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迷走神经刺激治疗偏头痛
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作者 吴毅(译) Tassorelli C +1 位作者 Grazzi L de tommaso m 《中国康复》 2018年第6期501-501,共1页
一项小型开放标签研究中,研究者发现无创迷走神经刺激(nVNS)可有效缓解偏头痛患者的疼痛。本研究进一步评估了这种治疗方式。本研究为多中心随机研究,纳入了18~75岁被诊断为有先兆/无先兆偏头痛的患者。nVNS组患者接受了5kHz正弦波冲击... 一项小型开放标签研究中,研究者发现无创迷走神经刺激(nVNS)可有效缓解偏头痛患者的疼痛。本研究进一步评估了这种治疗方式。本研究为多中心随机研究,纳入了18~75岁被诊断为有先兆/无先兆偏头痛的患者。nVNS组患者接受了5kHz正弦波冲击,持续时间1ms,每40ms重复一次,峰值电压24V,输出电流60mA。假刺激装置仅提供低频双相信号,可被身体感知,但不能刺激迷走神经。在偏头痛发作的20min内,受试者自行在颈部的右侧和左侧进行刺激。在刺激后15min、30min、60min、120min及24h、48h进行自我评估。如果疼痛在15min内没有改善,可做重复刺激。对于初次接受治疗的偏头痛患者,治疗后30min和60min患者疼痛完全缓解的比例显著高于假刺激组(P分别为0.012和0.023),但在治疗后120min,两组无差异。首次发作时,刺激组疼痛强度降低的平均百分比显著高于假刺激组,60min和120min时P值分别为0.033和0.004。结论:这项针对偏头痛患者的研究发现,无创迷走神经刺激可有效治疗偏头痛。 展开更多
关键词 无先兆偏头痛 迷走神经刺激 刺激治疗 疼痛强度 刺激迷走神经 完全缓解 治疗方式 随机研究
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偏头痛发作时激光诱发电位的地形学和双极分析
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作者 de tommaso m Guido m. +1 位作者 Libro G. 王英鹏 《世界核心医学期刊文摘(神经病学分册)》 2005年第4期23-24,共2页
Objective. - The aim of this study was to perform further evaluation of laser- evoked potentials (LEPs) during miraine attacks using multichannel recording and topographic analysis. Specifically, this study aimed to c... Objective. - The aim of this study was to perform further evaluation of laser- evoked potentials (LEPs) during miraine attacks using multichannel recording and topographic analysis. Specifically, this study aimed to confirm the pattern previously observed in acute migraine, while also defining the components of LEPs that are mainly modified during headache, as well as the correlation between features of LEPs and clinical variables. In addition, we aimed to conduct a dipolar source analysis of the main LEP waves in migraine patients to check the variability in the source location of LEPs during acute migraine. Background. - An amplitude enhancement of LEPs was previously detected during migraine attack using a single scalp derivation on the vertex; hyperalgesia to heat stimuli was also detected for both the face and hand. Methods. - Eighteen patients suffering from migraine without aura were analyzed. The supraorbital zones and the dorsum of the hand were stimulated on both the symptomatic and nonsymptomatic sides in all patients. The LEPs were recorded via 25 scalp electrodes. Dipolar source analysis of the P2 components was performed using a spherical model in all patients and using a realistic Magnetic Resonance model in four patients. Results. - During attacks, the later waves, and particularly the P2 component, were significantly enhanced; the amplitude of the P2 component obtained during the attack by stimulation of the supraorbital zone on the side of the headache was significantly correlated with the intensity of pain and the frequency of headache. In our patients, the P2 wave was generated in the anterior cingulate cortex, with a shift toward its rostrocaudal portion, and was mainly devoted to elaboration of the emotive compound of pain during migraine attack. Conclusions. - Cortical activation by laser stimuli during migraine attack was confirmed. This effect was more pronounced in patients with a higher frequency of migraine attacks. This may be due to a lack of inhibitory control over the transmission of pain to the cortex. The increased activation of cortical areas devoted to attention and emotion may be linked to headache. 展开更多
关键词 头痛发作 诱发电位 致偏 痛觉过敏 头皮电极 无症状 诱导法 热刺激 皮层区 尾状核
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