Riederer Franz, Schaer Marie, Gantenbein Andreas R, Luechinger Roger, Michels Lars, Kaya Marihan, Kollias Spyridon, Sándor Peter S
Neurological Center Rosenhuegel and Karl Landsteiner Institute for Epilepsy Research and Cognitive Neurology, Vienna, Austria.
Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, Zurich, CH-8091, Switzerland.
Headache. 2017 Feb;57(2):255-265. doi: 10.1111/head.12993. Epub 2016 Dec 28.
Using surface-based morphometry we aimed to provide a detailed examination of cortical alterations in medication-overuse headache (MOH), by disentangling between altered cortical thickness and gyrification (folding).
In MOH, pain modulation is probably dysfunctional at the cortical and subcortical level, resulting in a disequilibrium between pain inhibition and facilitation. Both increased and decreased cortical volumes have been reported in individuals with MOH. There is however no detailed examination to date that distinguishes between altered cortical thickness and gyrification. Such distinction would help to identify the nature and timing of neurodevelopmental mechanisms at play in affected individuals.
We investigated cortical thickness and gyrification in 29 patients with MOH according to International Headache Society criteria and 29 age- and gender-matched controls, using high-resolution structural MRIs of the brain analyzed with FreeSurfer. This is a secondary analysis of data from a previously published voxel-based morphometry study.
In patients with MOH compared to controls, reduced cortical thickness was observed in the left prefrontal cortex. We also observed higher local gyrification in one cluster extending from the fusiform cortex to adjacent medial temporal regions, and in another cluster in the right occipital pole. Higher gyrification in the right occipital pole predicted poor response after detoxification.
Corroborating previous volumetric results, our study adds information on the putative neurobiological mechanisms involved in MOH, suggesting neurodevelopmental changes in MOH.
我们旨在通过区分皮质厚度和脑回形成（折叠）的改变，利用基于表面的形态测量法对药物过量使用性头痛（MOH）的皮质改变进行详细检查。
在药物过量使用性头痛中，疼痛调节在皮质和皮质下水平可能功能失调，导致疼痛抑制和促进之间失衡。有报道称药物过量使用性头痛患者的皮质体积既有增加的情况，也有减少的情况。然而，迄今为止尚无详细检查来区分皮质厚度和脑回形成的改变。这种区分将有助于确定受影响个体中起作用的神经发育机制的性质和时间。
我们根据国际头痛协会标准，对29例药物过量使用性头痛患者和29例年龄及性别匹配的对照者进行了皮质厚度和脑回形成的研究，使用通过FreeSurfer分析的高分辨率脑部结构磁共振成像。这是对先前发表的基于体素的形态测量研究数据的二次分析。
与对照组相比，药物过量使用性头痛患者左侧前额叶皮质的皮质厚度降低。我们还观察到一个从梭状皮质延伸至相邻内侧颞叶区域的簇以及右侧枕极的另一个簇中局部脑回形成增加。右侧枕极脑回形成增加预示着戒毒后反应不佳。
我们的研究证实了先前的体积测量结果，增加了关于药物过量使用性头痛潜在神经生物学机制的信息，提示药物过量使用性头痛存在神经发育变化。
