以擴散光學技術量測偏頭痛病患之研究

Abstract

偏頭痛是一種反覆發生中度或重度搏動性頭痛的疾病，全台約有9.4%的人口深受偏頭痛之苦，而現今醫療診斷主要是靠醫師的問診，沒有一個快速且客觀的儀器去協助醫師來判斷病人的生理狀況。 本研究中我們利用近紅外光光譜技術量測偏頭痛病患前額葉的血液動力學變化，並以閉氣試驗作為生理干預法，包含42位陣發性偏頭痛病患、38位慢性偏頭痛病患和25位健康的正常人，我們計算在閉氣試驗時間下前額葉含氧血紅素濃度變化的斜率以及大小，發現偏頭痛病患與健康人有顯著性的差異，有機會透過這樣的方法來判斷大腦神經血管的調控性，幫助醫師更進一步了解患者的生理狀況。 然而這臨床研究是使用商業儀器，能提供的生理資訊依然不夠豐富，故我們建立了一套雙功能擴散光學系統，利用雷射都卜勒技術量測光訊號中的頻率訊號計算血流流速，結合原本的近紅外光系統，同時得知含氧缺氧血紅素濃度變化以及血流變化，透過血管束縛實驗量測四肢末梢的微循環驗證系統的可行性，未來改善系統的精準度，相信能為醫療診斷上提供更多的生理資訊。

Migraine is considered as a neurovascular coupling disorder due to the impaired cerebrovascular reactivity. We use functional near infrared spectroscopy system (fNIRS) on our study and apply a breath holding task as a metabolic perturbation to measure the hemodynamic changes of the migraine patients. Fourty-two patients with episodic migraine (EM), thirty-eight patients with chronic migraine (CM) and twenty-five health controls (HC) were enrolled. We calculated the slope and the amplitude of hemodynamic changes during the task for [HbO2] signal. The amplitude and slope of the oxyhemoglobin concentration change of health controls is higher than patients with episodic migraine and patients with chronic migraine (P < 0.01). It suggests that the vasoreactivity of prefrontal cortex is impaired in migraine, especially in chronic migraine. In addition, we produced a duo-functional diffuse optical system which combines the functional near infrared spectroscopy system with laser Doppler flowmetry. Measuring the microcirculation of the finger under the occlusion task indicated the accuracy of system. In the future, we will improve the accuracy of this system. We believe that our system would be useful in clinical diagnosis.