Gollion Cedric, Christensen Rune H, Ashina Håkan, Al-Khazali Haidar M, Fisher Patrick M, Amin Faisal Mohammad, Lauritzen Martin, Ashina Messoud
Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
J Cereb Blood Flow Metab. 2025 Mar;45(3):558-567. doi: 10.1177/0271678X241290606. Epub 2024 Oct 13.
Cortical spreading depression (CSD) is associated with pronounced alterations in cerebral blood flow. These alterations can be captured using high-field functional magnetic resonance imaging (fMRI). While compelling clinical and experimental data suggest that CSD is involved in the pathogenesis of migraine aura, the mechanistic intricacies remain poorly understood. Here, we use visual stimulus-induced blood oxygen level-dependent (BOLD) fMRI responses to characterize spatiotemporal alterations in cerebral blood flow during spontaneous attacks with migraine aura. Six adult participants diagnosed with migraine with aura underwent BOLD fMRI scans with a visual stimulation paradigm, consisting of flickering checkerboard stimulation. Our results revealed that auras with somatosensory symptoms corresponded with bilateral alterations of stimulus-induced BOLD responses in the somatosensory cortex, exhibiting anterior-to-posterior propagation and absence of antecedent occipital abnormalities. These altered stimulus-induced BOLD responses were bilateral, despite a unilateral manifestation of aura symptoms, and had no relationship with positive or negative aura symptoms. The bilateral abnormalities in stimulus-induced BOLD responses completes our current knowledge on migraine aura.
皮层扩散性抑制（CSD）与脑血流量的显著改变有关。这些改变可以通过高场功能磁共振成像（fMRI）来捕捉。尽管有令人信服的临床和实验数据表明CSD参与偏头痛先兆的发病机制，但其中的复杂机制仍知之甚少。在此，我们利用视觉刺激诱发的血氧水平依赖（BOLD）功能磁共振成像反应，来表征偏头痛先兆自发发作期间脑血流量的时空变化。六名被诊断为伴有先兆偏头痛的成年参与者接受了采用视觉刺激范式（包括闪烁棋盘格刺激）的BOLD功能磁共振成像扫描。我们的结果显示，伴有躯体感觉症状的先兆与躯体感觉皮层中刺激诱发的BOLD反应的双侧改变相对应，表现为从前向后传播且枕叶无先行异常。尽管先兆症状为单侧表现，但这些改变的刺激诱发BOLD反应是双侧的，且与先兆症状的阳性或阴性无关。刺激诱发BOLD反应的双侧异常完善了我们目前对偏头痛先兆的认识。
