| BackgroundAccording to the World Health Organization(WHO)Global Burden of Disease Survey in 2016 published by Lancet in 2017,migraine has become the third most common human disease in the world.According to the year of life lost to disability(YLDs),migraine is the seventh most common disability.Because of the high incidence and disability rate of migraine,the physical and mental health of patients is impaired,the work efficiency is reduced,the quality of life is reduced,and the family and society have a serious economic burden.However,its etiology and pathogenesis are still unclear.Therefore,it is one of the research hotspots in this field to actively explore and study the etiology and pathogenesis of migraine,improve the early diagnosis and intervention of migraine.It has been proved that the occurrence of many headache events in migraine patients is related to the inducing factors,and the induced migraine is more serious than the spontaneous migraine.This may be due to inducing factors that interfere with neuroelectric activity related to brain cells,increase the sensitivity of cerebral cortex and cause changes in cerebrovascular.Therefore,certain environmental and behavioral factors have become powerful triggers to trigger and accelerate migraine attacks.Mobile phone has become a necessity and indispensable communication tool in people's daily life.However,while mobile phones provide us with countless conveniences,the human living environment is polluted by more and more new electromagnetic field frequencies that have never appeared before.Research suggests that electromagnetic waves from mobile phones can affect various aspects of human physiology through their interactions with cells.The most important change is close contact with the head of these devices,which interferes with some functions of the brain.Previous studies have shown that increased daily cell phone use and weekly wi-fi use are significantly associated with the frequency and severity of migraine attacks.Event-related potential(ERP),as one of the objective indicators of electrophysiology,is a kind of brain potential change associated with psychological activities(i.e.,events),and hasbecome an important method for the objective evaluation of cognitive functions.Because of its safety,objectivity and no side effects,ERP is widely used in psychology,physiology,cognitive neuroscience and clinical medicine,and has high clinical and basic research value.At the same time,ERP not only has the advantages of short test time,easy acceptance by patients,no need for patient's language,words and action coordination,but also has high time resolution,which is known as "the response time of the 21st century".It can show the cognitive process of brain nerve cells at millisecond or even microsecond level.It provides a useful tool for evaluating migraine.An objective and feasible detection method opens up a new way for the diagnosis,condition monitoring,prognosis evaluation and etiological mechanism of migraine.As an endogenous component in ERP,the Contingent negative variation(CNV)is related to people's perception or cognitive psychological processing,closely related to people's attention,memory,intelligence and other processing processes,and is not affected by the physical characteristics of stimulation.Therefore,CNV has become an objective neuroelectrophysiological index to study the mechanism of brain nervous system activity in human cognitive process.Research suggests that during a migraine attack paroxysmal vascular and electrical changes are observed,caused by centrally triggered brain stem disturbances.The trigeminovascular system plays an important role in the pathogenesis of migraine and in pain processing.This abnormal pain processing is often associated with a cortical excitatory state which enables trigeminovascular nerve fifibers to depolarize.Therefore,CNV has become a good objective neurophysiological index in the study of the etiology and pathogenesis of migraine.Recent studies suggest that Radiofrequency electromagnetic fields(RF-EMF)emitted by mobile phone communication devices may be one of the environmental factors that trigger migraine attacks,but there is still no objective basis.CNV is an important objective electrophysiological index for evaluating migraine EEG activity.Does excessive use of mobile phones have an impact on CNV in migraine patients?And is there any difference in the impact between healthy people and healthy people?At present,there is no relevant report.In addition,Kropp and Gerber have concluded that migraines can occur in a 3-day cycle,based on CNV studies of migraine patients.However,in China's current diagnosis and treatment environment,the incidence of real migraine patients is far from so high.After reviewing Kropp and Gerber's research,it is concluded that the theory is based on specific conditions(specific population,region,severity of illness,susceptibility factors,etc.).Therefore,the clinical practice of the theory may not be consistent with the characteristics of migraine patients in China.So far,there has been no relevant report on the characteristics of migraine patients in this region.As mentioned above,since predisposing factors play a key role in the occurrence of migraine and mobile phones are one of the important environmental triggers,the mobile phone addiction will inevitably have an impact on the occurrence of migraine.Therefore,in order to reduce the impact of environmental factors on the experimental results,this study excluded the mobile phone addiction as an important external environmental factor in the early stage of the experiment.As we all know,migraine subtypes are predominant,and each subtype is divided into multiple derivative types.Among them,the incidence of migraine without aura is higher and the symptoms are hidden.Because of its unpredictability and difficulty in intervention,it brings more troubles to countless patients with migraine without aura.At the same time,due to the different characteristics and inducing factors of various types of migraine,this study only makes a preliminary study on the onset cycle of migraine patients without aura,and the research work of other types of migraine patients will be gradually carried out.Therefore,this topic is divided into two parts:First,the study of correlation negative change(CNV)in patients with migraine without aura caused by mobile phone addiction.Secondly,the study of cycle-related negative change(CNV)in patients with migraine without aura.In order to find out the objective basis for the influence of mobile phone addiction on migraine patients,review the onset cycle of migraine patients without aura,and provide theoretical basis for the prevention and treatment of clinical migraine patients.Chapter ?Study on contingent negative variation of mobile phone addiction in patients with migraine without auraObjective:To study the changes of CNV in patients with migraine without aura and healthy people after mobile phone addiction,and to clarify the effects of electromagnetic radiation from the electrophysiological point of view,so as to provide objective evidence for migraine attacks induced by mobile phone addictionMethods:147 patients with migraine without aura were selected from neurology clinic of Shandong Provincial Hospital Affiliated to Shandong University from September 2016 to June 2017.They were assessed with Mini-mental State Examination(MMSE),Montreal Cognitive Assessment(Mo CA)and Self-rating Anxiety Scale(S-SA).Elf-Rating Anxiety Scale(SAS)score,Self-rating depression scale(SDS)score,excluding patients with depression or anxiety or cognitive impairment.The remaining migraine patients were divided into mobile phone addiction group(group A,39)and no mobile phone addiction group(group B,38)by Smartphone Addiction Inventory(SPAI)score.Age-and gender-matched healthy controls were screened and scored by SPAI scale.They were divided into mobile phone addiction group(group C,33)and no mobile phone addiction group(group D,32).All healthy control groups were from medical staff and family members of Shandong Provincial Hospital Affiliated to Shandong University.Inform all migraine patients to complete headache diary every day in the next three months,record the number of headache attacks,and re-visit within 24 hours of each migraine attack,and all patients are in the duration of migraine attack,and each re-visit patients are evaluated by ERP test and headache score scale.Ten migraine patients in group A and eight migraine patients in group B were excluded from the data analysis.At last,the latency,amplitude and habitual index of Initial Contingent Negative Variation(iCNV)obtained from group A(29 participants),group B(30 participants),group C(33 participants),group D(32 participants)were analyzed by SPSS 23.0.Parts(IBM Corp.Armonk,NY,USA)are used for data analysis and processing.All data were expressed as mean± standard deviation.Student's T test or ANOVA were used for statistical analysis.For the statistical results,a=0.05 was used as the test level with no statistical significanceResults:According to the CNV study,for no mobile phone addiction group,there was no significant difference in iCNV latency,amplitude and habits between migraine group and control group(all P>0.05).For the mobile phone addiction group,compared with the no mobile phone addiction group,both the migraine group and the control group showed delayed iCNV latency,increased amplitude and decreased habits(all P<0.01;all P<0.05).Compared with the control group,the latency of iCNV in the migraine group was delayed,but the amplitude was increased and the habit was decreased(p<0.01).For the migraine group,the frequency of headache attacks and the severity of pain increased in the mobile phone addiction group compared with the no mobile phone addiction group(P<0.01)Conclusion:Mobile phone addiction affects the changes of iCNV in migraine patients and healthy people,which indicates that mobile phone addiction reduces the arousal and expectation of early warning stimuli in migraine patients and healthy people,and has a more significant impact on migraine patients.Meanwhile,mobile phone addiction increases the frequency and degree of pain in migraine patients Therefore,we suggest that both migraine patients and healthy people should try to reduce the use of mobile phones,especially migraine patients.Chapter ?Revisiting the periodicity of migraine attacks without aura through studying contingent negative variationObjective:To study the latency,amplitude and habitual changes of overall contingent negative variation(oCNV),initial contingent negative variation(iCNV),terminal contingent negative variation(tCNV),and postimperative negative variation(PINY)in adults at day 3-7 after the onset of migraine without aura.And to provide objective basis for exploring the onset cycle of migraine without aura.Methods:122 patients with migraine without aura were selected from the outpatient department of neurology,affiliated Provincial Hospital of Shandong University from July to December 2017.After MMSE score,Mo CA score,SAS score,SDS score and SPAI score,50 patients with migraine without excessive use of mobile phones were selected as the migraine group and 48 healthy people without excessive use of mobile phones were selected.As a healthy control group.Inform all patients of migraine without aura to go to the hospital every day for ERP examination 3-7 days after attack without taking medicine or treatment.At the same time,patients are required to record headache diary every day.8 migraine patients who quit the test halfway in the migraine group and 4 migraine patients who quit the test halfway in the healthy control group are excluded from data analysis.Finally,the amplitudes of oCNV,iCNV,tCNV and PINV recorded by 42 migraine patients(mean age 36.64±9.85)and 44 healthy controls(mean age 35.57±8.74)and the habitual indicators of initial CNV were analyzed and processed by SPSS 23.0 statistical software(IBM Corp.Armonk,NY,USA).All the data were normal distribution.The difference between groups was calculated by independent sample t test.The test level with a=0.05 as difference had no statistical significance.Result:There was no significant difference in latency of oCNV,iCNV,tCNV and PINV between migraine group and control group at 3-7 days after attack of migraine without aura(*p>0.05),and there was no significant difference in amplitude and habitual of oCNV,iCNV,tCNV and PINV between migraine group and control group(*P>0.05).Conclusion:For patients with migraine without aura,no significant negative changes of CNV were found in oCNV,iCNV,tCNV and PINV of latency,amplitude,habitual at 3-7 days after migraine attack.It is inferred that in this study,migraine patients without aura did not have the typical characteristics before the attack of migraine 3-7 days after the attack.Therefore,we believe that adults with migraine without aura may have a duration of more than three days after excluding the important trigger of mobile phone addiction. |
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