Wang Ting, Zhan Wang, Chen Qin, Chen Ning, Zhang Junpeng, Liu Qi, He Li, Zhang Junran, Huang Hua, Gong Qiyong
aDepartment of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University bDepartment of Radiology, Huaxi MR Research Center (HMRRC) cDepartment of Neurology, West China Hospital of Sichuan University dDepartment of Psychology, School of Public Administration, Sichuan University, Chengdu, People's Republic of China eNeuroimaging Center, University of Maryland, College Park, Maryland.
Neuroreport. 2016 Mar 2;27(4):257-63. doi: 10.1097/WNR.0000000000000529.
This study aimed to investigate the dysfunctional ascending/descending pain pathways at the thalamic level in patients with migraine without aura (MWoA) using the effective connectivity analysis of the resting-state functional MRI. Twenty MWoA and 25 matched healthy controls participated in the resting-state functional MRI scans. The directional interactions between the posterior thalamus (PTH) and other brain regions were investigated using the Granger causality analysis and choosing bilateral PTH as two individual seeds. Pearson's correlation analysis was carried out between the abnormal effective connectivity and the headache duration and pain intensity of MWoA. Compared with healthy controls, MWoA showed decreased inflows to the bilateral PTH from the ventromedial prefrontal cortex and the left precuneus/posterior cingulate cortex, decreased outflow from the left PTH to the ipsilateral dorsomedial prefrontal cortex, and increased inflow to the right PTH from the ipsilateral dorsolateral prefrontal cortex. In addition, the abnormal inflows to the right PTH from the ventromedial prefrontal cortex and the right dorsolateral prefrontal cortex correlated positively with the headache duration and pain intensity, respectively. The abnormal ascending/descending pain pathways between the thalamus and these cortical regions indicate a disrupted pain modulation in affective and sensory domains, which suggests a disequilibrium of pain inhibition and facilitation in MWoA. These findings may help to shed light on the pathophysiologic mechanisms of migraine.
本研究旨在利用静息态功能磁共振成像的有效连接分析，调查无先兆偏头痛（MWoA）患者丘脑水平上功能失调的上行/下行疼痛通路。20名MWoA患者和25名匹配的健康对照者参与了静息态功能磁共振成像扫描。使用格兰杰因果分析并选择双侧丘脑后部（PTH）作为两个独立种子，研究了PTH与其他脑区之间的定向相互作用。对MWoA患者异常的有效连接与头痛持续时间和疼痛强度进行了Pearson相关性分析。与健康对照者相比，MWoA患者显示腹内侧前额叶皮质和左侧楔前叶/后扣带回皮质向双侧PTH的流入减少，左侧PTH向同侧背内侧前额叶皮质的流出减少，同侧背外侧前额叶皮质向右侧PTH的流入增加。此外，腹内侧前额叶皮质和右侧背外侧前额叶皮质向右侧PTH的异常流入分别与头痛持续时间和疼痛强度呈正相关。丘脑与这些皮质区域之间异常的上行/下行疼痛通路表明情感和感觉领域的疼痛调制受到破坏，这提示MWoA患者疼痛抑制和易化失衡。这些发现可能有助于阐明偏头痛的病理生理机制。
