Aberrant Neuromagnetic Signatures with Chronic Migraine

慢性偏头痛的异常神经磁特征

• 批准号: 8635429
• 负责人: Jing Xiang
• 金额: $ 18.09万
• 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 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8635429
• 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; 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

ABSTRACT: 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.

摘要：慢性偏头痛是偏头痛的残疾并发症，头痛发生15或更多 每月几天。慢性偏头痛的患者经常经常出现药物过度使用的头痛 进一步使这种疾病复杂化，并给临床治疗头痛带来更多问题。由于疼痛 患有慢性偏头痛的患者通常会因体育锻炼而恶化，并且通常是标准的 治疗，患有慢性偏头痛的患者的生活品质非常低，这在术语中会极大地影响社会。 偏头痛研究最重要的进步之一是确认皮质超和低 - 用非侵入性神经影像学技术（例如磁脑电图（MEG））激活。梅格研究 偏头痛的表明，皮质激活的归一化可以降低偏头痛的发生率 攻击。抗癫痫药（AED）可能会改变皮质激活，在 预防偏头痛。但是，慢性头痛的皮质功能障碍可能是过度或低激活的 这取决于病理和大脑区域。潜在的脑机制知之甚少 而且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是 与一组大脑区域中的皮质超激活和性低激活有关。该假设基于 观察到急性偏头痛中皮质兴奋性的位置和程度已被定量，并且 用高级MEG方法（例如光束形成和小波）毫无创作。建立在我们的基础上 偏头痛和梅格的研究经验，我们建议解决以下特定目标：（1）量化 在患有慢性偏头痛的儿童中异常脑激活的时空和光谱特征。 MEG的头痛攻击； （2）确定大脑激活的时空和光谱变化 临床治疗前，期间和之后患有慢性偏头痛的儿童。本研究的创新是 慢性偏头痛的非常高频神经磁信号（最高2884 Hz）的测量 偏头痛的MEG研究通常仅限于低频范围（<70 Hz）。自高频 神经磁信号已局部到焦点大脑区域，如果成功，我们可以精确地确定 在拟议的研究中，高频MEG数据在何处以及在何种程度的皮质激活中发生了变化 慢性偏头痛。对异常皮质激活的位置和类型有更清晰的了解 发生的所有针对皮质兴奋性的治疗方法（例如AED，经颅磁刺激， 可以指定经颅直流刺激，针灸） - 目前表现出巨大的承诺 - 精致及其结果大大改善。鉴于高频神经磁信号是新的 生物标志物，对具有高级MEG方法的慢性偏头痛进行了更深入的研究，这是我们的重要下一步 了解偏头痛的病理生理学以及我们发展更好治疗和预防的能力 策略。