Region-specific changes in brain glutamate and gamma-aminobutyric acid across the migraine attack in children and adolescents.

IF 5.9 1区 医学 Q1 ANESTHESIOLOGY
PAIN® Pub Date : 2024-12-01 Epub Date: 2024-06-04 DOI:10.1097/j.pain.0000000000003289
Lydia Y Cho, Tiffany K Bell, Lindsay Craddock, Kate J Godfrey, Andrew D Hershey, Jonathan Kuziek, Mehak Stokoe, Kayla Millar, Serena L Orr, Ashley D Harris
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Abstract

Abstract: In patients with migraine, an excitation-inhibition imbalance that fluctuates relative to attack onset has been proposed to contribute to the underlying pathophysiology of migraine, but this has yet to be explored in children and adolescents. This prospective, observational, cohort study examined glutamate and gamma-aminobutyric acid (GABA) levels across the phases of a migraine attack and interictally in children and adolescents using magnetic resonance spectroscopy. Macromolecule-suppressed GABA (sensorimotor cortex and thalamus) and glutamate (occipital cortex, sensorimotor cortex, and thalamus) were measured in children and adolescents (10-17 years) with a migraine diagnosis with or without aura 4 times over 2 weeks. Linear mixed-effects models examined changes in glutamate and GABA during the 72 hours leading up to, and after the onset of an attack. We found significant region-specific changes in glutamate and GABA. Specifically, sensorimotor GABA significantly increased leading up to the headache phase, whereas glutamate significantly decreased following the headache onset in the occipital cortex and the thalamus. Post hoc analyses examined the 24 hours leading up to or following the onset of the headache phase. In the 24 hours before the headache onset, sensorimotor glutamate, occipital glutamate, and thalamic GABA decreased. In the 24 hours post headache onset, sensorimotor glutamate continued to decrease. Our results suggest changes in glutamate and GABA that are consistent with the thalamocortical dysrhythmia hypothesis. These findings provide insight into developmental migraine pathophysiology and may open future avenues for treatment targets specific to children and adolescents.

儿童和青少年偏头痛发作时脑谷氨酸和γ-氨基丁酸的特定区域变化。
摘要:有人认为,偏头痛患者的兴奋-抑制失衡会随着偏头痛的发作而波动,从而导致偏头痛的潜在病理生理学问题,但这一问题尚未在儿童和青少年中得到探讨。这项前瞻性、观察性、队列研究利用磁共振波谱学检查了儿童和青少年在偏头痛发作阶段和发作间期的谷氨酸和γ-氨基丁酸(GABA)水平。在 2 周内 4 次测量被诊断为有或无先兆偏头痛的儿童和青少年(10-17 岁)的大分子抑制 GABA(感觉运动皮层和丘脑)和谷氨酸(枕叶皮层、感觉运动皮层和丘脑)。线性混合效应模型检测了发作前和发作后 72 小时内谷氨酸和 GABA 的变化。我们发现谷氨酸和 GABA 有明显的区域特异性变化。具体来说,头痛发作前,感觉运动 GABA 明显增加,而头痛发作后,枕叶皮层和丘脑的谷氨酸明显减少。事后分析检查了头痛发作前或发作后的 24 小时。在头痛发作前的 24 小时内,感觉运动谷氨酸、枕叶谷氨酸和丘脑 GABA 均下降。在头痛发作后的 24 小时内,感觉运动谷氨酸继续减少。我们的研究结果表明,谷氨酸和GABA的变化与丘脑皮质节律失调假说一致。这些研究结果提供了对发育期偏头痛病理生理学的深入了解,并可能为今后针对儿童和青少年的治疗开辟道路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
PAIN®
PAIN® 医学-临床神经学
CiteScore
12.50
自引率
8.10%
发文量
242
审稿时长
9 months
期刊介绍: PAIN® is the official publication of the International Association for the Study of Pain and publishes original research on the nature,mechanisms and treatment of pain.PAIN® provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest.
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