偏头痛的心理学研究Ⅰ．心理量表检查与ERP的关系

A PSYCHOLOGICAL STUDY OF MIGRAINE:I.THE RELATIONSHIP BETWEEN PSYCHOLOGICAL ASSESSMENTS AND EVENTRELATED POTENTIAL

３２例无先兆偏头痛患者于发作间歇期，进行了四种、理量表和听觉Ｐ_（３００）检查，以３２例健康人作对照。显示偏头痛患者的艾森克个性问卷（ＥＰＯ）的神经质记分（Ｎ），Ａ型行为量表的ＴＨ和ＣＨ分，以及焦虑和抑郁自评量表（ＳＡＳ、ＳＤＳ）的得分均显著高于对照组；Ｐ_（３００）中的Ｎ_２波及Ｐ_３波的波幅低于对照组（Ｐ＜０．０５），各波的潜伏期及其余各波波幅均正常。经治疗症状好转后复查仅ＴＨ分数较前明显降低（Ｐ＜０．０５），原因有待探讨。所得结果支持偏头痛具有明显性格特征及情感障碍之说，且有轻度认知功能障碍。因前二者之间关系密切，而认知障碍与性格和情感改变无平行关系，故考虑情感改变可能也是偏头痛发作的因素之一，或与偏头痛有相同的发病因素。而认知障碍则可能为头痛的结果。研究表明应重视偏头痛防治中的心理因素。

Thirty-two migraineurs without aura and the same number of age and sexmatched normal controls were examined in the interictal period by ERP and psychological assessments including Eysenck Personality Questionnaire,Jenkins Activity Survey and Selfrating Anxiety and Depression Scales. The migraineurs had significantly higher scores on SAS,SDS,the neuroticism of EPQ and CH of,JAS.Lower amplitudes of N_2 and P_3 in auditory P300 were also found. Only the TH scores of JAS were significantly decreased when the clinical symptoms improved after treatment, the mechanism of which remained to be clarified. These findings supported the hypothesis that specific personality and emotional changes did exist in migraine. Besides, mild cognitive changes were also present.Since the personali ty and emotional changes were closely related with other and the cognitive dysfunction was not parallel with them, the emotional changes are considered either as a part of the causative factors of migraine or having the similar etiologic causes as that of migraine, while the cognitive dysfunction is, most probably,the result of headache. In short, this study indicates that the psychological factor should be emphasized in the management of migraine.