1 Headache Research Unit, University Department of Neurology CHR, Citadelle Hospital, University of Liège, Liège, Belgium.
2 IRCCS - Fondazione Bietti, Research Unit of Neurophysiology of Vision and Neurophthalmology, Rome, Italy.
Cephalalgia. 2019 Jul;39(8):978-987. doi: 10.1177/0333102419828984. Epub 2019 Feb 11.
The aim of this study was to evaluate the possibility that migraine patients exhibit specific age-related metabolic changes in the brain, which occur regardless of disease duration or the frequency of attacks.
We analysed the relation between brain glucose (F-fluorodeoxyglucose) uptake and age in healthy volunteers (n = 20) and episodic migraine patients (n = 19). In the latter, we additionally compared the correlation between F-fluorodeoxyglucose uptake and disease duration and monthly migraine days.
In contrast to controls, in migraine patients advancing age was positively correlated to increased metabolism in the brainstem (especially the posterior pons), hippocampus, fusiform gyrus and parahippocampus. Conversely, no significant correlations between cerebral metabolism and disease duration or migraine days were observed.
Findings of this cross-sectional study show that episodic migraine patients exhibit specific metabolic brain modifications while ageing. As such, age is correlated with metabolic changes in key regions of the brain previously associated with migraine's pathophysiology to a better extent than disease duration or the number of monthly migraine days. More than the repeated headache attacks, the continuous interaction with the environment seemingly models the brain of migraine sufferers in an adaptive manner. A positive control (e.g. chronic pain) is missing in this study and therefore findings cannot be proven to be migraine-specific.
本研究旨在评估偏头痛患者大脑中是否存在与年龄相关的特定代谢变化,这些变化与疾病持续时间或发作频率无关。
我们分析了健康志愿者(n=20)和发作性偏头痛患者(n=19)的大脑葡萄糖(F-氟代脱氧葡萄糖)摄取与年龄之间的关系。在后一组中,我们还比较了 F-氟代脱氧葡萄糖摄取与疾病持续时间和每月偏头痛天数之间的相关性。
与对照组相比,偏头痛患者随着年龄的增长,脑干(尤其是后脑桥)、海马体、梭状回和海马旁回的代谢增加呈正相关。相反,大脑代谢与疾病持续时间或偏头痛天数之间没有显著相关性。
这项横断面研究的结果表明,发作性偏头痛患者在衰老过程中表现出特定的大脑代谢改变。因此,年龄与先前与偏头痛病理生理学相关的大脑关键区域的代谢变化的相关性优于疾病持续时间或每月偏头痛天数。与反复头痛发作相比,与环境的持续相互作用似乎以一种适应性的方式塑造了偏头痛患者的大脑。本研究缺乏阳性对照(例如慢性疼痛),因此无法证明这些发现是偏头痛特异性的。