冷加压试验结合瞳孔对光反射研究慢性偏头痛自主神经功能

Autonomic function in chronic migraine patients:interictal cold pressor test and pupillometry

目的研究慢性偏头痛(CM)患者头痛缓解期的自主神经功能状态。方法收集2019年4月至2020年4月成都中医药大学附属医院神经内科就诊的CM患者20例,并选择同期健康受试者20名为对照组。采用冷加压试验结合瞳孔对光反射方法观测两组受试者冷加压试验前及冷加压2、5 min时间点瞳孔直径、瞳孔收缩速度、潜伏期、振幅、瞳孔恢复梯度最大值时间,同时采用电子式上臂式血压计测量心率和血压。结果CM组和对照组冷加压前瞳孔恢复梯度最大值时间比较无统计学差异(P>0.05),冷加压2 min和5 min时间点CM组瞳孔恢复梯度最大值时间较对照组明显延长(P<0.01和P<0.05);不同时间点两组间瞳孔直径、瞳孔收缩速度、潜伏期、振幅以及血压、心率比较差异均无统计学意义(均P>0.05)。结论CM患者存在副交感神经功能失调,CM的发生可能与自主神经系统失衡相关。

Objective To investigate the autonomic nervous system function in chronic migraine(CM)patients.Methods We enrolled 20 patients with CM and 20 healthy controls from the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from Apr 2019 to Apr 2020.We applied the cold pressor test combining with pupillometry.At baseline,2 minutes and 5 minutes of the cold pressor test,the pupil diameter,contraction velocity,latency,amplitude,the maximum recovery gradient time were monitored and heart rate,blood pressure were measured at the corresponding time points.Results There was no significant difference in the pupillary light reflex(PLR)parameter the maximum recovery gradient time between the chronic migraine patients and controls before the cold pressor test.The maximum recovery gradient time was significantly longer in CM patients than the controls at 2 min and 5 min of the cold pressor test(P<0.01,P<0.05).There was no significant difference in pupil diameter,contraction velocity,latency,amplitude,blood pressure or heart rate between the two groups at each time point(P>0.05).Conclusions Parasympathetic function is impaired in CM patients.CM may be associated with the imbalance of autonomous function.