共查询到20条相似文献,搜索用时 31 毫秒
1.
Giuseppe Cosentino Brigida FierroSimone Vigneri Simona TalamancaPiera Paladino Roberta BaschiSerena Indovino Simona MaccoraFrancesca Valentino Enrico FilecciaGiuseppe Giglia Filippo Brighina 《Pain》2014
The primary brain dysfunctions leading to the onset of a migraine attack remain largely unknown. Other important open questions concern the mechanisms of initiation, continuation, and termination of migraine pain, and the changes in brain function underlying migraine transformation. Brief trains of high-frequency repetitive transcranial magnetic stimulation (rTMS), when applied to the primary motor cortex at suprathreshold intensity (?120% of resting motor threshold [RMT]), elicit in healthy subjects a progressive, glutamate-dependent facilitation of the motor evoked potentials (MEP). Conversely, in conditions of increased cortical excitability, the rTMS trains induce inhibitory MEP responses likely mediated by cortical homeostatic mechanisms. We enrolled 66 migraine-without-aura patients, 48 migraine-with-aura patients, 14 patients affected by chronic migraine (CM), and 20 healthy controls. We assessed motor cortical response to 5-Hz rTMS trains of 10 stimuli given at 120% RMT. Patients with episodic migraine were studied in different phases of the migraine cycle: interictal, preictal, ictal, and postictal states. Results showed a facilitatory MEP response during the trains in patients evaluated in the preictal phase, whereas inhibitory responses were observed during and after a migraine attack, as well as in CM patients. In the interictal phase, different responses were observed, depending on attack frequency: facilitation in patients with low and inhibition in those with high attack recurrence. Our findings suggest that changes in cortical excitability and fluctuations in the threshold for inhibitory metaplasticity underlie the migraine attack recurrence, and could be involved in the process of migraine transformation. 相似文献
2.
Simone Vigneri Simona Talamanca Antonio Palermo Giuseppe Giglia Brigida Fierro 《European Journal of Pain》2011,15(9):928-935
Experimental evidence suggests impairment of inhibitory intracortical circuits in migraine, while not much is known about activity of facilitatory intracortical circuits. In the present work we evaluated the effects of high frequency‐repetitive transcranial magnetic stimulation (hf‐rTMS) on the activity of facilitatory circuits of motor cortex in 18 patients affected by migraine with aura and 18 healthy subjects. Trains of 10 stimuli were applied to the motor cortex at 5‐Hz frequency with recording of the EMG traces from the contralateral abductor pollicis brevis muscle (APB). Two intensities of stimulation (110% and 130% of resting motor threshold) were used in order to explore whether motor cortex excitability was differently modulated. Twelve patients underwent hf‐rTMS both before and during prophylactic treatment with levetiracetam. Results showed that rTMS delivered at 110% intensity of stimulation at rest had a facilitatory effect on MEP size in untreated patients, while left MEP unchanged in controls. Conversely, when rTMS was applied at 130%, we observed MEP potentiation in healthy subjects and paradoxical MEP inhibition in migraineurs. In treated patients, levetiracetam inhibited MEP size at both 110% and 130% intensity of stimulation. Our findings reveal an opposite response of migraine motor cortex to 5‐Hz rTMS when it is delivered at different stimulation intensities, providing evidence of both hyper‐responsivity and self‐limiting hyperexcitability capacity, in line with studies supporting the concept that under conditions of cortical hyperexcitability inhibitory mechanisms of homeostatic plasticity could be activated. 相似文献
3.
Ye Ran Ziming Yin Yajun Lian Yanmei Xu Yajie Li Jiale Liu Qun Gu Fanhong Yan Zhaoli Ge Yu Lian Dongmei Hu Sufen Chen Yangyang Wang Xiaolin Wang Rongfei Wang Xiaoyan Chen Jing Liu Mingjie Zhang Xun Han Wei Xie Zhe Yu Ya Cao Yingji Li Ke Li Zhao Dong Shengyuan Yu 《The journal of headache and pain》2022,23(1)
BackgroundThe aim of the study was to investigate whether MwoA and MwA are different manifestations of a single disease, distinct clinical entities, or located at two poles of a spectrum.MethodsIn this cross-sectional study, 5438 patients from 10 hospitals in China were included: 4651 were diagnosed with migraine without aura (MwoA) and 787 with migraine with aura (MwA). We used a validated standardized electronic survey to collect multidimensional data on headache characteristics and evaluated the similarities and differences between migraine subtypes. To distinguish migraine subtypes, we employed correlational analysis, factor analysis of mixed data (FAMD), and decision tree analysis.ResultsCompared to MwA, MwoA had more severe headaches, predominantly affected females, were more easily produced by external factors, and were more likely to have accompanying symptoms and premonitory neck stiffness. Patients with MwA are heterogeneous, according to correlation analysis; FAMD divided the subjects into three clear clusters. The majority of the differences between MwoA and MwA were likewise seen when typical aura with migraine headache (AWM) and typical aura with non-migraine headache (AWNM) were compared. Furthermore, decision trees analysis revealed that the chaotic MwA data reduced the decision tree’s accuracy in distinguishing MwoA from MwA, which was significantly increased by splitting MwA into AWM and AWNM.ConclusionsThe clinical phenomics of headache phenotype varies gradually from MwoA to AWM and AWNM, and AWM is a mid-state between MwoA and AWNM. We tend to regard migraine as a spectrum disorder, and speculate that different migraine subtypes have different “predominant regions” that generate attacks.Supplementary InformationThe online version contains supplementary material available at 10.1186/s10194-022-01461-5. 相似文献
4.
Barbara Gierse-Plogmeier Reyhan Colak-Ekici Anne Wolowski Ingrid Gralow Martin Marziniak Stefan Evers 《The journal of headache and pain》2009,10(4):249-254
Pain perception studies in migraine patients have shown trigeminal and peripheral pain facilitation during the migraine attack.
We were interested in differences of trigeminal and peripheral pain perception between migraine patients during the migraine
interval and healthy subjects. Perception of electrical pain stimulation was measured in 20 migraine subjects outside a migraine
attack (10 migraine with aura and 10 migraine without aura) and in 20 healthy subjects. We recorded sensory and pain thresholds,
pain ratings after suprathreshold stimulation, and pain rating after two trains of repetitive stimulation (i.e., pain facilitation).
Migraine subjects showed a significantly higher pain rating after suprathreshold stimulation in the trigeminal region as compared
to healthy subjects (4.8 ± 1.6 versus 3.8 ± 2.2, p < 0.04 after Bonferroni correction) but not in the peripheral region. Furthermore,
migraine subjects showed a pain facilitation after repetitive trigeminal stimulation whereas healthy subjects showed a pain
habituation. We observed no significant differences between migraine subjects and healthy subjects for all parameters in the
peripheral stimulation. Migraine patients with and without aura did not differ in any parameter. All subjects showed decreased
sensory and pain thresholds after trigeminal as compared to peripheral stimulation. Migraine subjects show an increased pain
perception after trigeminal but not after peripheral pain stimulation as compared to healthy subjects. This phenomenon is
probably due to the observed pain facilitation after painful trigeminal stimulation. 相似文献
5.
Yansong Li Guoliang Chen Jing Lv Lei Hou Zhao Dong Rongfei Wang Min Su Shengyuan Yu 《The journal of headache and pain》2022,23(1)
BackgroundResting-state EEG microstates are thought to reflect brief activations of several interacting components of resting-state brain networks. Surprisingly, we still know little about the role of these microstates in migraine. In the present study, we attempted to address this issue by examining EEG microstates in patients with migraine without aura (MwoA) during the interictal period and comparing them with those of a group of healthy controls (HC).MethodsResting-state EEG was recorded in 61 MwoA patients (50 females) and 66 HC (50 females). Microstate parameters were compared between the two groups. We computed four widely identified canonical microstate classes A-D.ResultsMicrostate classes B and D displayed higher time coverage and occurrence in the MwoA patient group than in the HC group, while microstate class C exhibited significantly lower time coverage and occurrence in the MwoA patient group. Meanwhile, the mean duration of microstate class C was significantly shorter in the MwoA patient group than in the HC group. Moreover, among the MwoA patient group, the duration of microstate class C correlated negatively with clinical measures of headache-related disability as assessed by the six-item Headache Impact Test (HIT-6). Finally, microstate syntax analysis showed significant differences in transition probabilities between the two groups, primarily involving microstate classes B, C, and D.ConclusionsBy exploring EEG microstate characteristics at baseline we were able to explore the neurobiological mechanisms underlying altered cortical excitability and aberrant sensory, affective, and cognitive processing, thus deepening our understanding of migraine pathophysiology. 相似文献
6.
LM Cupini M Matteis E Troisi P Calabresi G Bernardi M Silvestrini 《Cephalalgia : an international journal of headache》1995,15(2):140-144
In this study, the relationship between hormonal-related events and migraine with aura (MA) and without aura (MO) was investigated. Subjects included 268 women suffering from MA (88) and MO (180). Data were collected on the relationship between sex-hormone-related events and migraine. Migraine during menses was observed in a significantly higher percentage of MO than MA patients ( p < 0.03). Menstrual migraine was significantly more common in MO than in MA patients ( p < 0.01). Migraine began during pregnancy in a significantly higher percentage of MA than of MO patients ( p < 0.01). No significant difference was observed between the two groups of patients regarding the onset of migraine at menarche, after menopause, in the postpartum period or during the early cycles of oral contraceptives. Also, both groups of patients showed a similar migraine course during pregnancy, oral contraceptive use and menopause. Eight patients with coexisting migraine with aura and migraine without aura attacks reported the appearance of the aura symptom for the first time in the early cycles of oral contraceptive intake. These findings suggest that gonadal hormone fluctuation may influence both types of migraine. 相似文献
7.
The period between migraine attacks is characterized by paradoxical responses to repetitive sensory and transcranial magnetic stimulation (TMS). Abnormal long-term cortical functional plasticity may play a role and can be assessed experimentally by paired associative stimulation (PAS), in which somatosensory peripheral nerve stimuli are followed by TMS of the motor cortex. Changes in motor-evoked potential (MEP) amplitudes were recorded in 16 migraine without aura patients (MO) and 15 healthy volunteers (HV) before and after PAS, which consisted of 90 peripheral electrical right ulnar nerve stimulations and subsequent TMS pulses over the first dorsal interosseous (FDI) muscle activation site with a delay of 10 ms (excitability depressing) or 25 ms (excitability enhancing). As a control experiment of the 31 subjects studied, 8 (4 MO and 4 HV) also underwent PAS10 earlier, the recording of somatosensory high-frequency oscillations (HFOs) reflecting thalamocortical activation (early HFOs). Although PAS10 reduced MEP amplitudes in HV (−17.7%), it significantly increased amplitudes in MO (+35.9%). Although in HV MEP amplitudes were significantly potentiated (+55.1) after PAS25, only a slight, nonsignificant increase was observed in MO (+18.8%). In the control experiment, performed on 8 subjects pooled together, Pearson’s correlation showed an inverse relationship between the percentage of MEP amplitude changes after PAS10 and early HFO amplitudes (r = −0.81; P = .01). Because we observed that the more deficient the long-term PAS-induced change, the more the thalamocortical activation decreased, we hypothesize that the abnormalities in long-term cortical plasticity observed in the interictal period between migraine episodes could be due to altered thalamic control. 相似文献
8.
Werhahn KJ Wiseman K Herzog J Förderreuther S Dichgans M Straube A 《Cephalalgia : an international journal of headache》2000,20(1):45-50
We studied the excitability of the motor cortex using transcranial magnetic stimulation (TMS) in 12 patients with migraine with aura (MA) and nine patients with familial hemiplegic migraine (FHM). Motor thresholds at rest, the duration of the cortical and peripheral silent period and intracortical inhibition and facilitation using paired-pulse TMS at intervals of 2 to 15 ms were measured with patients free of attacks for at least 48 h. In contrast to previous reports we could not find any significant differences between patient groups and compared to controls (n=17) in the parameters tested. The results suggest that there are no interictal changes of excitability of the motor cortex in migraine. This study does not support the concept of general cortical hyperexcitability in migraine secondary to a genetic predisposition or a structural alteration of inhibitory interneurones in the cortex due to repeated parenchymal insults during attacks. 相似文献
9.
Xiaobin Huang Di Zhang Peng Wang Cunnan Mao Zhengfei Miao Chunmei Liu Chenjie Xu Xindao Yin Xinying Wu 《The journal of headache and pain》2021,22(1)
BackgroundGranger causality analysis (GCA) has been used to investigate the pathophysiology of migraine. Amygdala plays a key role in pain modulation of migraine attack. However, the detailed neuromechanism remained to be elucidated. We applied GCA to explore the amygdala-based directional effective connectivity in migraine without aura (MwoA) and to determine the relation with clinical characteristics.MethodsForty-five MwoA patients and forty age-, sex-, and years of education-matched healthy controls(HCs) underwent resting-state functional magnetic resonance imaging (fMRI). Bilateral amygdala were used as seed regions in GCA to investigate directional effective connectivity and relation with migraine duration or attack frequency.ResultsMwoA patients showed significantly decreased effective connectivity from right amygdala to right superior temporal gyrus, left superior temporal gyrus and right precentral gyrus compared with HCs. Furthermore, MwoA patients demonstrated significantly decreased effective connectivity from the left amygdala to the ipsilateral superior temporal gyrus. Also, MwoA patients showed enhanced effective connectivity from left inferior frontal gyrus to left amygdala. Effective connectivity outflow from right amygdala to right precentral gyrus was negatively correlated to disease duration.ConclusionsAltered directional effective connectivity of amygdala demonstrated that neurolimbic pain networks contribute to multisensory integration abnormalities and deficits in pain modulation of MwoA patients. 相似文献
10.
Platelet nitric oxide metabolites in migraine 总被引:5,自引:0,他引:5
T Shimomura F Murakami K Kotani S Ikawa S Kono 《Cephalalgia : an international journal of headache》1999,19(4):218-222
Nitric oxide (NO) is a candidate as a causative molecule in migraine. We determined nitrite, total nitrate/nitrite, and cyclic guanosine 3',5'-monophosphate (cGMP) concentrations in platelets from 30 migraine without aura (MwoA) patients and 17 migraine with aura (MwA) patients. All migraine patients were studied during their migraine attacks. The control group consisted of 28 healthy volunteers. Concentrations of platelet nitrite and total nitrate/nitrite were determined using simple and sensitive nitrate/nitrite fluorometric assay techniques. High concentrations of platelet nitrite and total nitrate/nitrite were found in patients with MwoA and MwA when compared with healthy controls. High concentrations of platelet cGMP were also found in patients with MwoA and MwA. The levels of platelet total nitrate/nitrite significantly decreased in headache-free periods after treatment with oral propranolol. These findings suggest that NO is produced in platelets during migraine attacks. It may also be related to the migrainous pain and the changes in cerebral blood flow experienced during migraine attacks. These data may provide new strategies for the treatment of migraine. 相似文献
11.
Pattern reversal visual evoked potentials (PVEPs) were recorded in 20 patients with migraine with aura (MA), 19 patients with migraine without headache (migraine equivalent; ME.) during interictal periods, and 34 normal subjects. All migraine patients had hemianopsia or fortification spectra during attacks. In both MA and ME patients of less than 49 years of age, there were significant ( p <0.01) differences in amplitude of PVEPs at the mid-occipital and contralateral to visual aura electrode sites compared to normal subjects. Amplitude of PVEPs in MA and ME showed significant ( p <0.001) increases when recorded soon after attacks, especially within 10 days. There was a significant ( p <0.0l) correlation between percentage asymmetries and the duration of illness in both MA and ME. We conclude from our PVEP findings that cortical spreading depression remains the most likely explanation for the migraine visual aura. 相似文献
12.
Marina de Tommaso Filippo Brighina Brigida Fierro Vito Devito Francesco Roberto Santostasi Vittorio Sciruicchio Eleonora Vecchio Claudia Serpino Paolo Lamberti Paolo Livrea 《The journal of headache and pain》2010,11(6):505-512
The aim of this study was to examine the effects of high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS)
of the left primary motor cortex (M1) on subjective pain and evoked responses induced by laser stimulation (LEPs) of the contralateral
hand and supraorbital zone in a cohort of migraine patients without aura during the inter-critical phase, and to compare the
effects with those of non-migraine healthy controls. Thirteen migraine patients and 12 sex- and age-matched controls were
evaluated. Each rTMS session consisted of 1,800 stimuli at a frequency of 5 Hz and 90% motor threshold intensity. Sham (control)
rTMS was performed at the same stimulation position. The vertex LEP amplitude was reduced at the trigeminal and hand levels
in the sham-placebo condition and after rTMS to a greater extent in the migraine patients than in healthy controls, while
the laser pain rating was unaffected. These results suggest that HF rTMS of motor cortex and the sham procedure can both modulate
pain-related evoked responses in migraine patients. 相似文献
13.
Little information exists
about a causal association between
PFO and migraine. Some patients
identify Valsalva-provoking activities
(VPA) as migraine triggers.
Therefore, we speculate about a pathogenic
connection. The object of the
study is to investigate the prevalence
of right-to-left shunt (RLS) in a
cohort of patients suffering migraine
with aura (MA) and its possible association
with migraine attacks triggered
by VPA. We investigated the circumstances
triggering the migraine
attacks, in a consecutive series of 72
MA patients and in a series of
migraine without aura age and gender-matched. The presence and extent
of RLS was assessed by transcranial
Doppler. Massive RLS appeared in
38.9% of MA and in 6.5% of
migraine without aura (p<0.001). MA
patients identified at least one VPA as
headache trigger in 45.8%. A trend
was found between these triggering
activities and massive RLS, both in
MAgroup OR 2.7 [1.02–7.17] and in
all migraine patients OR 2.5
[1.01–6.11]. According to our results,
patients with migraine who have larger
RLS tend to recognize activities
that increase the extent of the shunt as
a trigger of their migraine attacks. 相似文献
14.
Marina de Tommaso Marco Guido Giuseppe Libro Vittorio Scicchioiru Luciana Losito Olimpia Difruscolo Francomichele Puca 《The journal of headache and pain》2000,1(2):97-104
Objective. To evaluate the blink reflex (BR) in chronic cluster headache (CH) patients. Design. The elecrophysiological data
were collected in during the headache-free phase. Setting. Headache patients were recruited from outpatients seen for the
first time at the First Neurologic Clinic of Bari University. Patients and participants. Ten CH patients, 19 migraine without
aura patients with strictly unilateral headache (MwoA) and 18 normal controls were selected.
Measurements and results. The BR procedure was applied. In CH, a significant R2 duration increase was found on the symptomatic
side in comparison with MwoA and controls. In both patient groups an early appearance of the R3 component was bilaterally
clear. Conclusions. The BR findings confirm the central genesis of CH. The R3 abnormalities suggest a basic dysfunction of
the Central control on the trigeminal nociceptive circuits. The R2 involvement on the symptomatic side indicates a unilateral
facilitation of the trigeminal-facial connections persisting after the CH bout.
Received: 3 January 2000, Accepted in revised form: 2 November 2000 相似文献
15.
Cortical hyperexcitability is cortical under-inhibition: evidence from a novel functional test of migraine patients 总被引:5,自引:0,他引:5
Palmer JE Chronicle EP Rolan P Mulleners WM 《Cephalalgia : an international journal of headache》2000,20(6):525-532
Recent studies of the visual cortex in patients with migraine have generally concluded that migraine (particularly migraine with aura) is associated with a state of functional cortical hyperexcitability. The mechanisms giving rise to this hyperexcitability have hitherto been unclear. This paper reports two studies that used a novel investigative technique, derived from basic research in vision science, to examine specific deficits of inhibitory processing in primary visual cortex. The technique is termed the metacontrast test, and it examines visual masking under highly specified conditions. In Study 1, 12 migraine with aura patients (MA), 12 age-matched migraine without aura patients (MO) and 12 age- and sex-matched headache-free control subjects (C) were compared using the metacontrast test. MA patients were significantly less susceptible to visual masking in the metacontrast test than both MO and C groups: this result is highly consistent with a deficit in cortical inhibitory processing in MA patients. Study 2 examined MA patients taking a variety of migraine prophylactics, again using the metacontrast test. Test results normalized in those MA patients taking sodium valproate, but not in those taking other prophylactics. Sodium valproate is a GABA-A agonist that is known to cross the blood-brain barrier: GABA-ergic networks act as the primary inhibitory mechanism in visual cortex. Taken together, the results of these studies argue that cortical hyperexcitability, at least in MA patients, is likely to be a result of deficient intracortical inhibitory processes. 相似文献
16.
de Tommaso M Sciruicchio V Guido M Sasanelli G Puca F 《Cephalalgia : an international journal of headache》1999,19(1):23-26
We tested the hypothesis that migraine and tension-type headache are separate disorders based on visual evoked potentials. We recruited 120 migraine without aura patients (MwoA), 64 tension-type headache patients (TTH), and 51 healthy controls. We performed discriminant analysis combined with a stepwise selection of predictors. Mean values of the F1 component were significantly increased over Fp1, C3, P4, O2 and O1 electrodes in MwoA and TTH patients compared with normal subjects. Only the control subjects were correctly distinguished. The increased brain response to visual stimulation detected in both MwoA and TTH may suggest a common neuronal dysfunction in the two headache subtypes. 相似文献
17.
OBJECTIVE: Migraine is a disease of altered cortical excitability between attacks. However, the mechanisms of abnormal excitability in migraine are insufficiently investigated. Hence, the aim of the study was to investigate intracortical inhibition/facilitation of the motor circuit in migraine. METHODS: Sixteen women suffering from migraine without aura and 15 healthy women were investigated using a suprathreshold transcranial magnetic stimulation (TMS) in the paired-pulse paradigm with long interstimulus intervals (ISI = 20, 60, 120 ms) and measurement of the cortical silent period. RESULTS: We found no differences for the cortical silent period and for the long intracortical inhibition between the groups. Concerning intracortical facilitation, this ability was significantly more pronounced in patients suffering from migraine compared with healthy controls. CONCLUSION: Migraineurs produce an increased intracortical facilitation. The results may be discussed in line of glutamatergic mechanisms in migraine, which could be related to altered facilitation. 相似文献
18.
Marina de Tommaso Massimiliano Valeriani Michele Sardaro Claudia Serpino Olimpia Di Fruscolo Eleonora Vecchio Rosanna Cerbo Paolo Livrea 《The journal of headache and pain》2009,10(6):423-429
The association between estrogens “withdrawal” and attacks of migraine without aura is well-known. The aim of the study was
to examine the features of laser evoked potentials (LEPs), including habituation, in women suffering from migraine without
aura versus healthy controls, during the pre-menstrual and late luteal phases. Nine migraine without aura and 10 non-migraine
healthy women, were evaluated during the pre-menstrual phase and late luteal phase. The LEPs were recorded during the inter-critical
phase. The right supraorbital zone and the dorsum of the right hand were stimulated. Three consecutive series of 20 laser
stimuli were obtained for each stimulation site. Laser pain perception was rated by a 0–100 VAS after each stimulation series.
Migraine patients exhibited increased LEPs amplitude and reduced habituation compared to normal subjects. Laser-pain perception
was increased during the pre-menstrual phase in both patients and controls. Migraine patients and controls showed increased
P2 and N2–P2 amplitude in the pre-menstrual phase, on both stimulation sites. During the pre-menstrual phase the N2–P2 habituation
appeared to be reduced in both migraine and healthy women. The estrogen withdrawal occurring during the menstrual cycle may
favor reduced habituation of nociceptive cortex, which may facilitate pain symptoms and migraine in predisposed women. 相似文献
19.
The characteristics of
psychiatric comorbidity in migraine
have been studied in migraine with
aura (MA) and migraine without
aura (MO). Little information is
available concerning patients with
migraine aura without headache. In
a study of 201 patients with major
affective disorders (DSM–IV) we
have described the clinical characteristics
of patients with these three
sub–types of migraine (IHS criteria)
and compared the MA and migraine
aura without headache groups.
Compared to patients having MA
(n=57), the group with migraine
aura without headache (n=18) had a
higher age of onset of migraine
(28.5 vs. 19.2, p=0.001), significantly
lower prevalences of affective
temperaments (28% vs. 56%,
p=0.036), suicide attempts (17% vs.
53%, p=0.013) and Raynaud’s syndrome
(0% vs. 25%, p=0.017).
These results indicate that there
seem to be differences in the clinical
characteristics found in patients
with migraine with aura when compared
to those having the migraine
subtype without a headache phase.
This may convey new information
concerning the comorbid expression
of migraine and affective disorders
or concerning the processes that
differentiates the migraine types
with and without a subsequent pain
attack. 相似文献
20.
Reyngoudt H Paemeleire K Dierickx A Descamps B Vandemaele P De Deene Y Achten E 《The journal of headache and pain》2011,12(3):295-302
Proton magnetic resonance spectroscopy (1H-MRS) has been used in a number of studies to assess noninvasively the temporal changes of lactate (Lac) in the activated
human brain. Migraine neurobiology involves lack of cortical habituation to repetitive stimuli and a mitochondrial component
has been put forward. Our group has recently demonstrated a reduction in the high-energy phosphates adenosine triphosphate
(ATP) and phosphocreatine (PCr) in the occipital lobe of migraine without aura (MwoA) patients, at least in a subgroup, in
a phosphorus MRS (31P-MRS) study. In previous studies, basal Lac levels or photic stimulation (PS)-induced Lac levels were found to be increased
in patients with migraine with aura (MwA) and migraine patients with visual symptoms and paraesthesia, paresia and/or dysphasia,
respectively. The aim of this study was to perform functional 1H-MRS at 3 T in 20 MwoA patients and 20 control subjects. Repetitive visual stimulation was applied using MR-compatible goggles
with 8 Hz checkerboard stimulation during 12 min. We did not observe any significant differences in signal integrals, ratios
and absolute metabolite concentrations, including Lac, between MwoA patients and controls before PS. Lac also did not increase
significantly during and following PS, both for MwoA patients and controls. Subtle Lac changes, smaller than the sensitivity
threshold (i.e. estimated at 0.1–0.2 μmol/g at 3 T), cannot be detected by MRS. Our study does, however, argue against a significant
switch to non-aerobic glucose metabolism during long-lasting PS of the visual cortex in MwoA patients. 相似文献