In this prospective study, patients with migraine with aura were investigated during spontaneous migraine aura and interictally. Time compressed HD-EEG were analyzed for the presence of cortical spreading depolarization characterized by (a) slow potential changes below 0.05 Hz, (b) suppression of faster activity from 0.5 Hz - 45 Hz (c) spreading of these changes to neighboring regions during the aura phase. Further, topographical changes in alpha-power spectral density (8-14 Hz) during aura were analyzed.
In total, 26 HD-EEGs were recorded in patients with migraine with aura, thereof 10 HD-EEGs during aura. Eight HD-EEGs were recorded in the same subject. During aura, no slow potentials were recorded, but alpha-power was significantly decreased in parieto-occipito-temporal location on the hemisphere contralateral to visual aura, lasting into the headache phase. Interictal alpha-power in patients with migraine with aura did not differ significantly from age- and sex-matched healthy controls.
Unequivocal signatures of spreading depolarization were not recorded with EEG on the intact scalp in migraine. The decrease in alpha-power contralateral to predominant visual symptoms is consistent with focal depression of spontaneous brain activity as a consequence of cortical spreading depolarization but is not specific thereof.
Cortical spreading depolarization is relevant in migraine, other paroxysmal neurological disorders and neurointensive care.
方法:在这项前瞻性研究中,对有先兆的偏头痛患者进行了自发性先兆偏头痛患者的调查。分析时间压缩的HD-EEG是否存在皮层扩散去极化,其特征是(a)低于0.05Hz的缓慢电位变化,(b)抑制来自0.5Hz-45Hz的更快活动(c)在先兆阶段期间这些变化向相邻区域的扩散。Further,分析了先兆期间α功率谱密度(8-14Hz)的地形变化。
结果:总计,有先兆的偏头痛患者记录了26例HD-EEG,其中10个HD-EEG在先兆期间。在同一受试者中记录了8个HD-EEG。在光环期间,没有记录到慢电位,但α功率在视觉先兆对侧半球的顶枕-颞位置显着降低,持续到头痛阶段。有先兆的偏头痛患者的发作间期α功率与年龄和性别匹配的健康对照没有显着差异。
结论:在偏头痛的完整头皮上,EEG未记录到明显的扩散去极化特征。主要视觉症状对侧的α功率降低与皮层扩散去极化的结果是自发脑活动的局灶性抑制一致,但不是特异性的。
结论:皮质扩散去极化与偏头痛有关,其他阵发性神经系统疾病和神经重症监护。