Does throbbing pain have a brain signature?

Pain sometimes has a throbbing, pulsating quality, particularly when it is severe and disabling. We recently challenged the presumption that this throbbing quality is a sensory experience of arterial pulsations, but were unable to offer an alternative explanation for its rhythmic character. Here we report a case study of a woman with a history of daily headache consistent with the diagnosis of chronic migraine, but whose throbbing quality persisted long after the resolution of the headache. This chronic, daily, and persistent throbbing sensation, in the absence of headache pain, prompted closer examination for its neurophysiological correlate. By simultaneously recording the subjective report of the throbbing rhythm, arterial pulse, and high-density electroencephalogram, we found that the subjective throbbing rate (48 ± 1.7 beats per minute) and heart rate (68 ± 2 beats per minute) were distinct, in accord with our previous observations that the 2 are unrelated. On spectral analysis of the electroencephalogram, we found that the overall amount of activity in the alpha range (8 to 12 Hz), or alpha power, increased in association with greater throbbing intensity. In addition, we also found that the rhythmic oscillations of overall alpha power, the so-called modulations of alpha power, coincided with the timing of the throbbing rhythm, and that this synchrony, or coherence, was proportional to the subjective intensity of the throbbing quality. This index case will motivate further studies whose aim is to determine whether modulations of alpha power could more generally represent a neurophysiological correlate of the throbbing quality of pain.     

偏头痛的功能医学法治疗：附1例分析报告

偏头痛是成年人常见的一种疾病，复发率高。目前，临床治疗主要以缓解症状为主。本病例采用功能医学思维方法，探寻偏头痛的原因及其发展规律，分析其演变过程，为偏头痛治疗提供新的思路。     

The effect of anxiety and depression on the risk of irritable bowel syndrome in migraine patients

Bidirectional co-morbidity between migraine and depression has been observed. Mood disorders are associated with an increased risk of both migraine and irritable bowel syndrome (IBS). The aim of this study was to evaluate the risk of developing IBS in patients with migraine and to compare the risks between those with and without anxiety or depression.This research used the data contained in the National Health Insurance Research Database (NHIRD). A total of 2859 subjects with migraine and 5718 age-, sex-, hypertension-, diabetes-, mood disorder-matched controls were identified. Both cohorts excluded subjects with pre-existing catastrophic illness and IBS diagnosed before the index visit or within 30 days after the index visit. All individuals of both cohorts were tracked until either having the diagnosis of IBS, loss of follow-up, or IBS free up to 7 years. During the 7-year follow-up period, 8.4% of patients with migraine and 5.4% of control cohort developed IBS. Migraine is associated with an increased risk of developing IBS (HR = 1.58, 95% CI: 1.33–1.87). When separating the cohort into those with mood disorder and without it, migraine is a significant risk factor of IBS in patients without mood disorders, but not in patients with co-existed mood disorders. The findings of this study suggest that migraine is a risk factor of future IBS development for those without comorbid anxiety or depression. However, migraine does not contribute significantly additional risk to IBS development in patients with comorbid anxiety or depression.     

偏头痛行脑电图、经颅多普勒超声检查的评价研究

目的探讨偏头痛患者同时进行脑电图、经颅多普勒超声检查的意义,以提高偏头痛的诊断率。方法选取2009年3月～2013年12月在我院神经内科门诊就诊的128例偏头痛患者为病例组,同期在我院体检的120例为对照组,两组均进行脑电图、经颅多普勒超声检查,并对检查结果进行分析。结果病例组脑电图异常率、经颅多普勒超声异常率均高于正常对照组,差异有统计学意义（P〈0.05）。结论脑电图检查虽对诊断无特异性,但有一定的定位意义,也可用于与头痛性癫痫和脑炎的鉴别诊断。经颅多普勒超声可作为偏头痛的有效诊断依据。两者结合,可以提高偏头痛的诊断率。