Schwedt Todd J, Chong Catherine D, Peplinski Jacob, Ross Katherine, Berisha Visar
Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85255, USA.
Arizona State University, Phoenix, USA.
J Headache Pain. 2017 Aug 22;18(1):87. doi: 10.1186/s10194-017-0796-0.
The majority of individuals with post-traumatic headache have symptoms that are indistinguishable from migraine. The overlap in symptoms amongst these individuals raises the question as to whether post-traumatic headache has a unique pathophysiology or if head trauma triggers migraine. The objective of this study was to compare brain structure in individuals with persistent post-traumatic headache (i.e. headache lasting at least 3 months following a traumatic brain injury) attributed to mild traumatic brain injury to that of individuals with migraine.
Twenty-eight individuals with persistent post-traumatic headache attributed to mild traumatic brain injury and 28 individuals with migraine underwent brain magnetic resonance imaging on a 3 T scanner. Regional volumes, cortical thickness, surface area and curvature measurements were calculated from T1-weighted sequences and compared between subject groups using ANCOVA. MRI data from 28 healthy control subjects were used to interpret the differences in brain structure between migraine and persistent post-traumatic headache.
Differences in regional volumes, cortical thickness, surface area and brain curvature were identified when comparing the group of individuals with persistent post-traumatic headache to the group with migraine. Structure was different between groups for regions within the right lateral orbitofrontal lobe, left caudal middle frontal lobe, left superior frontal lobe, left precuneus and right supramarginal gyrus (p < .05). Considering these regions only, there were differences between individuals with persistent post-traumatic headache and healthy controls within the right lateral orbitofrontal lobe, right supramarginal gyrus, and left superior frontal lobe and no differences when comparing the migraine cohort to healthy controls.
In conclusion, persistent post-traumatic headache and migraine are associated with differences in brain structure, perhaps suggesting differences in their underlying pathophysiology. Additional studies are needed to further delineate similarities and differences in brain structure and function that are associated with post-traumatic headache and migraine and to determine their specificity for each of the headache types.
大多数创伤后头痛患者的症状与偏头痛难以区分。这些患者症状的重叠引发了一个问题，即创伤后头痛是否具有独特的病理生理学，或者头部创伤是否会引发偏头痛。本研究的目的是比较轻度创伤性脑损伤所致持续性创伤后头痛（即创伤性脑损伤后头痛持续至少3个月）患者与偏头痛患者的脑结构。
28例轻度创伤性脑损伤所致持续性创伤后头痛患者和28例偏头痛患者在3T扫描仪上接受脑磁共振成像检查。从T1加权序列计算区域体积、皮质厚度、表面积和曲率测量值，并使用协方差分析在受试者组之间进行比较。来自28名健康对照受试者的MRI数据用于解释偏头痛和持续性创伤后头痛之间的脑结构差异。
将持续性创伤后头痛患者组与偏头痛患者组进行比较时，发现区域体积、皮质厚度、表面积和脑曲率存在差异。右侧眶额外侧叶、左侧额中回尾侧、左侧额上回、左侧楔前叶和右侧缘上回区域的组间结构不同（p<0.05）。仅考虑这些区域，持续性创伤后头痛患者与健康对照者在右侧眶额外侧叶、右侧缘上回和左侧额上回存在差异，而将偏头痛队列与健康对照者进行比较时则无差异。
总之，持续性创伤后头痛和偏头痛与脑结构差异有关，这可能表明它们潜在的病理生理学存在差异。需要进一步研究以进一步阐明与创伤后头痛和偏头痛相关的脑结构和功能的异同，并确定它们对每种头痛类型的特异性。
