Zusammenfassung
Mit der Messung der “contingent negative variation” (CNV), einem langsamen Potential, das auf der Kopfoberfläche abgeleitet werden kann, bietet sich eine Methode an, mit der insbesondere die kortikale Pathophysiologie bei chronischen Kopfschmerzen untersucht werden kann. Dabei zeigt sich bei Patienten mit Migräne ohne Aura im schmerzfreien Intervall eine deutlich negativere CNV-Amplitude im Vergleich zu Gesunden. Dieses langsame Potential hängt eng mit der Aktivität zentraler noradrenerger Strukturen zusammen, weswegen sich diese Meßmethode bei zentral bedingten Erkrankungen anbietet. Neuere Studien, in denen die CNV wiederholt an Kopfschmerzpatienten gemessen wurde, weisen auf eine periodisch sich verändernde Amplitude hin. So kann bei Migränepatienten wenige Tage vor einem Migränean-fall ein Anstieg in der Negativierung der CNV beobachtet werden, der sich mit dem Anfall wieder normalisiert. Trotz zum Teil beein-druckender befunde im Gruppen-vergleich ist die Methode der CNV-Messung im Einzelfall sehr unspezifisch. Deswegen wird sich diese Meßmethode hauptsächlich im Bereich zur wissenschaftlichen Erforschung der Pathophysiologie von chronischen Kopfschmerzen und weniger als Routinediagnostikum etablieren.
Abstract
The contingent negative variation (CNV) is a slow cortical potential recorded from the scalp. This method allows the pathophysiology of chronic headaches to be elucidated. When assessed during the pain-free interval patients suffering from migraine without aura show significantly more negative amplitudes than healthy controls. This negativity reflects the activity of cerebral noradrenergic systems. Some studies using repeated recordings of the CNV show a periodicity in amplitude change. When migraine patients are assessed a few days before a migraine attack occurs, they show pronounced negativity, which normalized during the attack. Despite these interesting findings that are based on group comparisons, evaluating the CNV on an individual basis does not allow specific conclusions. Thus, assessment of the CNV is an important tool to examine pathophysiological aspects of chronic headaches, but is not suitable as a diagnostic procedure.
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Kropp, P., Göbel, H., Dworschak, M. et al. Elektrophysiologische Untersuchungen bei Kopfschmerzen: Die “contingent negative variation” (CNV). Schmerz 10, 130–134 (1996). https://doi.org/10.1007/s004820050032
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DOI: https://doi.org/10.1007/s004820050032