Smell & Taste Center, Deptartment of Otorhinolaryngology, TU Dresden, Dresden, Germany.
Headache Outpatient Clinic, University Pain Center, University Hospital, TU Dresden, Dresden, Germany.
Brain Topogr. 2023 Jan;36(1):52-71. doi: 10.1007/s10548-022-00924-x. Epub 2022 Nov 12.
In migraine, the trigeminal nerve is intimately involved in the pathophysiology of the disease. We hypothesized that alterations in the sensory trigeminal activation in migraine would be reflected by EEG-derived event-related potentials (ERP). We aimed to investigate differences in the temporal and spatial processing of trigeminal stimuli between interictal migraine patients and healthy subjects. ERP to trigeminal stimuli were recorded at 128-channels to allow localization of their cortical sources with high temporal resolution. Seventeen patients with episodic migraine without aura, 17 subjects with episodic migraine with aura, and 17 healthy subjects participated in the study. The first branch of the trigeminal nerve was stimulated using intranasal chemical (CO), cutaneous electrical, and cutaneous mechanical (air puff) stimuli. Analyses were performed with regard to micro-state segmentation, ERP source localization, and correlation with the patients' clinical characteristics. Topographical assessments of EEG configurations were associated with the pathological condition. The source analysis revealed altered trigeminal-sensory response patterns in the precuneus, temporal pole, and cerebellum for both migraine groups during the interictal phase. The estimated current source density was positively correlated with migraine disease duration, indicating brain functional and structural changes as a consequence of the disease. Hyperactivity of the cerebellar posterior lobe was observed as a specific trigeminal response of migraine patients with aura. In conclusion, our results suggest the presence of brain changes accompanying the advancement of migraine as an expression of dysfunctional central pain processing. Hence, we identified EEG patterns in response to mechano-/chemosensory stimuli that can serve as biomarkers of migraine.
在偏头痛中，三叉神经在疾病的病理生理学中起着密切的作用。我们假设偏头痛患者三叉神经感觉激活的改变将反映在脑电图衍生的事件相关电位（ERP）中。我们旨在研究间歇期偏头痛患者和健康受试者之间三叉神经刺激的时间和空间处理差异。使用 128 通道的脑电图记录三叉神经刺激的 ERP，以允许用高时间分辨率定位其皮质源。17 例无先兆发作性偏头痛患者、17 例有先兆发作性偏头痛患者和 17 例健康受试者参加了这项研究。三叉神经第一分支通过鼻内化学（CO）、皮肤电和皮肤机械（空气喷射）刺激进行刺激。分析涉及微状态分割、ERP 源定位以及与患者临床特征的相关性。脑电图配置的拓扑评估与病理状况有关。源分析显示，在间歇期，两个偏头痛组的楔前叶、颞极和小脑的三叉神经感觉反应模式发生改变。估计的电流密度与偏头痛疾病持续时间呈正相关，表明疾病导致大脑功能和结构的变化。观察到小脑后叶的过度活跃是偏头痛伴先兆患者的特定三叉神经反应。总之，我们的结果表明，随着偏头痛的进展，大脑发生变化，这是中枢性疼痛处理功能障碍的表现。因此，我们确定了对机械/化学感觉刺激的脑电图反应模式，这些模式可以作为偏头痛的生物标志物。
