Hemodynamic and Metabolic Coupling in Migraine

偏头痛的血流动力学和代谢耦合

• 批准号: 8624417
• 负责人: DAVID DUBOWITZ
• 金额: $ 23.25万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8624417
• 关键词: Address; Adult; Affect; Aftercare; Agonist; Area; Attention; Bed rest; Biological Markers; Biological Neural Networks; Blood Vessels; Caffeine; Carbon Dioxide; Cerebral cortex; Cerebrovascular Circulation; Cerebrum; Chronic; Classification; Common Migraine; Complex; Coupling; Data; Disease; Etiology; Evolution; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Headache; Image; International; Magnetic Resonance Imaging; Measures; Menstrual cycle; Metabolic; Metabolism; Methods; Migraine; Natural History; Nervous system structure; Neurons; Oxygen; Pain; Pathogenesis; Patients; Phase; Physiological; Physiology; Play; Process; Recurrence; Relative (related person); Rest; Risk; Role; Signal Transduction; Spreading Cortical Depression; Stimulus; Stroke; Sumatriptan; Symptoms; Synapses; Techniques; Testing; Time; Tissues; Woman; Work; attenuation; base; blood oxygen level dependent; blood oxygenation level dependent response; clinical application; economic impact; experience; hemodynamics; insight; nervous system disorder; neuronal excitability; novel; novel strategies; public health relevance; relating to nervous system; response; tissue oxygenation; tool; visual stimulus

Project Summary The long-term goal of these studies is to understand how altered cerebral hemodynamics and oxygen metabolism contribute to neurological disease, and identify their role in the pathophysiology of migraine. Our overall hypothesis is that cerebral blood flow (CBF) and oxygen metabolism (CMRO2) are abnormal in migraine, and this affects local cerebral tissue oxygenation (PtO2). Further, that the CBF / CMRO2 coupling in response to a visual stimulus is also abnormal in migraine. During recent studies we observed hypoperfusion and hypometabolism during migraine without aura, but a greater decline in metabolism resulted in a small increase in local tissue oxygenation during the headache phase. Following sumatriptan both CBF and CMRO2 were normalized. Following a visual stimulus, we observed an increased CBF response, and increased CBF/CMRO2 coupling response, possibly related to neuronal hyperexcitability. Neither of these stimulus-induced changes responded to sumatriptan. Our first specific aim is to characterize the changes in steady-state CBF and CMRO2 during baseline, prodrome symptoms, headache symptoms and in response to sumatriptan, and determine how this affects tissue oxygenation at different phases of migraine. Our second aim is to characterize the CBF/CMRO2 coupling in response to a high contrast vs. a low contrast visual stimulus, again at different phases of migraine. A third aim is to address changes in resting state BOLD synchrony during migraine, as an indication of increased cortical synchrony during migraine. Also to examine a phenomenon of non-aura spreading waves of BOLD signal attenuation, from resting state fMRI data. These studies will be conducted in 10 women with menstrual migraine, and 10 controls. These studies present a new approach to address basic mechanistic questions in migraine pathophysiology. The endpoint of this exploratory work is the characterization of CBF and CMRO2 coupling and its impacts on cerebral tissue oxygenation, as well as the role of BOLD synchrony, during the evolution / treatment of symptoms in menstrual migraine. This will establish the basis for applying these novel MRI tools to evaluate the natural history or response to therapy more widely in migraine disorders.

项目概要 这些研究的长期目标是了解大脑如何改变 血流动力学和氧代谢导致神经系统疾病，以及 确定它们在偏头痛病理生理学中的作用。我们的总体假设是 偏头痛时脑血流量（CBF）和氧代谢（CMRO2）异常， 这会影响局部脑组织氧合（PtO2）。进一步地，CBF/CMRO2 偏头痛中对视觉刺激的耦合反应也是异常的。最近期间 我们在无先兆偏头痛期间观察到灌注不足和代谢低下的研究， 但新陈代谢的更大程度下降导致局部组织的小幅增加 头痛阶段的氧合。继舒马普坦 CBF 和 CMRO2 后 已正常化。视觉刺激后，我们观察到 CBF 反应增加， CBF/CMRO2 耦合反应增加，可能与神经元相关 过度兴奋。这些刺激引起的变化都没有对舒马曲坦产生反应。 我们的第一个具体目标是表征稳态 CBF 和 CMRO2 的变化 在基线期间，前驱症状，头痛症状以及对 舒马曲坦，并确定其如何影响不同阶段的组织氧合 偏头痛。我们的第二个目标是表征 CBF/CMRO2 耦合以响应 高对比度与低对比度视觉刺激，同样是在偏头痛的不同阶段。一个 第三个目标是解决偏头痛期间静息状态 BOLD 同步性的变化，作为 偏头痛期间皮质同步性增加的迹象。还要检查一个 BOLD 信号衰减的非光环传播波现象，从静息状态 状态功能磁共振成像数据。这些研究将在 10 名患有经期偏头痛的女性中进行， 和 10 个控件。这些研究提出了解决基本机制问题的新方法 偏头痛病理生理学问题。这项探索性工作的终点是 CBF和CMRO2耦合的特征及其对脑组织的影响 氧合，以及 BOLD 同步的作用，在进化/治疗过程中 月经偏头痛的症状。这将为应用这些小说奠定基础 MRI 工具可更广泛地评估偏头痛的自然史或治疗反应 失调。