r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2022-27-6-41-49r-n-j-370Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSОценка эффективности терапии мигрени с использованием функциональной магнитно-резонансной томографии покоя при курсовой ритмической транскраниальной магнитной стимуляцииEvaluation of the effectiveness of migraine therapy using functional resting MRI with course rhythmic transcranial magnetic stimulationhttps://orcid.org/0000-0003-2905-9287ТруфановА. Г.TrufanovA. G.

Санкт-Петербург

Saint Petersburg

https://orcid.org/0000-0002-6242-1279МаркинК. В.MarkinK. V.

Маркин Кирилл Валерьевич

Санкт-Петербург

Saint Petersburg

vmeda.work@ya.ruhttps://orcid.org/0000-0003-2137-9841ФрунзаД. Н.FrunzaD. N.

Санкт-Петербург

Saint Petersburg

daryafrunza@yandex.ruhttps://orcid.org/0000-0001-8988-3011ЛитвиненкоИ. В.LitvinenkoI. V.

Санкт-Петербург

Saint Petersburg

litvinenkoiv@rambler.ruhttps://orcid.org/0000-0002-9874-5523ТарумовД. А.TarumovD. A.

Санкт-Петербург

Saint Petersburg

https://orcid.org/0000-0001-7612-792XКузнецоваЕ. В.KuznetsovaE. V.

Санкт-Петербург

Saint Petersburg

https://orcid.org/0000-0003-2249-1405ЕфимцевА. Ю.EfimtsevA. U.

Санкт-Петербург

Department of Radiology

Saint Petersburg

https://orcid.org/0000-0002-7314-7711ОдинакМ. М.OdinakM. M.

Санкт-Петербург

Saint Petersburg

Военно-медицинская академия имени С.М. КироваРоссияS.M. Kirov Military Medical AcademyRussian FederationНациональный медицинский исследовательский центр имени В.А. АлмазоваРоссияAlmazov National Medical Research CentreRussian Federation2022100120232764149Copyright © Труфанов А.Г., Маркин К.В., Фрунза Д.Н., Литвиненко И.В., Тарумов Д.А., Кузнецова Е.В., Ефимцев А.Ю., Одинак М.М., 20232023Труфанов А.Г., Маркин К.В., Фрунза Д.Н., Литвиненко И.В., Тарумов Д.А., Кузнецова Е.В., Ефимцев А.Ю., Одинак М.М.Trufanov A.G., Markin K.V., Frunza D.N., Litvinenko I.V., Tarumov D.A., Kuznetsova E.V., Efimtsev A.U., Odinak M.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/370Обоснование

Обоснование: в условиях поиска новых возможностей терапии мигрени требуется строгий контроль их эффективности с помощью объективных методов обследования.

Цель исследования

Цель исследования. Объективная оценка эффективности транскраниальной магнитной стимуляции (ТМС) у пациентов с мигренью на основе данных функциональной магнитно-резонансной томографии (фМРТ).

Материал и методы

Материал и методы. У 19 пациентов с мигренью была выполнена фМРТ в состоянии покоя до и после пятидневного курса терапии ТМС стыка нижнелобной и височной долей билатерально. Изменения функциональной коннективности (ФК) основных нейрональных сетей головного мозга, а также клинические показатели боли и качества жизни пациентов оценивались до и после проведенного курса ТМС.

Результаты

Результаты. На фоне терапии наблюдалось снижение показателей интенсивности боли и тревоги, а также уменьшение количества принимаемых лекарств от острой боли. Изменения ФК затронули три основные сети: сеть пассивного режима работы мозга, сеть выявления значимости и зрительную сеть. При этом сниженная эффективность терапии отмечалась у пациентов с более высоким уровнем выраженности депрессивных симптомов и наличием нейровизуализационных критериев депрессии.

Заключение

Заключение. Исследование позволяет предположить об эффективности применения ТМС у пациентов с мигренью на основе нейровизуализации. Стоит обращать особое внимание на наличие депрессивной симптоматики у пациентов с мигренью.

Introduction

Introduction. In the context of the search for new migraine therapy options, strict control of their eff ectiveness by means of objective examination methods is required.

Objective

Objective. Objective assessment of the eff ectiveness of TMS in patients with migraine on the basis of functional magnetic resonance imaging (fMRI) data.

Material and methods

Material and methods. Resting-state fMRI before and after a fi ve-day course of TMS of the junction of the inferior frontal and temporal lobes bilaterally was performed in 19 patients with migraine. Changes in functional connectivity (FC) of the main neuronal networks of the brain, as well as clinical parameters of pain and quality of life of the patients were assessed before and after the course of TMS.

Results

Results. A decrease in pain intensity and anxiety scores, as well as a decrease in the number of acute pain medications taken, was observed against the background of the therapy. Changes in FC aff ected three main networks: the default mode network, the salience and visual networks. At the same time, decreased effi cacy of therapy was noted in patients with higher severity of depressive symptoms and presence of neuroimaging criteria of depression.

Conclusion

Conclusion. The study suggests the effi cacy of TMS in patients with migraine based on neuroimaging criteria. It is worth paying special attention to the presence of depressive symptoms in migraine patients.

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The authors declare that there are no conflicts of interest present.