偏头痛的静息态脑电图和脑磁图--系统回顾和荟萃分析

Paul Theo Zebhauser, Henrik Heitmann, Elisabeth S. May, Markus Ploner
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摘要

脑磁图/脑电图(M/EEG)可以帮助人们深入了解偏头痛的病理生理学,并有助于开发具有临床价值的生物标记物。为了整合和总结有关偏头痛脑功能变化的现有证据,我们对偏头痛静息态 M/EEG 发现进行了系统回顾和荟萃分析(PROSPERO CRD42021272622)。在检索 MEDLINE、Web of Science Core Collection 和 EMBASE 后,我们纳入了 27 项研究。采用改良的纽卡斯尔-渥太华量表评估偏倚风险。通过计票进行半定量分析,并使用随机效应模型对偏头痛患者与健康参与者之间的 M/EEG 差异进行荟萃分析。荟萃分析显示,偏头痛患者在发作间期的θ频率(3-8赫兹)的大脑活动功率高于健康参与者。此外,我们还发现偏头痛患者在发作间期的阿尔法和贝塔连接性较低。我们没有观察到 M/EEG 特征与疾病严重程度之间存在关联。此外,我们还发现一些证据表明,偏头痛发作前阶段的δ和β功率高于发作间期。所纳入研究的最大偏倚风险来自于缺乏对合并症的控制以及非自控或非盲化的 M/EEG 评估。这些发现可为今后有关偏头痛病理生理学和基于大脑的生物标记物的 M/EEG 研究提供指导,这些研究应考虑合并症,并以标准化的合作方法为目标。
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Resting-state electroencephalography and magnetoencephalography in migraine–a systematic review and meta-analysis
Magnetoencephalography/electroencephalography (M/EEG) can provide insights into migraine pathophysiology and help develop clinically valuable biomarkers. To integrate and summarize the existing evidence on changes in brain function in migraine, we performed a systematic review and meta-analysis (PROSPERO CRD42021272622) of resting-state M/EEG findings in migraine. We included 27 studies after searching MEDLINE, Web of Science Core Collection, and EMBASE. Risk of bias was assessed using a modified Newcastle–Ottawa Scale. Semi-quantitative analysis was conducted by vote counting, and meta-analyses of M/EEG differences between people with migraine and healthy participants were performed using random-effects models. In people with migraine during the interictal phase, meta-analysis revealed higher power of brain activity at theta frequencies (3–8 Hz) than in healthy participants. Furthermore, we found evidence for lower alpha and beta connectivity in people with migraine in the interictal phase. No associations between M/EEG features and disease severity were observed. Moreover, some evidence for higher delta and beta power in the premonitory compared to the interictal phase was found. Strongest risk of bias of included studies arose from a lack of controlling for comorbidities and non-automatized or non-blinded M/EEG assessments. These findings can guide future M/EEG studies on migraine pathophysiology and brain-based biomarkers, which should consider comorbidities and aim for standardized, collaborative approaches.
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