Kalita Jayantee, Uniyal Ravi, Misra Usha K, Bhoi Sanjeev K
1 Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Clin EEG Neurosci. 2018 Sep;49(5):342-350. doi: 10.1177/1550059417734106. Epub 2017 Oct 3.
We report neuronal sensitization and impaired habituation in migraine using pattern reversal visual evoked potential (PRVEP) and correlate these with clinical characteristics of migraine. Sixty-five migraineurs and 30 healthy controls were included. A detailed clinical examination was done and migraine characteristics, including migraine trigger, photophobia, phonophobia, and allodynia were noted. Consecutive 5 blocks of PRVEP were recorded averaging 100 epochs at 3 Hz stimuli. The amplitude of N75 and P100 were measured. Amplitude of first block was considered for sensitization, and impaired habituation was considered if any subsequent block was not suppressed. Migraineurs had sensitization of P100 (14.01 ± 6.02 vs 11.60 ± 5.17 µV; P = .049), but not of N75 (42.22 ± 4.79 vs 11.08 ± 4.56 µV; P = .27) compared with the controls. Impaired habituation of N75 was more marked and persisted up to fourth block of VEP recoding. Impaired habituation of P100 was significant only in the third block. Baseline N75 and P100 amplitudes were higher in females, and N75 was also higher in those with longer duration of illness. These phenomena did not correlate with visual triggers. Sensitization and impaired habituation were marked during headache. Based on the PRVEP findings, it may be concluded that migraineurs have sensitization of P100 and impaired habituation of N75 especially during headache. These phenomena may be useful for therapeutic monitoring.
我们使用模式翻转视觉诱发电位（PRVEP）报告偏头痛患者的神经元致敏和习惯化受损情况，并将这些与偏头痛的临床特征相关联。研究纳入了65名偏头痛患者和30名健康对照者。进行了详细的临床检查，并记录了偏头痛特征，包括偏头痛触发因素、畏光、畏声和痛觉过敏。以3Hz的刺激连续记录5组PRVEP，每组平均100个波阵面。测量N75和P100的波幅。将第一组的波幅用于评估致敏情况，如果后续任何一组未被抑制，则认为存在习惯化受损。与对照组相比，偏头痛患者的P100出现致敏（14.01±6.02对11.60±5.17µV；P=0.049），但N75未出现致敏（42.22±4.79对11.08±4.56µV；P=0.27）。N75的习惯化受损更为明显，一直持续到VEP记录的第四组。P100的习惯化受损仅在第三组显著。女性的基线N75和P100波幅较高，病程较长者的N75波幅也较高。这些现象与视觉触发因素无关。在头痛期间，致敏和习惯化受损较为明显。基于PRVEP的研究结果，可以得出结论，偏头痛患者尤其是在头痛期间存在P100致敏和N75习惯化受损。这些现象可能有助于治疗监测。
