Headache and Neurological Pain Research Group, Vall d'Hebron Institute of Research (VHIR), Department of Medicine, Universitat Autonoma Barcelona, Barcelona, Spain.
Headache Unit, Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
J Headache Pain. 2023 Aug 7;24(1):104. doi: 10.1186/s10194-023-01618-w.
BACKGROUND: Migraine is a cyclic, neurosensory disorder characterized by recurrent headaches and altered sensory processing. The latter is manifested in hypersensitivity to visual stimuli, measured with questionnaires and sensory thresholds, as well as in abnormal cortical excitability and a lack of habituation, assessed with visual evoked potentials elicited by pattern-reversal stimulation. Here, the goal was to determine whether factors such as age and/or disease severity may exert a modulatory influence on sensory sensitivity, cortical excitability, and habituation. METHODS: Two similar experiments were carried out, the first comparing 24 young, episodic migraine patients and 28 healthy age- and gender-matched controls and the second 36 middle-aged, episodic migraine patients and 30 healthy age- and gender-matched controls. A neurologist confirmed the diagnoses. Migraine phases were obtained using eDiaries. Sensory sensitivity was assessed with the Sensory Perception Quotient and group comparisons were carried out. We obtained pattern-reversal visual evoked potentials and calculated the N1-P1 Peak-to-Peak amplitude. Two linear mixed-effects models were fitted to these data. The first model had Block (first block, last block) and Group (patients, controls) as fixed factors, whereas the second model had Trial (all trials) and Group as fixed factors. Participant was included as a random factor in both. N1-P1 first block amplitude was used to assess cortical excitability and habituation was defined as a decrease of N1-P1 amplitude across Blocks/Trials. Both experiments were performed interictally. RESULTS: The final samples consisted of 18 patients with episodic migraine and 27 headache-free controls (first experiment) and 19 patients and 29 controls (second experiment). In both experiments, patients reported increased visual hypersensitivity on the Sensory Perception Quotient as compared to controls. Regarding N1-P1 peak-to-peak data, there was no main effect of Group, indicating no differences in cortical excitability between groups. Finally, significant main effects of both Block and Trial were found indicating habituation in both groups, regardless of age and headache frequency. CONCLUSIONS: The results of this study yielded evidence for significant hypersensitivity in patients but no significant differences in either habituation or cortical excitability, as compared to headache-free controls. Although the alterations in patients may be less pronounced than originally anticipated they demonstrate the need for the definition and standardization of optimal methodological parameters.
背景:偏头痛是一种周期性的神经感觉障碍,其特征是反复发作的头痛和感觉处理异常。后者表现为对视觉刺激的超敏反应,通过问卷调查和感觉阈值来测量,以及异常的皮质兴奋性和缺乏习惯化,通过模式反转刺激诱发的视觉诱发电位来评估。在这里,目的是确定年龄和/或疾病严重程度等因素是否会对感觉敏感性、皮质兴奋性和习惯化产生调节影响。
方法:进行了两项类似的实验,第一项比较了 24 名年轻的发作性偏头痛患者和 28 名年龄和性别匹配的健康对照者,第二项比较了 36 名中年的发作性偏头痛患者和 30 名年龄和性别匹配的健康对照者。一位神经科医生确认了诊断。偏头痛阶段是通过电子日记获得的。使用感觉知觉商来评估感觉敏感性,并进行组间比较。我们获得了模式反转视觉诱发电位,并计算了 N1-P1 峰峰值幅度。对这些数据进行了两个线性混合效应模型拟合。第一个模型将块(第一块、最后一块)和组(患者、对照)作为固定因素,而第二个模型将试验(所有试验)和组作为固定因素。参与者被包括在两个模型中作为随机因素。使用 N1-P1 第一块幅度来评估皮质兴奋性,定义为 N1-P1 幅度随块/试验的降低。这两个实验都是在间歇期进行的。
结果:最终样本包括 18 名发作性偏头痛患者和 27 名无头痛对照组(第一项实验)和 19 名患者和 29 名对照组(第二项实验)。在两项实验中,患者在感觉知觉商上报告的视觉超敏反应均高于对照组。关于 N1-P1 峰峰值数据,组间没有主要影响,表明组间皮质兴奋性没有差异。最后,发现块和试验都有显著的主要影响,表明两组都有习惯化,与年龄和头痛频率无关。
结论:本研究结果表明,与无头痛对照组相比,患者存在显著的超敏反应,但在习惯化或皮质兴奋性方面没有显著差异。尽管患者的改变可能不如最初预期的那么明显,但它们表明需要定义和标准化最佳方法参数。
Cephalalgia. 2016-8
Cephalalgia. 2016-11-12
J Headache Pain. 2009-12-10
Medicina (Kaunas). 2024-1-15
Neuropsychol Rev. 2023-12
Front Pain Res (Lausanne). 2022-7-5
Cephalalgia. 2022-11
Vision (Basel). 2021-4-28
Clin EEG Neurosci. 2022-5
Front Neurol. 2020-10-22
Neuropsychiatr Dis Treat. 2020-11-2
Front Integr Neurosci. 2020-4-3