Kalita Jayantee, Misra Usha K, Kumar Mritunjai, Bansal Robin, Uniyal Ravi
30093Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
All India Institute of Medical Sciences, Rishikesh, India.
Clin EEG Neurosci. 2022 May;53(3):196-203. doi: 10.1177/1550059421991707. Epub 2021 Mar 1.
Palinopsia in migraine has been reported recently, which may be due to the dysexcitability of visual cortical neurons. In this cross-sectional study, we report the correlation of neuronal dysexcitability with palinopsia using pattern shift visual evoked potential (PSVEP) in 91 migraineurs and 25 healthy controls. The presence of palinopsia was evaluated using a novel objective method, and revealed more frequent palinopsia in the migraineurs compared to the controls (53 of 91 [58.2%] vs 3 of 25 [12%]; < .001). Five consecutive blocks of PSVEP were recorded for the evaluation of sensitization and impaired habituation. Amplitudes of N75 and P100 in block 1 were considered for sensitization. Impaired habituation of N75 and P100 was considered if any amplitudes in blocks 2 to 5 were higher than block 1. Impaired habituation was more frequent in migraineurs compared with the controls, and was more marked in wave N75 (81.3% vs 32%; < .001) than wave P100 (63.7% vs 44%; = .12). Impaired habituations of wave N75 (81.7% vs 58.9%; = .008) and wave P100 (71.7% vs 46.4%; = .008) were more frequent in those with palinopsia compared with those without. There was a lack of suppression of P100 amplitude in block 3 in the palinopsia group compared to the controls. The duration of palinopsia correlated with the extent of impaired habituation of N75. It can be concluded that the impaired habituation of PSVEP waveforms is a biomarker of palinopsia in migraine.
近期有偏头痛性持续性视觉现象的相关报道,这可能是由于视觉皮层神经元的兴奋异常所致。在这项横断面研究中,我们运用模式翻转视觉诱发电位(PSVEP)报告了91例偏头痛患者和25名健康对照者中神经元兴奋异常与偏头痛性持续性视觉现象之间的相关性。我们采用一种全新的客观方法评估偏头痛性持续性视觉现象的存在情况,结果显示,与对照组相比,偏头痛患者中出现该现象的频率更高(91例中有53例[58.2%],而25例对照组中有3例[12%];P<0.001)。记录连续5个PSVEP组块以评估敏化和习惯化受损情况。第1组块中N75和P100的波幅用于评估敏化。若第2至5组块中的任何波幅高于第1组块,则认为N75和P100的习惯化受损。与对照组相比,偏头痛患者中习惯化受损更为常见,且在N75波(81.3%对32%;P<0.001)比P100波(63.7%对44%;P = 0.12)更为明显。与无偏头痛性持续性视觉现象者相比,有该现象者中N75波(81.7%对58.9%;P = 0.008)和P100波(71.7%对46.4%;P = 0.008)的习惯化受损更为常见。与对照组相比,偏头痛性持续性视觉现象组在第3组块中P100波幅缺乏抑制。偏头痛性持续性视觉现象的持续时间与N75习惯化受损程度相关。可以得出结论,PSVEP波形的习惯化受损是偏头痛性持续性视觉现象的一个生物标志物。
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