Publication: Migrenli olgularda görsel olaya ilişkin endojen potansiyeller
Abstract
Migreni olan kişiler migreni olmayan kişilere oranla farklı görsel ve işitsel bilgi oluştururlar. Migren atakları arasında kognitif etkilenmeyi gösteren kortikal fonksiyonlarda elektrofizyolojik ve fonksiyonel değişiklikler saptanırken bazı çalışmalarda kortikal değişiklikler veya kognitif performansta azalma saptanmamıştır. Çalışmamızda migrenin kognitif işlevler üzerine etkisinin olup olmadığı eğer varsa hangi işlevlerin etkilendiğini araştırmak amacıyla dikkat, bellek, dil, yürütücü işlevler, görsel ve mekansal işlevleri değerlendiren nöropsikolojik testler ile görsel olaya ilişkin potansiyeller (OİEP) tetkikinde kayıtlanan N2 ve P3 dalga latansları arasındaki ilişkiyi değerlendirmeyi amaçladık. Çalışmaya yaşları 16-45 arasında, migren tanısı alan 32 hasta (26 kadın, 6 erkek). alındı. Kontrol grubu olarak yaş ve eğitim düzeyi uyumlu 20 sağlıklı olgu seçildi. Beck depresyon envanteri uygulanarak depresyonu olanlar çalışmaya alınmadı. OİEP tetkikinde kontrol grubu ile karşılaştırıldığında migren grubunda Fz, Cz ve Pz ‘den kayıtla N2 (p=0.000) ve P3 (p=0.000) latansları kontrol grubuna oranla uzun bulunmuştur. En uzun N2 ve P3 latansı Fz’den kayıtla elde edilmiş olup arkadan öne doğru gelindiğinde latansın uzadığı saptanmıştır. Hastalar migren tiplerine göre incelendiğinde auralı ve aurasız gruplara ait N2 ve P3 latans ortalama değerleri açısından istatistiksel anlamlı fark saptanmamıştır (p<0.05). Nöropsikolojik bataryada kullanılan testler her bir gruba ayrı ayrı uygulanmıştır. Migrenli grup kontrol grubu ile karşılaştırıldığında dikkat, bellek, yürütücü işlevler, ikili benzerlik, dil işlevi skorları anlamlı olarak düşük bulunmuş olup OİEP’de kayıtlanan N2 ve P3 latansları ile kognitif testler arasında ters yönde korelasyon saptanmıştır (p=0.000). Auralı ve aurasız grup arasında istatistiksel olarak fark bulunmamıştır (p>0.05). Sonuç olarak migrende kognitif işlevler etkilenmektedir. OİEP tetkiki nörokognitif testlerle kanıtlanan migrendeki kognitif etkilenmeyi destekler bulgular ortaya koymaktadır. OİEP migren için tek başına tanısal test olmamasına karşın özellikle kognitif süreci izlemek için önemli, uygulaması kolay, noninvaziv bir tekniktir . gren, görsel olaya ilişkin potansiyeller, kognitif işlevler
VISUAL EVENT RELATED POTENTIALS IN MIGRANEOUS PATIENTS Individuals who experience migraine process visual and auditory information differently from those without migraine. Functional and electrophysiologic alterations in cortical functioning have been found during the migraine interval. However, not all studies have found such cortical alterations or cognitive performance decrements. In our study, we have aimed to examine whether migraine is associated with cognitive efficiency, if so, to correlate the neuropsychological tests of attention, memory, language, cognitive efficiency,and visuospatial abilities with the latencies of N2 and P3 recorded on visual event-related potentials (ERP). Thirty-two patients with the diagnosis of migraine ( 26 female, 6 male) age ranged between 16-45 and 20 controls with the similar age and educational state were included in the study. Patients with depression that was examined by Beck depression inventory were excluded. Migraine group had significantly longer latencies for N2 (p=0.000) and P3 (p=0.000) waves recorded by Fz, Cz, and Pz electrodes when compared with the control group. The longest latencies were recorded on Fz and the latencies were observed to be longer from back to the front. There was no statistically difference between the patients with and without aura (p>0.05) Neuropsychological battery was applied for both of the groups. The scores of attention, memory, language, cognitive efficiency, and verbal paired associates in the migraine group were significantly lower compared with the control group and there was a negative correlation between the cognitive tests and the latencies of N2 and P3 (p=0.000). There was no statistically difference between the patients with and without aura (p>0.05). In conclusion, cognitive function is effected in migraine. ERP supports the cognitive impairment in the migraine that has been observed by the neuropsychological tests. Though ERP is not a major test for the diagnosis of migraine, it is important for the follow-up of the cognitive abilities, and is a noninvasive technique that can be applied easily. Key words: Migraine, visual event-related potentials, cognitive functions
VISUAL EVENT RELATED POTENTIALS IN MIGRANEOUS PATIENTS Individuals who experience migraine process visual and auditory information differently from those without migraine. Functional and electrophysiologic alterations in cortical functioning have been found during the migraine interval. However, not all studies have found such cortical alterations or cognitive performance decrements. In our study, we have aimed to examine whether migraine is associated with cognitive efficiency, if so, to correlate the neuropsychological tests of attention, memory, language, cognitive efficiency,and visuospatial abilities with the latencies of N2 and P3 recorded on visual event-related potentials (ERP). Thirty-two patients with the diagnosis of migraine ( 26 female, 6 male) age ranged between 16-45 and 20 controls with the similar age and educational state were included in the study. Patients with depression that was examined by Beck depression inventory were excluded. Migraine group had significantly longer latencies for N2 (p=0.000) and P3 (p=0.000) waves recorded by Fz, Cz, and Pz electrodes when compared with the control group. The longest latencies were recorded on Fz and the latencies were observed to be longer from back to the front. There was no statistically difference between the patients with and without aura (p>0.05) Neuropsychological battery was applied for both of the groups. The scores of attention, memory, language, cognitive efficiency, and verbal paired associates in the migraine group were significantly lower compared with the control group and there was a negative correlation between the cognitive tests and the latencies of N2 and P3 (p=0.000). There was no statistically difference between the patients with and without aura (p>0.05). In conclusion, cognitive function is effected in migraine. ERP supports the cognitive impairment in the migraine that has been observed by the neuropsychological tests. Though ERP is not a major test for the diagnosis of migraine, it is important for the follow-up of the cognitive abilities, and is a noninvasive technique that can be applied easily. Key words: Migraine, visual event-related potentials, cognitive functions