左侧背外侧前额叶皮质的高频重复经颅磁刺激可缓解偏头痛患者的头痛并增强额颞叶连接。
High frequency-rTMS of the left DLPFC relieve headaches and enhance frontal-temporal connectivity in migraine.
作者信息
Song Penghui, Li Siran, Shao Yuxuan, Zhu Shuxiang, Wang Yuping, Xu Peng, Lin Hua
机构信息
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; Beijing Key Laboratory of Neuromodulation, Beijing 100053, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China; Center for Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Beijing 100053, China; Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100053, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
出版信息
Clin Neurophysiol. 2025 May;173:166-172. doi: 10.1016/j.clinph.2025.03.019. Epub 2025 Mar 22.
OBJECTIVE
Migraine is a neurological disorder linked to altered cortical excitability. High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) is a promising non-invasive method for modulating nociceptive circuits, yet its precise mechanisms remain unclear. This study applied HF-rTMS to the left dorsolateral prefrontal cortex (DLPFC) and assessed brain network changes using transcranial magnetic stimulation combined with electroencephalography (TMS-EEG).
METHODS
We analyzed dynamic brain connectivity in 15 migraine patients versus 15 healthy controls. A randomized, double-blind, sham-controlled trial evaluated a 14-day HF-rTMS (20 Hz) protocol in 28 migraine patients. Brain network reorganization and migraine severity, measured by the Visual Analog Scale (VAS) and monthly migraine days (MMD), were assessed both immediately after treatment and at a one-month follow-up.
RESULTS
Migraine patients exhibited reduced left DLPFC connectivity compared to healthy controls. HF-rTMS significantly increased frontal-temporal network connectivity, correlating with a marked reduction in VAS and MMD scores (p < 0.001).
CONCLUSION
These findings provide novel evidence that HF-rTMS targeting the left DLPFC effectively alleviates migraine symptoms by enhancing frontal-temporal cortical plasticity.
SIGNIFICANCE
This study highlights the potential of neuromodulation techniques in the treatment of migraine.
目的
偏头痛是一种与皮质兴奋性改变相关的神经障碍。高频重复经颅磁刺激（HF-rTMS）是一种有前景的用于调节伤害性感受回路的非侵入性方法，但其确切机制仍不清楚。本研究将HF-rTMS应用于左侧背外侧前额叶皮质（DLPFC），并使用经颅磁刺激结合脑电图（TMS-EEG）评估脑网络变化。
方法
我们分析了15名偏头痛患者和15名健康对照者的动态脑连接性。一项随机、双盲、假对照试验评估了28名偏头痛患者的为期14天的HF-rTMS（20赫兹）方案。通过视觉模拟量表（VAS）和每月偏头痛天数（MMD）测量的脑网络重组和偏头痛严重程度，在治疗后立即和1个月随访时进行评估。
结果
与健康对照者相比，偏头痛患者左侧DLPFC的连接性降低。HF-rTMS显著增加了额颞网络连接性，这与VAS和MMD评分的显著降低相关（p < 0.001）。
结论
这些发现提供了新的证据，即针对左侧DLPFC的HF-rTMS通过增强额颞皮质可塑性有效缓解偏头痛症状。
意义
本研究突出了神经调节技术在偏头痛治疗中的潜力。
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