with three-way ANOVAs with repeated measures.
After PMR-training, migraine patients showed a significant reduction of migraine frequency. Preliminary to the PMR-training, migraine patients exhibited higher amplitudes in the early component of the CNV (iCNV) and the overall CNV (oCNV) than healthy controls, but no differences regarding habituation. After completion of the PMR-training, migraineurs showed a normalization of the iCNV amplitude, but neither of the oCNV nor of the habituation coefficient.
The results confirm clinical efficacy of PMR for migraine prophylaxis. The pre-treatment measure confirms altered cortical information processing in migraine patients. Regarding the changes in the iCNV after PMR-training, central nervous mechanisms of the PMR-effect are supposed which may be mediated by the serotonin metabolism.
在诸如关联性负变（CNV）等诱发电位中可见的中枢信息处理在偏头痛患者中发生改变，这些患者表现出较高的CNV波幅和减弱的习惯化。在不同的偏头痛预防性治疗方案下，这两个特征均显示恢复正常，而渐进性肌肉松弛（PMR）尚未得到研究。我们在一项准随机对照试验中研究了PMR对偏头痛患者临床病程和CNV的影响。
对35名偏头痛患者和46名健康对照者进行了检查。16名偏头痛患者和21名健康参与者进行了为期6周的PMR训练，在训练前后以及训练完成后三个月进行CNV测量。其余参与者作为对照。采用重复测量的双向方差分析（ANOVA）分析临床病程。采用独立样本t检验检查偏头痛患者与健康对照者治疗前的CNV差异。采用重复测量的三向ANOVA检查CNV参数的变化过程。
PMR训练后，偏头痛患者的偏头痛发作频率显著降低。在PMR训练前，偏头痛患者在CNV的早期成分（iCNV）和总体CNV（oCNV）中表现出比健康对照者更高的波幅，但在习惯化方面没有差异。PMR训练完成后，偏头痛患者的iCNV波幅恢复正常，但oCNV和习惯化系数均未恢复正常。
结果证实了PMR预防偏头痛的临床疗效。治疗前的测量结果证实了偏头痛患者皮质信息处理的改变。关于PMR训练后iCNV的变化，推测PMR效应的中枢神经机制可能由血清素代谢介导。
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