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伴有先兆的偏头痛与白质束改变。

Migraine with aura and white matter tract changes.

作者信息

Petrušić Igor, Daković Marko, Kačar Katarina, Mićić Olivera, Zidverc-Trajković Jasna

机构信息

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Faculty of Physical Chemistry, University of Belgrade, Belgrade, Serbia.

出版信息

Acta Neurol Belg. 2018 Sep;118(3):485-491. doi: 10.1007/s13760-018-0984-y. Epub 2018 Jul 13.

Abstract

We aimed to explore whether a migraine with aura (MA) is associated with structural changes in tracts of a white matter and to compare parameters of diffusivity between subgroups in migraineurs. Forty-three MA and 20 healthy subjects (HS), balanced by sex and age, were selected for this study. Analysis of diffusion tensor parameters was used to identify differences between MA patients and HS, and then between MA subgroups. A diffusion tensor probabilistic tractography analysis showed that there is no difference between MA patients and HS. However, using more-liberal uncorrected statistical threshold, we noted a trend in MA patients toward lower diffusivity indices of selected white matter tracts located in the forceps minor and right anterior thalamic radiation (ATR), superior longitudinal fasciculus (temporal part) (SLFT), cingulum-cingulate tract, and left uncinate fasciculus. Migraineurs who experienced somatosensory and dysphasic aura, besides visual symptoms, had tendency toward lower diffusivity indices, relative to migraineurs who experienced only visual symptoms, in the right inferior longitudinal fasciculus, forceps minor, and right superior longitudinal fasciculus (parietal part), SLFT, and cingulum-angular bundle. Aura frequency were negatively correlated with axial diffusivity and mean diffusivity of the right ATR (partial correlation = - 0.474; p = 0.002; partial correlation = - 0.460; p = 0.002), respectively. There were no significant differences between MA patients and HS, neither between MA subgroups. Migraineurs with abundant symptoms during the aura possibly have more myelinated fibers relative to those who experience only visual symptoms. Lower diffusivity indices of the right ATR are linked to more frequent migraine with aura attacks.

摘要

我们旨在探讨伴先兆偏头痛(MA)是否与白质纤维束的结构变化相关,并比较偏头痛患者亚组之间的扩散率参数。本研究选取了43例MA患者和20例健康受试者(HS),并根据性别和年龄进行了均衡匹配。采用扩散张量参数分析来识别MA患者与HS之间的差异,然后再分析MA亚组之间的差异。扩散张量概率纤维束成像分析显示,MA患者与HS之间没有差异。然而,使用更宽松的未校正统计阈值时,我们注意到MA患者中位于小钳和右侧丘脑前辐射(ATR)、上纵束(颞部)(SLFT)、扣带-扣带回束以及左侧钩束的选定白质纤维束的扩散率指数有降低的趋势。除视觉症状外还经历过躯体感觉和言语困难先兆的偏头痛患者,相对于仅经历视觉症状的偏头痛患者,在右侧下纵束、小钳以及右侧上纵束(顶叶部分)、SLFT和扣带-角束中,其扩散率指数有降低的趋势。先兆频率分别与右侧ATR的轴向扩散率和平均扩散率呈负相关(偏相关系数 = -0.474;p = 0.002;偏相关系数 = -0.460;p = 0.002)。MA患者与HS之间以及MA亚组之间均无显著差异。相对于仅经历视觉症状的偏头痛患者,在先兆期间有丰富症状的偏头痛患者可能有更多的有髓纤维。右侧ATR较低的扩散率指数与更频繁的伴先兆偏头痛发作有关。

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