目的:在这项前瞻性队列研究中,我们的目的是评估,使用高密度脑电图(HD-EEG),慢性偏头痛(CM)患者的功能连接(FC)的纵向变化。
背景:OBTA是CM的治疗方法。一些研究表明OBTA对中枢神经系统的调节作用;然而,对偏头痛的研究是有限的。
方法:这项研究是在“PoliclinicoTorVergata,\"罗马,意大利,包括12例接受OBTA治疗的CM成年患者和15例健康对照(HC)。患者在入组时(T0)和治疗开始后3个月(T1)接受临床量表。在T0和T1的CM患者中使用64通道系统记录HD-EEG。使用源重建方法来识别大脑活动。使用加权相位滞后指数分析了δ-θ-α-β-低γ波段的FC。使用交叉验证方法评估T0和T1时HC和CM之间的FC变化,以估计结果的可靠性。
结果:与T0时的HCs相比,CM患者在δ中显示出超连接网络(p=0.046,接受者工作特征曲线下面积[AUC:0.76-0.98],科恩的κ[0.65-0.93])和β(p=0.031,AUC[0.68-0.95],科恩κ[0.51-0.84]),主要涉及眶额,枕骨,颞极和眶额,上颞叶,枕骨,扣带回区,和α波段的次连通网络(p=0.029,AUC[0.80-0.99],科恩κ[0.42-0.77]),主要涉及扣带,颞极,和precuneus。与T0相比,T1时CM患者在δ波段显示出低连接网络(p=0.032,AUC[0.73-0.99],科恩κ[0.53-0.90])和α波段的超连通网络(p=0.048,AUC[0.58-0.93],科恩κ[0.37-0.78]),涉及感觉运动,眶额,扣带回,和颞叶皮层.
结论:这些初步结果表明,与通过单次OBTA治疗恢复的对照组相比,CM患者的EEG-FC中断,提示OBTA的主要中枢调节作用。
OBJECTIVE: In this pilot prospective cohort
study, we aimed to evaluate, using high-density electroencephalography (HD-EEG), the longitudinal changes in functional connectivity (FC) in patients with chronic migraine (CM) treated with onabotulinumtoxinA (OBTA).
BACKGROUND: OBTA is a treatment for CM. Several studies have shown the modulatory action of OBTA on the central nervous system; however, research on migraine is limited.
METHODS: This
study was conducted at the Neurology Unit of \"Policlinico Tor Vergata,\" Rome, Italy, and included 12 adult patients with CM treated with OBTA and 15 healthy controls (HC). Patients underwent clinical scales at enrollment (T0) and 3 months (T1) from the start of treatment. HD-EEG was recorded using a 64-channel system in patients with CM at T0 and T1. A source reconstruction method was used to identify brain activity. FC in δ-θ-α-β-low-γ bands was analyzed using the weighted phase-lag index. FC changes between HCs and CM at T0 and T1 were assessed using cross-validation methods to estimate the results\' reliability.
RESULTS: Compared to HCs at T0, patients with CM showed hyperconnected networks in δ (p = 0.046, area under the receiver operating characteristic curve [AUC: 0.76-0.98], Cohen\'s κ [0.65-0.93]) and β (p = 0.031, AUC [0.68-0.95], Cohen\'s κ [0.51-0.84]), mainly involving orbitofrontal, occipital, temporal pole and orbitofrontal, superior temporal, occipital, cingulate areas, and hypoconnected networks in α band (p = 0.029, AUC [0.80-0.99], Cohen\'s κ [0.42-0.77]), predominantly involving cingulate, temporal pole, and precuneus. Patients with CM at T1, compared to T0, showed hypoconnected networks in δ band (p = 0.032, AUC [0.73-0.99], Cohen\'s κ [0.53-0.90]) and hyperconnected networks in α band (p = 0.048, AUC [0.58-0.93], Cohen\'s κ [0.37-0.78]), involving the sensorimotor, orbitofrontal, cingulate, and temporal cortex.
CONCLUSIONS: These preliminary results showed that patients with CM presented disrupted EEG-FC compared to controls restored by a single session of OBTA treatment, suggesting a primary central modulatory action of OBTA.