偏头痛发作期间及体内痛觉过敏时多巴胺D2/D3失衡。
Dopamine D2/D3 imbalance during migraine attack and allodynia in vivo.
作者信息
DaSilva Alexandre F, Nascimento Thiago D, Jassar Hassan, Heffernan Joseph, Toback Rebecca L, Lucas Sarah, DosSantos Marcos F, Bellile Emily L, Boonstra Philip S, Taylor Jeremy M G, Casey Kenneth L, Koeppe Robert A, Smith Yolanda R, Zubieta Jon-Kar
机构信息
From the Headache & Orofacial Pain Effort (H.O.P.E.), Biologic & Materials Sciences Department, School of Dentistry (A.F.D., T.D.N., H.J., R.L.T., S.L., M.F.D.), Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute (A.F.D., J.H.. J.-K.Z.), Department of Biostatistics (E.L.B., P.S.B., J.M.G.T.), Department of Neurology (K.L.C.), PET Physics Section, Division of Nuclear Medicine, Radiology Department (R.A.K.), and Department of Obstetrics and Gynecology (Y.R.S.), University of Michigan, Ann Arbor.
出版信息
Neurology. 2017 Apr 25;88(17):1634-1641. doi: 10.1212/WNL.0000000000003861. Epub 2017 Mar 29.
OBJECTIVE
To evaluate in vivo the dynamics of endogenous dopamine (DA) neurotransmission during migraine ictus with allodynia.
METHODS
We examined 8 episodic migraineurs and 8 healthy controls (HC) using PET with [C]raclopride. The uptake measure of [C]raclopride, nondisplaceable binding potential (BP), would increase when there was a reduction in endogenous DA release. The opposite is true for a decrease in [C]raclopride BP. Patients were scanned twice: one PET session was during a spontaneous migraine ictus at rest, followed by a sustained thermal pain threshold (STPT) challenge on the trigeminal region, eliciting an allodynia experience; another was during interictal phase.
RESULTS
Striatal BP of [C]raclopride in migraineurs did not differ from HC. We found a significant increase in [C]raclopride BP in the striatum region of migraineurs during both headache attack and allodynia relative to interictal phase. However, when compared to the migraine attack at rest, migraineurs during the STPT challenge had a significant sudden reduction in [C]raclopride BP in the insula. Such directional change was also observed in the caudate of HC relative to the interictal phase during challenge. Furthermore, ictal changes in [C]raclopride BP in migraineurs at rest were positively correlated with the chronicity of migraine attacks, and negatively correlated with the frequency during challenge.
CONCLUSIONS
Our findings demonstrate that there is an imbalanced uptake of [C]raclopride during the headache attack and ictal allodynia, which indicates reduction and fluctuation in ictal endogenous DA release in migraineurs. Moreover, the longer the history and recurrence of migraine attacks, the lower the ictal endogenous DA release.
目的
在体内评估伴有痛觉过敏的偏头痛发作期间内源性多巴胺（DA）神经传递的动态变化。
方法
我们使用[C]雷氯必利正电子发射断层扫描（PET）检查了8名发作性偏头痛患者和8名健康对照者（HC）。当内源性DA释放减少时，[C]雷氯必利的摄取量测量值，即不可置换结合电位（BP）会增加。[C]雷氯必利BP降低时情况则相反。对患者进行了两次扫描：一次PET扫描是在静息状态下的自发偏头痛发作期间，随后在三叉神经区域进行持续热痛阈（STPT）刺激，引发痛觉过敏体验；另一次是在发作间期。
结果
偏头痛患者中[C]雷氯必利的纹状体BP与健康对照者无差异。我们发现，与发作间期相比，偏头痛患者在头痛发作和痛觉过敏期间纹状体区域的[C]雷氯必利BP显著增加。然而，与静息状态下的偏头痛发作相比，在STPT刺激期间偏头痛患者脑岛中的[C]雷氯必利BP突然显著降低。在刺激期间，健康对照者的尾状核相对于发作间期也观察到了这种方向性变化。此外，静息状态下偏头痛患者[C]雷氯必利BP的发作期变化与偏头痛发作的慢性程度呈正相关，与刺激期间的发作频率呈负相关。
结论
我们的研究结果表明，在头痛发作和发作性痛觉过敏期间，[C]雷氯必利的摄取存在失衡，这表明偏头痛患者发作期内源性DA释放减少且有波动。此外，偏头痛发作的病史和复发时间越长，发作期内源性DA释放越低。
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