İlker ÖZTÜRK, Halit FİDANCI

Migren ve Gerilim Tipi Baş Ağrısı Hastalarında Pattern Reversal ve Flaş Görsel Uyarılmış Potansiyeller

Amaç: Migren ve gerilim tipi baş ağrısı (GTBA) en sık izlenen primer baş ağrılarıdır. Migren ve GTBA hastalarına görsel uyarılmış potansiyelleri (GUPlar) uygulayarak, bu primer baş ağrılarının patofizyolojisi ile ilgili bilgilerin elde edilmesi amaçlandı. Gereç ve Yöntemler: Sağlıklı bireyler, epizodik migren ve epizodik GTBA hastaları bu prospektif çalışmaya dahil edildi. Tüm katılımcılara pattern reversal ve flaş GUPlar uygulandı. Hastalar interiktal dönemde iken GUP uygulandı. Ayrıca migren ve GTBA hastalarının baş ağrı şiddetleri Vizüel Analog Skala (VAS) ile analiz edildi. Bulgular: Otuz bir sağlıklı birey, 27 gerilim-tipi baş ağrısı hastası ve 31 migren hastası çalışmaya dahil edildi. Gruplar arasında yaş ve cinsiyet farklı değildi (p>0,05). Migren hastalarının VAS skorları (8,0±1,1), GTBA hastalarının VAS skorlarına (6,5±1,1) göre daha yüksekti (p<0.001). Kontrol, GTBA ve migren hastalarının sağ/sol P100 dalga latanslarının ortalaması sırasıyla 89,8±7,5/91,0±6,2, 91,0±4,9/91,3±5,2, 97,6±8,1/97,1±7,5 ms idi. Kontrol, GTBA ve migren hastalarının sağ/sol P2 dalga latanslarının ortalaması sırasıyla 104,7±15,9/104,8±14,5, 98,6±11,5/98,7±10,8, 115,5±16,3/118,3±6,2 ms idi. Migren grubunun P100, P2, N3, P3 dalgalarının latansları gerilim tipi baş ağrısı ve kontrol grubuna göre daha yüksekti (p<0.05). Sonuç: Bu çalışma migren hastalarının GUP latanslarının kontrol ve epizodik GTBA hastalarına göre daha yüksek olduğunu göstermiştir. Bu bulgular migrenin patofizyolojisinde periferik mekanizmaların yanı sıra santral mekanizmaların rol oynadığına ve epizodik GTBA’nın periferik dokulardan kaynaklandığına işaret edebilir.

Anahtar Kelimeler:

Migren, Gerilim tipi baş ağrısı, görsel uyarılmış potansiyeller

Pattern Reversal and Flash Visual Evoked Potentials in Patients with Migraine and Tension-Type Headache

Objective: Migraine and tension-type headache (TTH) are the most common primary headaches. It was aimed to obtain information about the pathophysiology of these primary headaches by performing visual evoked potentials (VEPs) to patients with migraine and TTH. Material and Methods: Healthy individuals, episodic migraine, and episodic TTH patients were included in this prospective study. Pattern reversal and flash VEPs were performed to all participants. VEP was applied while the patients were in the interictal period. In addition, headache severity of migraine and TTH patients were analyzed with Visual Analogue Scale (VAS). Results: Thirty-one healthy individuals, 27 TTH patients, and 31 migraine patients were included in the study. Age and gender were not different between the groups (p>0.05). VAS scores of migraine patients (8.0±1.2) were higher than those of TTH patients (6.5±1.1) (p <0.001). The mean right/left P100 wave latencies of control, TTH, and migraine patients were 89.8±7.5/91.0 ± 6.2, 91.0±4.9/91.3±5.2, 97.6±8.1/97.1±7.5 ms, respectively. The mean right/left P2 wave latencies of control, TTH, and migraine patients were 104.7±15.9/104.8±14.5, 98.6±11.5/98.7±10.8, 115.5±16.3/118.3±6.2 ms, respectively. The latencies of P100, P2, N3, and P3 waves in migraine group were higher than those in TTH and control groups (p<0.05). Conclusion: This study showed that migraine patients had higher VEP latencies than controls and episodic TTH patients. These findings may indicate that central mechanisms as well as peripheral mechanisms play a role in the pathophysiology of migraine and that episodic TTH originates from peripheral tissues.

Keywords:

Migraine, Tension-type headache, visual evoked potential,

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