异常心率变异性及其在预测慢性偏头痛患者治疗效果中的应用：一项探索性研究。

Abnormal heart rate variability and its application in predicting treatment efficacy in patients with chronic migraine: An exploratory study.

作者信息

Chuang Chun-Hsiang, Li Jhe-Yu, King Jung-Tai, Chen Wei-Ta, Chen Shih-Pin, Wang Yen-Feng, Liu Hung-Yu, Hsiao Fu-Jung, Pan Li-Ling Hope, Wang Shuu-Jiun, Lai Kuan-Lin

机构信息

Research Center for Education and Mind Sciences, College of Education, National Tsing Hua University, Hsinchu, Taiwan.

Institute of Information Systems and Applications, College of Electrical Engineering and Computer Science, National Tsing Hua University, Hsinchu, Taiwan.

出版信息

Cephalalgia. 2023 Oct;43(10):3331024231206781. doi: 10.1177/03331024231206781.

DOI:10.1177/03331024231206781

PMID:37851663

Abstract

AIM

This study aimed to investigate the extent of autonomic nervous system dysfunction in patients with chronic migraine using heart rate variability analysis. In addition, we explored the potential association between heart rate variability and treatment outcomes in patients receiving preventive treatment.

METHODS

In this cross-sectional and prospective study, we compared heart rate variability profiles in 81 preventive-naïve chronic migraine patients and 58 healthy controls. In addition, treatment responses of patients, who received a 12-week treatment with flunarizine, were assessed in relation to baseline heart rate variability.

RESULTS

We observed that chronic migraine patients had a reduced heart rate variability, signifying autonomic dysfunction in comparison to healthy controls. Furthermore, patients presenting normal heart rate variability, characterized by a standard deviation exceeding 30 milliseconds in normal-to-normal RR intervals, experienced a superior response to flunarizine treatment. This improvement was exemplified by a significantly larger reduction in monthly headache days for patients with higher heart rate variability compared to those with lower heart rate variability: -9.7 (5.9) vs. -6.2 (6.0) days ( = .026).

CONCLUSIONS

Autonomic dysfunction occurs in chronic migraine as evaluated by heart rate variability. A preserved function is associated with a better treatment outcome to flunarizine. Neurologic Signatures of Chronic Pain Disorders, NCT02747940. Registered 22 April 2016, https://clinicaltrials.gov/ct2/show/NCT02747940.

摘要

目的

本研究旨在通过心率变异性分析调查慢性偏头痛患者自主神经系统功能障碍的程度。此外，我们还探讨了接受预防性治疗的患者心率变异性与治疗结果之间的潜在关联。

方法

在这项横断面前瞻性研究中，我们比较了81例未接受过预防性治疗的慢性偏头痛患者和58例健康对照者的心率变异性特征。此外，对接受氟桂利嗪12周治疗的患者的治疗反应与基线心率变异性进行了评估。

结果

我们观察到，与健康对照者相比，慢性偏头痛患者的心率变异性降低，这表明存在自主神经功能障碍。此外，心率变异性正常（以正常RR间期标准差超过30毫秒为特征）的患者对氟桂利嗪治疗的反应更好。心率变异性较高的患者每月头痛天数的减少幅度明显大于心率变异性较低的患者，这体现了这种改善：-9.7（5.9）天 vs. -6.2（6.0）天（P = 0.026）。