van den Hoek Thomas C, van de Ruit Mark, Terwindt Gisela M, Tolner Else A
Department of Neurology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands.
Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands.
Brain Sci. 2024 May 17;14(5):508. doi: 10.3390/brainsci14050508.
Migraine is a highly prevalent brain condition with paroxysmal changes in brain excitability believed to contribute to the initiation of an attack. The attacks and their unpredictability have a major impact on the lives of patients. Clinical management is hampered by a lack of reliable predictors for upcoming attacks, which may help in understanding pathophysiological mechanisms to identify new treatment targets that may be positioned between the acute and preventive possibilities that are currently available. So far, a large range of studies using conventional hospital-based EEG recordings have provided contradictory results, with indications of both cortical hyper- as well as hypo-excitability. These heterogeneous findings may largely be because most studies were cross-sectional in design, providing only a snapshot in time of a patient's brain state without capturing day-to-day fluctuations. The scope of this narrative review is to (i) reflect on current knowledge on EEG changes in the context of migraine, the attack cycle, and underlying pathophysiology; (ii) consider the effects of migraine treatment on EEG features; (iii) outline challenges and opportunities in using EEG for monitoring attack susceptibility; and (iv) discuss future applications of EEG in home-based settings.
偏头痛是一种非常普遍的脑部疾病，其脑部兴奋性会发生阵发性变化，据信这有助于引发发作。发作及其不可预测性对患者的生活有重大影响。由于缺乏对即将发作的可靠预测指标，临床管理受到阻碍，这些指标可能有助于理解病理生理机制，以确定新的治疗靶点，这些靶点可能介于目前可用的急性和预防性治疗方法之间。到目前为止，大量使用传统医院脑电图记录的研究得出了相互矛盾的结果，表明既有皮层兴奋性增高也有降低的情况。这些不同的发现可能主要是因为大多数研究在设计上是横断面的，仅提供了患者脑部状态的一个时间点快照，而没有捕捉到日常波动。本叙述性综述的范围是：（i）反思偏头痛、发作周期和潜在病理生理学背景下脑电图变化的现有知识；（ii）考虑偏头痛治疗对脑电图特征的影响；（iii）概述使用脑电图监测发作易感性的挑战和机遇；以及（iv）讨论脑电图在家庭环境中的未来应用。
