Chen Zhiye, Chen Xiaoyan, Liu Mengqi, Ma Lin, Yu Shengyuan
Department of Radiology, Chinese PLA General Hospital, Beijing, China.
Department of Neurology, Chinese PLA General Hospital, Beijing, China.
Front Neurol. 2019 Jun 6;10:606. doi: 10.3389/fneur.2019.00606. eCollection 2019.
It is believed than hypothalamus (HTH) might be involved in generation of migraine, and evidence from high resolution fMRI reported that the more anterior part of HTH seemed to play an important role in migraine chronification. The current study was aimed to identify the alteration of morphology and resting-state functional connectivity (FC) of the hypothalamus (HTH) in interictal episodic migraine (EM) and chronic migraine (CM). High-resolution structural and resting-state functional magnetic resonance images were acquired in 18 EM patients, 16 CM patients, and 21 normal controls (NC). The volume of HTH was calculated and voxel-based morphometry (VBM) was performed over the whole HTH. Receiver operating characteristics (ROC) curve analysis was applied to evaluate the diagnostic efficacy of HTH volume. Correlation analyses with clinical variables were performed and FC maps were generated for positive HTH regions according to VBM comparison. The volume of the HTH significantly decreased in both EM and CM patients compared with NC. The cut-off volume of HTH as 1.429 ml had a good diagnostic accuracy for CM with sensitivity of 81.25% and specificity of 100%. VBM analyses identified volume reduction of posterior HTH in EM vs. NC which was negatively correlated with headache frequency. The posterior HTH presented decreased FC with the left inferior temporal gyrus (Brodmann area 20) in EM. Decreased volume of anterior HTH was identified in CM vs. NC and CM vs. EM which was positively correlated with headache frequency in CM. The anterior HTH presented increased FC with the right anterior orbital gyrus (AOrG) (Brodmann area 11) in CM compared with NC and increased FC with the right medial orbital gyrus (MOrG) (Brodmann area 11) in CM compared with EM. Our study provided evidence of structural plasticity and FC changes of HTH in the pathogensis of migraine generation and chronification, supporting potential therapeutic target toward the HTH and its peptide.
人们认为下丘脑（HTH）可能参与偏头痛的发作，高分辨率功能磁共振成像（fMRI）的证据表明，下丘脑更靠前的部分似乎在偏头痛慢性化过程中起重要作用。本研究旨在确定发作间期发作性偏头痛（EM）和慢性偏头痛（CM）患者下丘脑（HTH）的形态学改变和静息态功能连接（FC）。对18例EM患者、16例CM患者和21名正常对照（NC）进行了高分辨率结构和静息态功能磁共振成像检查。计算下丘脑体积，并对整个下丘脑进行基于体素的形态学测量（VBM）。应用受试者工作特征（ROC）曲线分析评估下丘脑体积的诊断效能。进行与临床变量的相关性分析，并根据VBM比较为下丘脑阳性区域生成功能连接图。与NC相比，EM和CM患者的下丘脑体积均显著减小。下丘脑体积的截断值为1.429 ml时，对CM具有良好的诊断准确性，敏感性为81.25%，特异性为100%。VBM分析发现，与NC相比，EM患者下丘脑后部体积减小，且与头痛频率呈负相关。在EM患者中，下丘脑后部与左侧颞下回（布罗德曼20区）的功能连接降低。与NC相比，CM患者下丘脑前部体积减小，且与CM患者的头痛频率呈正相关。与NC相比，CM患者下丘脑前部与右侧眶前回（布罗德曼11区）的功能连接增加；与EM相比，CM患者下丘脑前部与右侧眶内侧回（布罗德曼11区）的功能连接增加。我们的研究为偏头痛发作和慢性化发病机制中下丘脑的结构可塑性和功能连接变化提供了证据，支持将下丘脑及其肽作为潜在的治疗靶点。
