Postaurikuler bölgeden kaydedilen sempatik deri yanıtları ile otonom fonksiyonları değerlendirilen vestibüler migren tanılı hastaların, migren tanılı hastalar ve sağlıklı kontrol grubu ile karşılaştırılması
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bolu Abant İzzet Baysal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Vestibüler migren (VM) ve Klasik Migrenin (KM) doğrudan tanımlanmış bir nedeni bulunmamakla birlikte patofizyolojisinde otonom disregülasyonun olduğu uzun yıllardır tartışılmaktadır. Bu tez çalışmasında, VM ve KM hastaları ataklar arası dönemde değerlendirilmiş ve daha önce çok az çalışmada kullanılmış olan postauriküler sempatik deri yanıtı (PASDY) tekniği kullanılmıştır. Yaş olarak uyumlu normal kontrol olgularla VM, KM olan olguların SDY arasında fark olup olmadığı, migren türlerinin otonom teorinin bir belirteci olabilecek SDY üzerine etkisinin olup olmadığı araştırılmıştır. Çalışmaya bilinen herhangi bir kronik hastalık ve/veya ilaç kullanım öyküsü olmayan yaş median değeri 39,5 olan 21 kadın (%80,8) ve 5 erkekten (%19,2) oluşan 26 kişilik VM hastaları, yaş median değeri 32,5 olan 24 kadın (%77,4) ve 7 erkekten (%22,6) oluşan 31 kişilik KM hastaları ve yaş median değeri 38 olan 13 kadın (%50) ve 13 erkekten (%50) olaşan 26 kişilik Sağlıklı Kontrol dahil edilmiştir. VM hastaları ile kontrol grubu arasında Sağ ve Sol Amplitüd değerlerinde anlamlıya yakın bir fark dikkati çekmektedir (Sol p=0,193, Sağ p=0,202). Buradan yola çıkarak VM hastaları ve kontrol grubu arasında Sağ ve Sol Amplitüd değerleri kombine edilerek analiz yapıldığında istatistiksel olarak anlamlı Amplitüd farkı dikkati çekmiştir (p=0.047). KM hastaları ile kontrol grubu arasında Sağ ve Sol Amplitüd değerleri karşılaştırıldığında istatistiksel anlamlı farklılık elde edilememiştir (Sol Amplitüd p=0,306, Sağ Amplitüd p=0,254). VM ve KM grubunda kendi içinde semptomatik asemptomatik taraf karşılaştırması yapıldığında iki grupta da belirgin taraf bulgusu tarifleyen hastalarda semptomatik tarafa ait SDY amplitüd değerleri asemptomatik tarafa kıyasla istatistiksel olarak anlamlı düzeyde düşük amplitüdlü elde edilmiştir (p=0,008, p=0.014). VM KM grubu karşılaştırmalı olarak değerlendirildiğinde ise amplitüd değerlerinin VM lehine yüksek olduğu tespit edilmiştir. Sonuç olarak bu çalışma literatürde pek çok çalışmada işaret edilen KM'de görülen asimetrik sempatik hipofonksiyonun/disfonksiyonun ortak patofizyolojiye dair pek çok sinonim özellikleri barındıran VM hastalarında da benzer şekilde olabileceğini göstermiştir. ANAHTAR KELİMELER: Klasik migren, Vestibüler migren, Otonom sinir sistemi, Sempatik disfonksiyon, Sempatik deri yanıtı
Although there is no directly defined cause of vestibular migraine (VM) and classical migraine (CM), it has been discussed for many years that there is autonomic dysregulation in their pathophysiology. In this thesis study, patients with VM and CM were evaluated in the period between attacks and the postauricular sympathetic skin response (PASSR) technique, which has been used in very few studies before, was used. It was investigated whether there is a difference between SSR in age-matched normal control subjects and subjects with VM, CM, and whether migraine types have an effect on SSR, which can be an indicator of autonomous theory. 26 patients with VM, 21 women (80.8%) and 5 men (19.2%) with a median age of 39.5 without any known chronic disease and/or drug use, and a median age of 32.5 were included in the study. Included were 31 CM patients, 24 women (77.4%) and 7 men (22.6%), and 26 Healthy Controls, 13 women (50%) and 13 men (50%) with a median age of 38 years. There is a significant difference in Right and Left Amplitude values between VM patients and the control group (Left p=0.193, Right p=0.202). From this point of view, when the analysis was performed by combining Right and Left Amplitude values between VM patients and the control group, a statistically significant difference in Amplitude was noticed (p=0.047). When the Right and Left Amplitude values were compared between the CM patients and the control group, no statistically significant difference was found (Left Amplitude p=0.306, Right Amplitude p=0.254). When the symptomatic asymptomatic sides were compared within the VM and CM groups, the SSR amplitude values of the symptomatic side were found to be statistically significantly lower than the asymptomatic side in patients with prominent side findings in both groups (p=0,008, p=0.014). When the VM KM groups were evaluated comparatively, it was determined that the amplitude values were high in favor of VM. In conclusion, this study showed that the asymmetric sympathetic hypofunction/dysfunction seen in CM, which has been pointed out in many studies in the literature, may be similar in VM patients who have many synonyms for the common pathophysiology. KEYWORDS: Classical migraine, vestibular migraine, autonomic nervous system, sympathetic dysfunction, sympathetic skin response
Although there is no directly defined cause of vestibular migraine (VM) and classical migraine (CM), it has been discussed for many years that there is autonomic dysregulation in their pathophysiology. In this thesis study, patients with VM and CM were evaluated in the period between attacks and the postauricular sympathetic skin response (PASSR) technique, which has been used in very few studies before, was used. It was investigated whether there is a difference between SSR in age-matched normal control subjects and subjects with VM, CM, and whether migraine types have an effect on SSR, which can be an indicator of autonomous theory. 26 patients with VM, 21 women (80.8%) and 5 men (19.2%) with a median age of 39.5 without any known chronic disease and/or drug use, and a median age of 32.5 were included in the study. Included were 31 CM patients, 24 women (77.4%) and 7 men (22.6%), and 26 Healthy Controls, 13 women (50%) and 13 men (50%) with a median age of 38 years. There is a significant difference in Right and Left Amplitude values between VM patients and the control group (Left p=0.193, Right p=0.202). From this point of view, when the analysis was performed by combining Right and Left Amplitude values between VM patients and the control group, a statistically significant difference in Amplitude was noticed (p=0.047). When the Right and Left Amplitude values were compared between the CM patients and the control group, no statistically significant difference was found (Left Amplitude p=0.306, Right Amplitude p=0.254). When the symptomatic asymptomatic sides were compared within the VM and CM groups, the SSR amplitude values of the symptomatic side were found to be statistically significantly lower than the asymptomatic side in patients with prominent side findings in both groups (p=0,008, p=0.014). When the VM KM groups were evaluated comparatively, it was determined that the amplitude values were high in favor of VM. In conclusion, this study showed that the asymmetric sympathetic hypofunction/dysfunction seen in CM, which has been pointed out in many studies in the literature, may be similar in VM patients who have many synonyms for the common pathophysiology. KEYWORDS: Classical migraine, vestibular migraine, autonomic nervous system, sympathetic dysfunction, sympathetic skin response
Açıklama
Tıp Fakültesi, Nöroloji Ana Bilim Dalı
Anahtar Kelimeler
Nöroloji, Neurology
