Indeks zadržavanja daha u epizodičnim glavoboljama
Sažetak
Uvod/Cilj. Istraživanja cerebrovaskularne reaktivnosti kod osoba sa primarnim glavoboljama fokusirana su uglavnom na migrenu, dok je manji broj studija bio usmeren na glavobolju tenzionog tipa ili poređenje cerebralne hemodinamike između migrene i glavobolje tenzionog tipa. Cerebrovaskularna reaktivnost kod osoba sa migrenom je dosta ispitivana, primenom različite metodologije i sa različitim zaključcima. Istovremeno, cerebrovaskularna reaktivnost kod osoba sa glavoboljom tenzionog tipa i klaster glavoboljom bila je predmet istraživanja značajno manjeg broja studija. Ovim istraživanjem, cilj nam je bio da uporedimo intraiktalnu cerebrovaskularnu reaktivnost merenu metodom zadržavanja daha kod bolesnika sa epizodičnim formama tri najčešća tipa primarnih glavobolja. Metode. Ispitivanje je sprovedeno kod 243 ispitanika, 100 osoba sa migrenom sa aurom (grupa I), 70 osoba sa migrenom bez aure (grupa II), 38 osoba sa epizodičnom glavoboljom tenzionog tipa (grupa III), 35 osoba sa epizodičnom formom klaster glavobolje (grupa IV) i 30 zdravih ispitanika u kontrolnoj grupi (grupa V). Ispitianicima je urađena transkranijalna Doppler sonografija i test zadržavanja daha, pri čemu su analizirane dobijene vrednosti srednjih brzina protoka, indeksa pulsatilnosti i indeksa zadržavanja daha (Breath-holding index – BHI), merenih i izračunavanih za srednju cerebralnu arteriju. Rezultati. Srednje brzine protoka i indeksi pulsatilnosti nisu se razlikovali među ispitivanim grupama. Vrednosti BHI bile su značajno veće u grupi ispitanika sa migrenom sa aurom (1,668 ± 0,269) u poređenju sa ispitanicima sa migrenom bez aure (1,411 ± 0,358, p = 0,005), glavoboljom tenzionog tipa (1,401 ± 0,428, p = 0,035), klaster glavoboljom (1,203 ± 0,311, p < 0,01) i zdravim kontrolama (1,195 ± 0,269, p < 0,01) ukazujući na povećanu reaktivnost na hiperkapniju kod osoba sa migrenom sa aurom. Zaključak. Naši rezultati podržavaju hipotezu o postojanju interiktalne hipersenzitivnosti i slabosti habituacije kod osoba sa migrenom.
Reference
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