高密度脑电图中的偏头痛先兆特征。

Signatures of migraine aura in high-density-EEG.

机构信息

Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; University of Zurich, Medical Faculty, Zurich, Switzerland.

Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology.

出版信息

Clin Neurophysiol. 2024 Apr;160:113-120. doi: 10.1016/j.clinph.2024.01.008. Epub 2024 Feb 18.

DOI:10.1016/j.clinph.2024.01.008

PMID:38422969

Abstract

OBJECTIVE

Cortical spreading depolarization is highly conserved among the species. It is easily detectable in direct cortical surface recordings and has been recorded in the cortex of humans with severe neurological disease. It is considered the pathophysiological correlate of human migraine aura, but direct electrophysiological evidence is still missing. As signatures of cortical spreading depolarization have been recognized in scalp EEG, we investigated typical spontaneous migraine aura, using full band high-density EEG (HD-EEG).

METHODS

In this prospective study, patients with migraine with aura were investigated during spontaneous migraine aura and interictally. Time compressed HD-EEG were analyzed for the presence of cortical spreading depolarization characterized by (a) slow potential changes below 0.05 Hz, (b) suppression of faster activity from 0.5 Hz - 45 Hz (c) spreading of these changes to neighboring regions during the aura phase. Further, topographical changes in alpha-power spectral density (8-14 Hz) during aura were analyzed.

RESULTS

In total, 26 HD-EEGs were recorded in patients with migraine with aura, thereof 10 HD-EEGs during aura. Eight HD-EEGs were recorded in the same subject. During aura, no slow potentials were recorded, but alpha-power was significantly decreased in parieto-occipito-temporal location on the hemisphere contralateral to visual aura, lasting into the headache phase. Interictal alpha-power in patients with migraine with aura did not differ significantly from age- and sex-matched healthy controls.

CONCLUSIONS

Unequivocal signatures of spreading depolarization were not recorded with EEG on the intact scalp in migraine. The decrease in alpha-power contralateral to predominant visual symptoms is consistent with focal depression of spontaneous brain activity as a consequence of cortical spreading depolarization but is not specific thereof.

SIGNIFICANCE

Cortical spreading depolarization is relevant in migraine, other paroxysmal neurological disorders and neurointensive care.

摘要

目的

皮质扩散性抑制在物种间高度保守。它在直接皮质表面记录中很容易检测到，并已在患有严重神经疾病的人类皮质中记录到。它被认为是人类偏头痛先兆的病理生理学相关物，但仍缺乏直接电生理证据。由于在头皮 EEG 中已经识别出皮质扩散性抑制的特征，我们使用全带宽高密度 EEG（HD-EEG）研究了典型的自发性偏头痛先兆。

方法

在这项前瞻性研究中，在自发性偏头痛先兆和发作间期对偏头痛先兆患者进行了研究。对时间压缩的 HD-EEG 进行了分析，以寻找皮质扩散性抑制的特征，这些特征包括：（a）低于 0.05 Hz 的慢电位变化，（b）0.5 Hz-45 Hz 更快活动的抑制，（c）在先兆期向相邻区域传播这些变化。此外，还分析了先兆期α-功率谱密度（8-14 Hz）的拓扑变化。