Uglem Martin, Omland Petter Moe, Stjern Marit, Gravdahl Gøril Bruvik, Sand Trond
Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
NTNU, Faculty of Medicine and Health Sciences, P.B. 8905, N-7491, Trondheim, Norway.
J Headache Pain. 2017 Oct 2;18(1):100. doi: 10.1186/s10194-017-0810-6.
BACKGROUND: Migraineurs seem to have cyclic variations in cortical excitability in several neurophysiological modalities. Laser-evoked potentials (LEP) are of particular interest in migraine because LEP specifically targets pain pathways, and studies have reported different LEP-changes both between and during headaches. Our primary aim was to explore potential cyclic variations in LEP amplitude and habituation in more detail with a blinded longitudinal study design. METHODS: We compared N1 and N2P2 amplitudes and habituation between two blocks of laser stimulations to the dorsal hand, obtained from 49 migraineurs with four sessions each. We used migraine diaries to categorize sessions as interictal (> one day from previous and to next attack), preictal (< one day before the attack), ictal or postictal (< one day after the attack). Also, we compared 29 interictal recordings from the first session to 30 controls. RESULTS: N1 and N2P2 amplitudes and habituation did not differ between preictal, interictal and postictal phase sessions, except for a post hoc contrast that showed deficient ictal habituation of N1. Habituation is present and similar in migraineurs in the interictal phase and controls. CONCLUSIONS: Hand-evoked LEP amplitudes and habituation were mainly invariable between migraine phases, but this matter needs further study. Because hand-evoked LEP-habituation was similar in migraineurs and controls, the present findings contradict several previous LEP studies. Pain-evoked cerebral responses are normal and show normal habituation in migraine.
背景:偏头痛患者在几种神经生理模式下的皮质兴奋性似乎存在周期性变化。激光诱发电位(LEP)在偏头痛研究中特别受关注,因为LEP专门针对疼痛通路,并且研究报告了头痛发作期间和发作之间LEP的不同变化。我们的主要目的是通过一项盲法纵向研究设计更详细地探索LEP振幅和习惯化的潜在周期性变化。 方法:我们比较了从49名偏头痛患者中获得的、每人均有四个疗程的、对手背进行的两个激光刺激块之间的N1和N2P2振幅及习惯化情况。我们使用偏头痛日记将会话分类为发作间期(距上次发作和下次发作超过一天)、发作前期(发作前一天内)、发作期或发作后期(发作后一天内)。此外,我们将第一次疗程的29次发作间期记录与30名对照者的记录进行了比较。 结果:除事后对比显示N1在发作期的习惯化不足外,发作前期、发作间期和发作后期各疗程之间的N1和N2P2振幅及习惯化并无差异。发作间期的偏头痛患者和对照者均存在习惯化且情况相似。 结论:手部诱发的LEP振幅和习惯化在偏头痛各阶段之间主要无变化,但这一问题仍需进一步研究。由于偏头痛患者和对照者的手部诱发LEP习惯化情况相似,目前的研究结果与之前的多项LEP研究相矛盾。疼痛诱发的大脑反应在偏头痛中是正常的,且显示出正常的习惯化。
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