1 Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy.
2 IRCCS Neuromed, Pozzilli (IS), Italy.
Cephalalgia. 2019 Feb;39(2):237-244. doi: 10.1177/0333102418784747. Epub 2018 Jun 19.
To study the effects of trains of repetitive transcranial magnetic stimulation (rTMS) over the motor cortex in patients with chronic migraine (CM) with or without medication overuse (MOH).
Thirty-two patients (CM [n = 16]; MOH [n = 16]) and 16 healthy volunteers (HVs) underwent rTMS recording. Ten trains of 10 stimuli each (120% resting motor threshold) were applied over the left motor cortex at 1 Hz or 5 Hz in random order. The amplitude of motor evoked potential (MEP) was evaluated from electromyographic recording in the first dorsal interosseous muscle. The slope of the linear regression line for the 10 stimuli for each participant was calculated using normalized data.
rTMS-1 Hz had a normal depressive effect on MEP amplitude in all groups. rTMS-5 Hz depressed instead of potentiating MEP amplitudes in MOH patients, with a significantly different response from that in HVs and CM patients. The slope of the linear regression of MEP amplitudes was negatively correlated with pain intensity in CM patients, and with the duration of overuse headache in MOH patients.
This different plastic behaviour suggests that MOH and CM, despite exhibiting a similar clinical phenotype, have different neurophysiological learning processes, probably related to different pathophysiological mechanisms of migraine chronification.
研究经颅重复磁刺激（rTMS）对伴有或不伴有药物过度使用（MOH）的慢性偏头痛（CM）患者运动皮质的影响。
32 名患者（CM [n=16]；MOH [n=16]）和 16 名健康志愿者（HV）接受 rTMS 记录。10 个刺激的 10 个 trains（120%静息运动阈值）以 1Hz 或 5Hz 的随机顺序施加到左运动皮质。通过第一背侧间骨肌的肌电图记录评估运动诱发电位（MEP）的幅度。使用归一化数据计算每个参与者的 10 个刺激的线性回归线的斜率。
rTMS-1Hz 对所有组的 MEP 幅度均有正常的抑制作用。rTMS-5Hz 抑制而不是增强 MOH 患者的 MEP 幅度，与 HV 和 CM 患者的反应明显不同。MEP 幅度的线性回归斜率与 CM 患者的疼痛强度呈负相关，与 MOH 患者过度使用性头痛的持续时间呈负相关。
这种不同的可塑性行为表明，尽管 MOH 和 CM 表现出相似的临床表型，但它们具有不同的神经生理学习过程，可能与偏头痛慢性化的不同病理生理机制有关。
