Unal Zeynep, Domac Fusun Mayda, Boylu Ece, Kocer Abdulkadir, Tanridag Tulin, Us Onder
Neurology Department, Manisa State Hospital for Mental Health and Neurological Disorders, Manisa, Turkey.
Neurology Department, Erenköy Training and Research Hospital for Psychiatric and Neurological Disorders, Istanbul, Turkey.
North Clin Istanb. 2016 Apr 26;3(1):1-8. doi: 10.14744/nci.2016.30301. eCollection 2016.
Activation of trigeminovascular system is thought to play an important role in migraine pathogenesis. Blink reflex (BR) test is an easy method to study the trigeminal system. Latencies recorded in BR test were evaluated to examine neurophysiological changes that occur in migraine patients.
A total of 40 patients diagnosed with migraine (9 with aura and 31 without aura) according to the International Headache Society (IHS) International Classification of Headache Disorders, 2nd edition, and 30 healthy control subjects were assessed using BR test. Supraorbital nerve was stimulated on each side, and unilateral early component (R1), and bilateral late component (R2) latencies were evaluated.
Significantly longer latency values were recorded on both right and left sides (RR1 and LR1) as well as both ipsilateral and contralateral R2 on the left side (LR2i and LR2c) in the migraine group compared to the control group. Longer RR1 and LR1 latencies were found in patients with migraine who had an attack at the time of study (p<0.01). There was no statistically significant correlation between the location of pain and latencies in the interictal period (p>0.05). But significantly longer R1 and R2i latencies were found at the symptomatic side of patients examined during the headache attack (p=0.037 and p=0.028 respectively). There was no statistically significant correlation between the recorded latencies and gender, attack duration, attack frequency and migraine type (p>0.05).
Results of BR test in the present study are thought to point to a dysfunction in brainstem and trigeminovascular connections of patients with migraine headache and support the trigeminovascular theory of migraine.
三叉神经血管系统的激活被认为在偏头痛发病机制中起重要作用。眨眼反射(BR)测试是研究三叉神经系统的一种简便方法。评估BR测试中记录的潜伏期,以检查偏头痛患者发生的神经生理变化。
根据国际头痛协会(IHS)《头痛疾病国际分类》第二版,对40例被诊断为偏头痛的患者(9例有先兆,31例无先兆)和30名健康对照者进行BR测试评估。刺激每侧眶上神经,评估单侧早期成分(R1)和双侧晚期成分(R2)的潜伏期。
与对照组相比,偏头痛组右侧和左侧(RR1和LR1)以及左侧同侧和对侧R2(LR2i和LR2c)的潜伏期值均显著延长。在研究时发作的偏头痛患者中发现RR1和LR1潜伏期更长(p<0.01)。发作间期疼痛部位与潜伏期之间无统计学显著相关性(p>0.05)。但在头痛发作期间检查的患者症状侧发现R1和R2i潜伏期显著延长(分别为p=0.037和p=0.028)。记录的潜伏期与性别、发作持续时间、发作频率和偏头痛类型之间无统计学显著相关性(p>0.05)。
本研究中BR测试的结果被认为表明偏头痛患者脑干和三叉神经血管连接存在功能障碍,并支持偏头痛的三叉神经血管理论。