Shibata Yasushi, Ishiyama Sumire, Matsushita Akira
Department of Neurosurgery, Headache Clinic, Mito Medical Center, University of Tsukuba, Mito Kyodo General Hospital, Mito, Japan.
Doctoral Program in Clinical Sciences, Graduate school of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
Clin Neurol Neurosurg. 2018 Nov;174:167-173. doi: 10.1016/j.clineuro.2018.09.022. Epub 2018 Sep 17.
Migraine and medication overuse headache are common, but its pathophysiology remains unclear. Differential diagnosis of chronic headache is still challenging. Conventional brain imaging techniques exclude secondary causes of headache but cannot produce a proper diagnosis. Accordingly, more sensitive diagnostic methods are needed for certain diagnosis. In the present study, we performed voxel-wise tract-based spatial statistics of 1.5-T diffusion tensor imaging in migraine patients and healthy volunteers.
One hundred and three migraine patents and 46 healthy volunteers were registered. The fractional anisotropy values in the white matter of each group compared to age-matched healthy volunteers.
Compared to the controls, the migraine without aura with medication overuse headache had remarkable fractional anisotropy decrease in the white matter in several regions. The migraine with aura without medication overuse headache also had significant fractional anisotropy decrease compared to the controls. The disease duration and frequency of migraine attack were not correlated with fractional anisotropy values of the corpus callosum.
Our 1.5-T DTI study demonstrated significantly lower fractional anisotropy in the white matter in the MoA with medication overuse headache and MwA without medication overuse headache groups, suggesting that fractional anisotropy abnormalities may be useful biomarkers in headache patients.
偏头痛和药物过量使用性头痛很常见,但其病理生理学仍不清楚。慢性头痛的鉴别诊断仍然具有挑战性。传统的脑成像技术可排除头痛的继发性原因,但无法做出准确诊断。因此,需要更敏感的诊断方法来进行确切诊断。在本研究中,我们对偏头痛患者和健康志愿者进行了基于体素的1.5-T扩散张量成像的纤维束空间统计分析。
登记了103例偏头痛患者和46名健康志愿者。将每组白质中的分数各向异性值与年龄匹配的健康志愿者进行比较。
与对照组相比,伴有药物过量使用性头痛的无先兆偏头痛患者在几个区域的白质中分数各向异性显著降低。与对照组相比,无药物过量使用性头痛的有先兆偏头痛患者的分数各向异性也显著降低。偏头痛发作的病程和频率与胼胝体的分数各向异性值无关。
我们的1.5-T DTI研究表明,伴有药物过量使用性头痛的无先兆偏头痛组和无药物过量使用性头痛的有先兆偏头痛组白质中的分数各向异性显著降低,提示分数各向异性异常可能是头痛患者有用的生物标志物。