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目的观察非先兆性偏头痛及慢性偏头痛发作间期视觉诱发电位(VEP)的变化特点,并探讨两者发作间期视皮层兴奋性改变的可能机制。方法对非先兆性偏头痛组、慢性偏头痛组及健康对照组(各组n=20)的个体分别进行VEP检查,每叠加100次形成一个VEP波形,连续记录6个波形,测量每个波形N1-P2的波幅,比较起始波形的N1-P2波幅在三组间有无差别,并分析每组内从第一个波形至第六个波形N1-P2波幅的变化趋势。结果起始波形N1-P2振幅比较:非先兆性偏头痛组低于正常组[(6.05±2.22)μV<(6.54±1.81)μV,P<0.05],慢性偏头痛组高于正常组[(8.32±1.74)μV>(6.54±1.81)μV,P<0.05],均有统计学意义;各组内第一个波形至第六个波形N1-P2波幅的变化趋势分析:健康组呈下降趋势(r=-0.03),非先兆性偏头痛组呈上升趋势(r=0.21),慢性偏头痛组呈下降趋势(r=-0.14)。结论非先兆性偏头痛患者大脑皮层兴奋性适应性缺损,即兴奋性易感性升高,与皮质低预激活水平有关;不同于非先兆性偏头痛患者,慢性偏头痛患者大脑皮层兴奋性适应性升高,与抑制环路活性降低有关。
Objective To observe the changes of visual evoked potential (VEP) in non-aura migraine and chronic migraine attacks, and to explore the possible mechanism of excitability changes in the visual cortex between the two groups. Methods VEPs were performed on subjects without aura migraine, chronic migraine and healthy controls (n = 20 in each group). VEPs were formed 100 times in each stack. Six waveforms were recorded continuously and each waveform was measured N1-P2 amplitude. The N1-P2 amplitudes of the initial waveform were compared among the three groups, and the change trend of N1-P2 amplitude from the first waveform to the sixth waveform in each group was analyzed. RESULTS: Compared with normal group, the amplitude of N1-P2 in the initial migraine group was significantly lower than that in the normal group [(6.05 ± 2.22) μV <(6.54 ± 1.81) μV, P <0.05] 8.32 ± 1.74) μV> (6.54 ± 1.81) μV, P <0.05], all of which were statistically significant. The change tendency of N1-P2 amplitude from the first waveform to the sixth waveform in each group showed that the health group showed a decreasing trend (r = -0.03), non-aura migraine group increased (r = 0.21), and chronic migraine group showed a downward trend (r = -0.14). Conclusions Excitability-induced defects in the cortex of the non-atrophic migraine are associated with increased susceptibility to excitability and low cortical pre-activation levels. Unlike non-atrophic migraineurs, the excitability of the cerebral cortex in patients with chronic migraine Increase, and inhibit the activity of the loop decreased.