J Korean Neurol Assoc > Volume 20(3); 2002 > Article

Journal of the Korean Neurological Association 2002;20(3): 260-264.

"경두개 자기자극을 이용한 편두통 및 만성 긴장성 두통에서의 발작간 운동피질 흥분성"

송은향 , 이정석 최용석 김정미 김두응 한정호

서울보훈병원 신경과, 안양병원 신경과

"Interictal Motor Cortex Excitability in Migraine and Chronic Tension Type Headache using Transcranial Magnetic Stimulation"

Eun-Hyang Song, M. D.

"Department of Neurology, Seoul Veterans Hospital Department of Neurology, Anyang Hospital"

Abstract

"Background : The pathophysiology of migraine is only partly understood. Transcranial magnetic stimulation has been developed to study cortical physiology noninvasively. Chronic tension-type headache has not been studied with transcranial magnetic stimulation. Among other hypotheses, it has been proposed that interictal hypoexcitability could be partly responsible for the migraine. M e t h o d s : Patients were divided into three groups: normal subjects(n=30), migraine with(n=11) or without aura(n=19) and chronic tension-type headache(n=30) according to the International Headache Society criteria. We studied cortical excitability between normal subjects and patients with migraine with or without aura and between normal and patients with chronic tension-type headache. Results : The mean amplitude of cortex and spinal cord for normal subjects was 3.76 ±1.74 mV, 2.03 ±1.54 mV(abductor digiti minimi muscles, respec-tively) and 2.99 ±2.04 mV, 3.88 ±3.89 mV(abductor hallucis muscles, respectively). The mean amplitude of cortex and spinal cord for migraine with aura or without aura was 2.16 ±1.21 mV, 0.90+0.80 mV(abductor digiti minimi muscles, respectively) and 1.88 ±1.23 mV, 2.31 ±2.25 mV(abductor hallucis muscles, respectively). The mean amplitude of cor-tex and spinal cord for chronic tension-type headache was 1.61 ±0.50 mV, 0.72 ±0.32 mV(abductor digiti minimi mus-cles, respectively) and 1.54 ±0.55 mV, 1.51 ±0.59 mV(abductor hallucis muscles, respectively). The amplitude of motor evoked potentials of cortex and spinal cord in migraine and chronic tension-type headache showed significant decreases compared to normal subjects(p<0.001). Conclusions : These results are explained by cortical and spinal hypoexcitabili-ty in migraine and chronic tension-type headache. We suggest that enhanced serotonergic activity could be some rule for cortical hypoexcitability.Key Words : Transcranial magnetic stimulation, Interictal cortical excitability, Headache"