Migren Hastalarında Atak sırasında ve Ataklar arasındaki dönemlerde Anormal P50 Baskılanması

Yıl 2015, , 7 - 13, 05.01.2016

Suat Kamışlı , Mehmet Tecellioğlu Handan Kahraman

https://doi.org/10.24938/kutfd.124924

Öz

Sönümleme normal kişilerde aşırı duysal yüklenmeye karşı korteksi korumak için bir adaptasyon mekanizması olarak tanımlanabilir. Migrende en sık elektrofizyolojik anormallik sönümlemenin yokluğudur. İlginç olarak bir migren atağından hemen önce ve atak sırasında sönümleme normalize edilmiştir. Bu çalışmada kolinerjik kontrol altında sönümleme yanıtını değerlendirmek için p50 supresyon metoduna (duyusal perdeleme) karşı ortaya çıkan sönümleme yanıtına başka bir bakış açısı sağlamak amaçlanmıştır.

Çalışma 17 aurasız migren ve kontrol grubu olarak 18 sağlıklı gönüllüyü içermekteydi. Yöntem, duyusal perdelemeyi göstermek için p50 uyarı örneği ile eşleştirildi. İlk uyarı (S1), ikinci uyarı (S2), amplitüt, latans ve iktal-interiktal periyotlardaki duyusal perdeleme oranı sağlıklı bireylerle karşılaştırıldı.

Atak ve interiktal peryotlarda migrenli gruptaki p50 süpresyon oranı kontrol grubuna göre belirgin bir şekilde azalma gösterdi (p < 0.05). Kontrol grubu ile karşılaştırıldığında farklılık büyük oranda S1 amplitütündeki düşüklük ile ilişkiliydi (p<0.05). S1 ve S2 amplitütleri ve p50 supresyon oranı atak sırasında kontrol değerlerine yakın olmasına rağmen gruplar arasında hala büyük farklılıklar görülmektedir (p < 0.05).

Sonuç olarak, sönümlemenin kaybı düşüncesi interiktal kortikal hipoeksitabilite ve iktal olarak bunun normalize edilmesi ile ilişkilidir. Dolayısıyla çalışma migren hastalarında talamo-kortikal eksitatör kolinerjik aktivitede bir disfonksiyon olabileceğini önermektedir. 

Anahtar Kelimeler

Duyusal perdeleme, pedinkülopontin nucleus, kolinerjik yetmezlik, migren

Abnormal P50 Suppression in Migraine Patients during the Attack and Interattack Period

Öz

Habituation can be defined as an adaptive mechanism that protects the cortex against sensory overload in normal persons. The most common interictal electrophysiological abnormality in
migraine is lack of habituation. İnterestingly, habituation is normalized just before and during a migraine attack. It was aimed to provide another perspective on habituation response
through P50 suppression (sensory gating) method, used in the evaluation of the pre- attention habituation response, under the cholinergic control. The study population consisted of 17 migraine patients without aura and 18 healthy volunteers were included as a control group. The method for demonstrating sensory gating is the pairedstimulus P50 paradigm. We compared the initial stimulus (S1), second stimulus (S2) amplitude and latency and the percentage of sensory gating in the ictal and interictal periods with healthy controls. The percentage of P50 suppression of the migraine group in the attack and interictal periods were significantly reduced compared with those of the control group (P < 0.05). This difference was related to significantly lower S1 amplitude in the migraine group compared with the control group (P < 0.05). Although, the S1 and S2 amplitudes and percentages of P50 suppression were closer to the control values during an attack, the differentiations between groups was observed still significant (P < 0.05). This conclusion supports the notions of loss of habituation associated with interictal cortical hypoexcitability and the ictal normalization of the loss of habituation. The present study suggests that migraine patients may have a dysfunction in thalamo-cortical excitatory cholinergic activity

Anahtar Kelimeler

Sensory gating, pedinculopontine nucleus, cholinergic insufficiency, migraine

Kaynakça

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