偏头痛发作间期疼痛刺激的脑磁图研究

Magnetoencephalography study of pain stimulation in interictal period of migraine

目的探讨偏头痛患者在发作间期大脑对疼痛电刺激的反应特点。方法收集30例发作间期的无先兆偏头痛患者(偏头痛组)和30名年龄、性别相匹配的健康对照者(对照组),利用脑磁图描记术记录正中神经疼痛电刺激下诱导的脑电磁信号。比较偏头痛组与对照组之间在痛觉处理上的差异。结果与对照组相比,偏头痛组疼痛电刺激疼痛阈值显著降低(P<0.05),疼痛电刺激产生的体感诱发磁场M20潜伏期明显延长(P<0.01)。偏头痛组疼痛诱发Gamma振荡平均能量较对照组显著增强(P<0.01),且Gamma震荡能量值与视觉模拟评分法(VAS)、偏头痛残疾程度评估量表(MIDAS)评分均呈正相关(VAS左手:r=0.45,P<0.05;VAS右手:r=0.46,P<0.05;MIDAS左手:r=0.47,P<0.01;MIDAS右手:r=0.59,P<0.01)。结论偏头痛患者发作间期存在疼痛感觉异常,且痛觉刺激相关的皮质兴奋性增高。

Objective To investigate the response characteristics of brain to electrical pain stimulation during the interictal period in migraine patients. Methods Thirty migraine patients without aura in interictal period （migraine group ） and 30 age and gender matched healthy controls （control group ） were collected. The brain magnetoencephalography （MEG） signal evoked by median never pain stimulation was collected. The difference of electrical pain stimulation evoked signal between migraine group and control group were analyzed. Results Compared with control group, the pain threshold of electrical stimulation in migraine group was significantly reduced （P 〈0. 05）, the latency of somatosensory evoked magnetic fields （SEF） M20 evoked by electrical stimulation in migraine group was significantly longer （P 〈 O. 01 ）. The average spectral power of pain evoked Gamma oscillations in migraine group was significantly enhanced than control group （ P 〈 0. 01 ）. And the Gamma oscillation power value was positively related with visual analogue scale （VAS） and Migraine disability level assessment scale （MIDAS） scores （ VAS left hand： r = 0.45, P 〈 0.05 ; VAS right hand ： r = 0.46, P 〈 0. 05 ; MIDAS left hand ： r = 0. 47, P 〈 0. 01; MIDAS right hand： r = 0. 59, P 〈 0. 01 ）. Conclusion Migraine patients have a cutaneous allodynia in interictal period, and the excitability of pain stimulation related cortical is increased.