1 Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
2 Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
Cephalalgia. 2018 Apr;38(4):744-753. doi: 10.1177/0333102417712718. Epub 2017 May 25.
Background Brain excitability is changed in migraine but not fully characterized yet. This study explored if somatosensory gating is altered in migraine and linked to migraine chronification. Methods Paired electrical stimuli were delivered to the left index fingers of 21 patients with migraine without aura (MO), 22 patients with chronic migraine (CM), and 36 controls. The first and second responses to the paired stimuli were obtained from the contralateral primary (cSI), contralateral secondary (cSII) and ipsilateral secondary (iSII) somatosensory cortices to compute the gating ratios (second vs. first response strengths). Results The first and second cSI responses and gating ratios differed in all groups ( p < 0.05); the responses were typically smaller in the MO and CM groups. The cSI gating ratio increased as a continuum across controls (0.73 ± 0.04, p < 0.001), MO (0.83 ± 0.04) to CM (0.97 ± 0.06) and was higher in CM vs. controls ( p < 0.001). When MO and CM were combined, cSI gating ratio was associated with headache frequency (r = 0.418, p = 0.005). Paired responses and gating ratios of cSII and iSII did not differ among the groups. Conclusions Somatosensory gating is altered in migraine and associated with headache chronification. Further studies must clarify if this abnormal sensory modulation is a true gating deficit independent of low preexcitation level.
背景 偏头痛患者大脑兴奋性发生改变,但尚未完全明确。本研究旨在探讨偏头痛患者感觉门控是否改变,以及其是否与偏头痛慢性化相关。
方法 对 21 例无先兆偏头痛(MO)患者、22 例慢性偏头痛(CM)患者和 36 例健康对照者的左侧食指进行双侧电刺激。记录对侧初级体感皮层(cSI)、对侧次级体感皮层(cSII)和同侧次级体感皮层(iSII)的第 1 及第 2 对刺激反应,计算感觉门控比值(第 2 反应与第 1 反应强度比)。
结果 三组的第 1 及第 2 cSI 反应和门控比值均有差异(p<0.05),MO 和 CM 组的反应通常较小。cSI 门控比值在对照组(0.73±0.04,p<0.001)、MO 组(0.83±0.04)到 CM 组(0.97±0.06)呈连续递增,且 CM 组高于对照组(p<0.001)。MO 和 CM 合并后,cSI 门控比值与头痛频率相关(r=0.418,p=0.005)。cSII 和 iSII 的成对反应和门控比值在三组间无差异。
结论 偏头痛患者感觉门控异常,且与头痛慢性化相关。进一步的研究必须明确这种异常的感觉调制是否是一种真正的门控缺陷,而不是低预激水平的结果。