Klinik und Hochschulambulanz für Neurologie, Charité Universitätsmedizin Berlin, Berlin, Germany; Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany.
Headache. 2015 Feb;55(2):241-51. doi: 10.1111/head.12496. Epub 2015 Feb 3.
In patients with episodic migraine (EM), diffusion tensor imaging (DTI) revealed microstructural white matter alterations in various brain regions related to pain processing. Some of these changes were correlated with migraine duration and attack frequency, suggesting that migraine is a progressive disease with proceeding structural alterations of the brain. This study aimed to identify possible microstructural white matter alterations in patients with chronic migraine (CM) using DTI. We hypothesized that alterations in DTI are more pronounced in patients with CM compared with EM.
Individually, age- and sex-matched subjects with CM without aura, EM without aura, and healthy controls (n = 21 per group) underwent conventional head magnetic resonance imaging and DTI imaging in a 3T MRI scanner and were included in analysis. DTI data were analyzed using a tract-based spatial statistics approach. Fractional anisotropy (FA), mean diffusivity, radial diffusivity, and axial diffusivity were compared between subjects with CM and EM, CM and controls, EM and controls, as well as between all subjects with migraine (EM + CM) and controls.
In chronic migraineurs (mean age 49 ± 7.5 years), we did not find any statistically significant difference (P < .05, threshold-free cluster enhancement corrected for multiple comparison) in DTI-derived parameters in comparison with episodic migraineurs (FA: P > .245) and healthy controls (FA: P > .099). In contrast to previous DTI studies, we did not find alterations in DTI-derived indices in subjects with EM compared with healthy controls (FA: P > .486).
No microstructural white matter changes could be observed in middle-aged chronic and episodic migraineurs using DTI. CM does not seem to be a risk factor for progressive microstructural changes in DTI.
在发作性偏头痛（EM）患者中，弥散张量成像（DTI）显示与疼痛处理相关的各种脑区存在微观结构的白质改变。这些变化中的一些与偏头痛的持续时间和发作频率相关，这表明偏头痛是一种进行性疾病，其大脑结构会逐渐发生改变。本研究旨在使用 DTI 来确定慢性偏头痛（CM）患者可能存在的微观结构白质改变。我们假设与 EM 相比，CM 患者的 DTI 改变更为明显。
分别将年龄和性别匹配的无先兆 CM 患者、无先兆 EM 患者和健康对照者（每组 21 例）纳入研究，在 3T MRI 扫描仪中进行常规头部磁共振成像和 DTI 成像，并进行分析。使用基于束的空间统计学方法分析 DTI 数据。比较 CM 患者与 EM 患者、CM 患者与对照组、EM 患者与对照组之间，以及所有偏头痛患者（EM+CM）与对照组之间的各向异性分数（FA）、平均弥散度、径向弥散度和轴向弥散度。
在慢性偏头痛患者（平均年龄 49±7.5 岁）中，与发作性偏头痛患者（FA：P>.245）和健康对照组（FA：P>.099）相比，我们未发现 DTI 衍生参数存在任何具有统计学意义的差异（P<.05，采用阈值自由聚类增强校正多重比较）。与之前的 DTI 研究相反，我们在 EM 患者中并未发现与健康对照组相比，DTI 衍生指数发生改变（FA：P>.486）。
使用 DTI 未观察到中年慢性和发作性偏头痛患者的微观结构白质改变。CM 似乎不是 DTI 中微观结构进行性改变的危险因素。
