Abstract：
Cortical spreading depolarization is highly conserved among the species. It is easily detectable in direct cortical surface recordings and has been recorded in the cortex of humans with severe neurological disease. It is considered the pathophysiological correlate of human migraine aura, but direct electrophysiological evidence is still missing. As signatures of cortical spreading depolarization have been recognized in scalp EEG, we investigated typical spontaneous migraine aura, using full band high-density EEG (HD-EEG).
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.
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.
摘要：
目的：皮层扩散去极化在物种之间高度保守。它在直接皮质表面记录中很容易检测到，并已记录在患有严重神经系统疾病的人的皮质中。它被认为是人类偏头痛先兆的病理生理相关性，但仍缺少直接的电生理学证据.由于在头皮脑电图中已经认识到皮质扩散去极化的特征，我们调查了典型的自发性偏头痛先兆,采用全波段高密度脑电图（HD-EEG）。
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。
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。
