Aberrant Neuromagnetic Signatures with Chronic Migraine

慢性偏头痛的异常神经磁特征

• 批准号: 8742008
• 负责人: Jing Xiang
• 金额: $ 21.7万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8742008
• 关键词: Acupuncture procedure; Acute; Address; Adult; Affect; Aftercare; Analgesic Overuse Headaches; Anti-Inflammatory Agents; Anti-inflammatory; Antiepileptic Agents; Area; Biological Markers; Brain; Brain region; Cerebrum; Child; Childhood; Chronic; Chronic Headaches; Clinical; Clinical Treatment; Complication; Data; Development; Diagnosis; Disease; Disease Progression; Electroencephalography; Fingers; Frequencies; Functional disorder; Future; General Population; Goals; Headache; Incidence; Lead; Life; Location; Magnetoencephalography; Measurement; Measures; Methodology; Methods; Migraine; Modality; Motor Cortex; Outcome; Pain; Pathologic; Pathology; Patients; Pediatrics; Pharmaceutical Preparations; Physical activity; Play; Prevalence; Prevention; Prevention strategy; Process; Quality of life; Refractory; Reporting; Research; Research Personnel; Resolution; Role; Severities; Signal Transduction; Societies; Solutions; Specific qualifier value; Technology; Transcranial magnetic stimulation; base; effective therapy; experience; improved; innovation; neuroimaging; neurophysiology; prevent; public health relevance; response; spatiotemporal; standard care; treatment response; treatment strategy; triptans

DESCRIPTION (provided by applicant): Chronic migraine is a disabling complication of migraine with headaches that occurs 15 or more days per month. Patients with chronic migraine frequently experience medication overuse headaches that may further complicate this disorder and cause more problems for clinically treating headaches. Since the pain of a patient with chronic migraine typically worsens with physical activity and is often refractory to standard treatment, patients with chronic migraine have very low qualities of life which in term greatly impacts society. One of the most important advances in migraine research is the confirmation of cortical hyper- and hypo- activation with non-invasive neuroimaging technologies such as magnetoencephalography (MEG). MEG study of migraine has shown that the normalization of cortical activation can reduce the incidence of migraine attacks. Antiepileptic drugs (AED), which may change cortical activation, are frequently effective in the prevention of migraine. However, cortical dysfunction in chronic headaches can be hyper- or hypo-activation which depends on the pathology and brain regions. The underlying cerebral mechanism is poorly understood and has rarely been studied in pediatric chronic migraine. We hypothesize that pediatric chronic migraine is associated with cortical hyper- and hypo-activation in a set of brain areas. This hypothesis is based on the observations that the location and degree of cortical excitability in acute migraine have been quantitatively and noninvasively determined with advanced MEG methods such as beamforming and wavelet. Building on our research experience in migraine and MEG, we propose to address the following specific aims: (1) quantify the spatiotemporal and spectral signatures of aberrant brain activation in children with chronic migraine during headache attacks with MEG; (2) determine the spatiotemporal and spectral changes of brain activation in children with chronic migraine before, during and after clinical treatment. The innovation of the present study is the measurements of very high-frequency neuromagnetic signals (up to 2884 Hz) in chronic migraine because MEG study of migraine is conventionally limited to a low-frequency range (< 70 Hz). Since high-frequency neuromagnetic signals are well localized to focal brain areas, if successful, we can precisely determine with high-frequency MEG data in the proposed study where and to what degree cortical activation changed in chronic migraine. With a clearer understanding of the location and types of aberrant cortical activation occurring, all of the treatments targeted at cortical excitability (e.g. AED, transcranial magnetic stimulation, transcranial direct current stimulation, acupuncture) - which currently show great promise -could be specified, refined and their outcomes significantly improved. Given that high-frequency neuromagnetic signals are a new biomarker, a more in-depth study of chronic migraine with advanced MEG methods is a critical next step in our understanding of migraine pathophysiology and our ability to develop better treatment and prevention strategies.

描述（由申请人提供）：慢性偏头痛是偏头痛的残疾并发症，头痛每月15天或以上。慢性偏头痛的患者经常会出现过度使用的药物，这可能会使这种疾病更加复杂，并给临床治疗头痛带来更多问题。由于患有慢性偏头痛患者的疼痛通常会因体育锻炼而恶化，并且经常对标准治疗难治性，因此慢性偏头痛患者的生活品质非常低，这在术语中会极大地影响社会。偏头痛研究的最重要进步之一是用非侵入性神经影像学技术（如磁脑摄影（MEG））确认皮质高和过度激活。 MEG的偏头痛研究表明，皮质激活的归一化可以减少偏头痛攻击的发生率。可能改变皮质激活的抗癫痫药（AED）通常在预防偏头痛方面有效。但是，慢性头痛中的皮质功能障碍可能是过度或低激活，取决于病理和大脑区域。潜在的脑机制知之甚少，很少在小儿慢性偏头痛中进行研究。我们假设小儿慢性偏头痛与一组脑中的皮质性超活激活有关 区域。该假设基于以下观察结果：急性偏头痛中的皮质兴奋性的位置和程度已通过高级MEG方法（例如波束形成和小波）进行了定量和无创确定。在我们在偏头痛和梅格方面的研究经验的基础上，我们建议解决以下特定目的：（1）量化在梅格（MEG）头痛攻击期间，患有慢性偏头痛儿童异常脑激活的时空和光谱特征； （2）确定临床治疗前，期间和之后患有慢性偏头痛儿童的脑激活的时空和光谱变化。本研究的创新是在慢性偏头痛中对非常高频神经磁信号（高达2884 Hz）的测量，因为MEG偏头痛的研究通常仅限于低频范围（<70 Hz）。由于高频神经磁信号已稳定在焦点大脑区域中，因此，如果成功，我们可以在拟议的研究中精确地确定高频MEG数据，在慢性偏头痛中，皮质激活发生了什么程度的变化。更清楚地了解发生的异常皮质激活的位置和类型，所有针对皮质兴奋性的治疗方法（例如AED，经颅磁刺激，经颅直流电流刺激， 针灸） - 目前表现出巨大的希望 - 可以指定，完善，其结果大大改善。鉴于高频神经磁信号是一种新的生物标志物，因此对慢性偏头痛的更深入研究是我们对偏头痛病理生理学的理解以及制定更好治疗和预防策略的能力的关键下一步。