偏頭痛靜息腦波頻譜分析暨頭痛程度評估

Abstract

過去的研究已然發現偏頭痛患者的靜息腦電圖頻譜具有異常的特徵，該特徵對於未來的臨床診斷上有其應用潛力。然而這些研究的結果多數難達共識，且探討偏頭痛大腦在頭痛周期中不同階段的差異者鮮少。本研究目的在於長期觀察每位偏頭痛患者在各個頭痛階段的腦電圖頻譜差異，並找出該頻譜差異與頭痛程度的相關性。本研究針對無視覺預兆的偏頭痛病人，於每二至四周進行一次腦電圖試驗，以收錄病人在不同頭痛階段的腦電圖資料。本研究亦招募健康的受試者作為研究控制組。共計95位病人及59位健康的受試者完成試驗，並完成收錄17對頭痛間期-頭痛期與53對頭痛間期-前期的成對資料。本研究擷取位於Fpz和枕葉區的閉眼靜息腦電圖，並以小波轉換成頻域資料做組內分析。結果顯示：在頭痛期，病人枕葉腦區的阿爾法能量相較於頭痛間期有著顯著增加的現象 (p < 0.01)。另外在頭痛間期與頭痛期，病人位在Fpz的德爾塔腦波能量出現高於健康受試者的情況 ，然而在頭痛前期，該頻帶腦波能量顯著下降 (p < 0.01)成健康受試者的範圍。結果亦發現：頭痛期對頭痛間期之阿爾法鋒值能量的比值，和頭痛當下的疼痛程度成正相關，而頭痛前期與頭痛間期之低頻帶(1~8赫茲)谷值能量的比值，則和平均疼痛程度成負相關。在這項長期、配對研究中，我們的結果表示偏頭痛大腦在不同的頭痛階段腦部活動有所變化，而該腦部活動的變化幅度可能與偏頭痛嚴重程度相關。

Abnormalities of resting electroencephalography (EEG) spectrum had been found in patients with migraine and had the potential to aid in the clinical diagnosis. However, these results are not conclusive and the studies on the dynamic change of brain activity across migraine phases are rare. This study aimed to longitudinally investigate the change of EEG spectrum in different migraine phases and figured out the relationships between the EEG marker and headache intensity. EEG was collected every 2 to 4 weeks in patients with migraine without aura to cover different migraine phases. EEG was also recorded for healthy controls as a comparison. The closed-eyes, resting EEG data at Fpz and the occipital area were transformed to wavelet spectrum and were used in the paired study. Ninety-five patients and 59 controls finished the study. Seventeen interictal-ictal pairs and 53 interictal-preictal pairs were collected. Results showed that in the ictal phase, alpha power increased significantly (p<0.01) at the occipital area as comparing to the interictal phase. Delta power at Fpz for patients in inter- and ictal phases was higher than that of the control group, but in preictal phase, it decreased significantly (p < 0.01) to the control group’s level. The alpha peak power in ictal phase relative to interictal phase was positively correlated to current headache intensity while the low-frequency (1~8 Hz) power in preictal phase also relative to interictal phase was negatively correlated to the average headache intensity. In this long-term, paired study, our findings suggest that activity of a migraine brain alter along migraine phases and the magnitude of this change can be related to the severity of a migraine.