Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway.
Cephalalgia. 2023 Mar;43(3):3331024221148391. doi: 10.1177/03331024221148391.
Migraine is a brain disorder with a multifaceted and unexplained association to sleep. Brain excitability likely changes periodically throughout the migraine cycle. In this study we examine the effect of insufficient sleep on neuronal excitability during the course of the migraine cycle.
We examined 54 migraine patients after two nights of eight-hour habitual sleep and two nights of four-hour restricted sleep in a randomised, blinded crossover study. We performed transcranial magnetic stimulation and measured cortical silent period, short- and long-interval intracortical inhibition, intracortical facilitation and short-latency afferent inhibition. We analysed how responses changed before and after attacks with linear mixed models.
Short- interval intracortical inhibition was more reduced after sleep restriction compared to habitual sleep the shorter the time that had elapsed since the attack ( = 0.041), and specifically in the postictal phase ( = 0.013). Long-interval intracortical inhibition was more increased after sleep restriction with time closer before the attack ( = 0.006), and specifically in the preictal phase ( = 0.034). Short-latency afferent inhibition was more decreased after sleep restriction with time closer to the start of the attack ( = 0.026).
Insufficient sleep in the period leading up to a migraine attack may cause dysfunction in cortical GABAergic inhibition. The results also suggest that migraine patients may have increased need for sufficient sleep during a migraine attack to maintain normal neurological function after the attack.
偏头痛是一种脑部疾病，与睡眠存在多方面且尚未得到解释的关联。大脑兴奋性可能在偏头痛周期中周期性地发生变化。在这项研究中，我们研究了在偏头痛周期过程中睡眠不足对神经元兴奋性的影响。
我们在一项随机、双盲交叉研究中，在偏头痛患者经历了两个 8 小时习惯性睡眠夜和两个 4 小时限制睡眠夜后，对 54 名偏头痛患者进行了检查。我们进行了经颅磁刺激，并测量了皮质静息期、短程和长程皮质内抑制、皮质内易化和短潜伏期传入抑制。我们通过线性混合模型分析了在发作前后反应如何变化。
与习惯性睡眠相比，睡眠限制后短程皮质内抑制在距发作时间越短的情况下减少得越多（=0.041），特别是在发作后阶段（=0.013）。长程皮质内抑制在距发作时间越近的情况下增加得越多（=0.006），特别是在发作前阶段（=0.034）。短潜伏期传入抑制在距发作开始时间越近的情况下减少得越多（=0.026）。
在偏头痛发作前的时间段内睡眠不足可能导致皮质 GABA 能抑制功能障碍。研究结果还表明，偏头痛患者在偏头痛发作期间可能需要更多的充足睡眠来维持发作后的正常神经功能。
