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源自拉丁语“re - cordis,穿过心脏”:在讲述重大生活事件时,自主神经调节可区分偏头痛患者与对照组。

From the latin "re-cordis, passing through the heart": autonomic modulation differentiates migraineurs from controls when recounting a significant life event.

作者信息

Guidotti Sara, Torelli Paola, Ambiveri Giordano, Fiduccia Alice, Castaldo Matteo, Pruneti Carlo

机构信息

Clinical Psychology, Clinical Psychophysiology, and Clinical Neuropsychology Labs., Dept. of Medicine and Surgery, University of Parma, Parma, Italy.

Headache Center, Neurology Unit, University Hospital of Parma, Parma, Italy.

出版信息

Neurol Sci. 2025 Jan;46(1):313-323. doi: 10.1007/s10072-024-07739-7. Epub 2024 Aug 27.

Abstract

OBJECTIVE

The literature on clinical psychophysiology highlights the possibility of using Heart Rate Variability (HRV) as an index of psychophysical balance and resilience to stress. This study investigates the differences in stress reactivity and subsequent recovery between a group of migraineurs and healthy controls.

METHODS

Socio-demographic (i.e., sex, age, profession, marital status, and level of education) and psychophysiological (HR and HRV) measures of a group of thirty subjects with migraine (26 migraineurs without aura (86.7%), 2 migraineurs with aura (6.7%), and 2 migraineurs with and without aura (6.7%)) and from thirty healthy control subjects were collected. In particular, HRV was analyzed through frequency-domain parameters, including Low-Frequency (LF; 0.04-0.15 Hz) and High-Frequency (HF; 0.15-0.4 Hz) bands as well as LF/HF ratio during a Psychophysiological Stress Profile (PSP) structured in seven phases: (1) Baseline, (2) Objective stressor 1 (Stroop Test), (3) Rest 1, (4) Objective stressor 2 (Mental Arithmetic Task), (5) Rest 2, (6) Subjective stressor (recount a significant life event), and (7) Rest 3. The LF, HF, and LF/HF ratio values were transformed into a logarithmic scale (i.e., log-LF, log-HF, and log LF/HF ratio). Additionally, LF and HF were converted into normalized units (0-100) (i.e., LF% and HF%) which, in turn, were used to obtain reactivity and recovery to stress through delta values (Δ) calculation.

RESULTS

Subjects with migraine reported greater ΔLF% levels of reactivity and recovery to subjective stressor, demonstrating a prevalence of sympathetic activity while recounting a personal life event. At the same time, a lowering of the same values was found in the subjects of the group control.

DISCUSSION

Our results underline the importance of conducting a psychophysiological assessment in patients with headaches because reduced stress management skills could influence the clinical manifestations of the disease, considering stress as one of the most common triggers for migraine patients.

摘要

目的

临床心理生理学文献强调了将心率变异性(HRV)用作心理生理平衡和应激恢复力指标的可能性。本研究调查了一组偏头痛患者与健康对照组在应激反应性及随后恢复方面的差异。

方法

收集了一组30名偏头痛患者(26名无先兆偏头痛患者(86.7%)、2名有先兆偏头痛患者(6.7%)以及2名有和无先兆偏头痛患者(6.7%))和30名健康对照者的社会人口统计学指标(即性别、年龄、职业、婚姻状况和教育水平)以及心理生理指标(心率和HRV)。具体而言,通过频域参数分析HRV,这些参数包括低频(LF;0.04 - 0.15赫兹)和高频(HF;0.15 - 0.4赫兹)频段以及在由七个阶段构成的心理生理应激剖面图(PSP)期间的LF/HF比值:(1)基线期,(2)客观应激源1(斯特鲁普测验),(3)休息1,(4)客观应激源2(心算任务),(5)休息2,(6)主观应激源(讲述一件重大生活事件),以及(7)休息3。将LF、HF和LF/HF比值转换为对数尺度(即log - LF、log - HF和log LF/HF比值)。此外,将LF和HF转换为归一化单位(0 - 100)(即LF%和HF%),进而通过计算差值(Δ)来获得对应激的反应性和恢复情况。

结果

偏头痛患者在对主观应激源的反应性和恢复方面报告了更高的ΔLF%水平,表明在讲述个人生活事件时交感神经活动占主导。与此同时,在对照组受试者中发现相同数值降低。

讨论

我们的结果强调了对头痛患者进行心理生理评估的重要性,因为考虑到压力是偏头痛患者最常见的触发因素之一,压力管理技能的降低可能会影响疾病的临床表现。

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