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Klinische Neurophysiologie 2004; 35(1): 22-38
DOI: 10.1055/s-2003-814844
Originalia
© Georg Thieme Verlag Stuttgart · New York

Neurophysiologische Befunde bei Migräne - Spiegelbild der Pathophysiologie oder Epiphänomen?

Neurophysiological Findings in Migraine - Do they Reflect Pathophysiological Events or Epiphenomena?T.  Probst1 , A.  Wolters1 , R.  Benecke1 , E.  Kunesch1
  • 1Neurologische Klinik und Poliklinik der Universität Rostock
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Publication History

Publication Date:
02 March 2004 (online)

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Zusammenfassung

Neuronale Dysfunktionen von Kortex und Hirnstamm spielen für die Pathophysiologie der Migräne eine entscheidende Rolle. Funktionelle bildgebende Verfahren (fMRT), Perfusionsmessungen und elektrophysiologische Untersuchungsverfahren wie EEG und MEG, multimodal evozierte Potenziale, ereigniskorrelierte Potenziale und Reflexuntersuchungen haben bei Migränepatienten eine Vielzahl von auffälligen und teilweise widersprüchlichen Befunden erbracht. Diese hängen vom Zeitpunkt der Untersuchung innerhalb des Migränezyklus (interiktual, Aura, Kopfschmerzphase) und zum Teil vom Migränetyp (Migräne mit oder ohne Aura) ab. Dysfunktionen von Filter- und Schutzmechanismen, die das ZNS regulär vor einem exzessiven sensorischen Informationsfluss abschirmen, besitzen wahrscheinlich für die Auslösung von Migräneattacken eine große Bedeutung. In konkurrierenden Modellvorstellungen werden eine neuronale Hyperexzitabilität im ZNS, aber auch eine kortikale Hypoexzitabilität als Prädispositionsfaktoren für Migräneattacken propagiert.

Abstract

Neuronal dysfunctions of the cortex and brainstem play a major role in the pathophysiology of migraine. Functional brain imaging (fMRI), perfusion measurements and electrophysiological investigations such as EEG and MEG, multimodal evoked potentials, event-related potentials and reflex measurements have revealed many abnormal and even contradictory findings. These depend on the investigation time within the migraine cycle (interictual, aura and acute headache) and partly on the migraine subtype (migraine with or without aura). Dysfunctions of filter mechanisms protecting the brain from an overflow of sensory input might play a crucial role in inclucing migraine attacks. Competing pathophysiological models suggest neuronal hyperexcitability within the CNS, but also hypoexcitability of the cerebral cortex as predisposing factors in migraine.

Key words

Migraine - pathophysiology - cortex - hyperexcitability - evoked potentials

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Dr. med. T. Probst,
Prof. Dr. med. E. Kunesch

Klinik für Neurologie und Poliklinik · Universität Rostock

Gehlsheimer Straße 20

18147 Rostock

Email: thomas.probst@med.uni-rostock.de

Email: erwin.kunesch@med.uni-rostock.de

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