Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China.
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China.
J Headache Pain. 2019 Nov 11;20(1):104. doi: 10.1186/s10194-019-1058-0.
BACKGROUND: Functional connectivity (FC) has been used to investigate the pathophysiology of migraine. Accumulating evidence is pointing toward malfunctioning of brainstem structures, i.e., the red nucleus (RN) and substantia nigra (SN), as an important factor in migraine without aura (MwoA). We aimed to identify atypical FC between the RN and SN and other brain areas in patients with MwoA and to explore the association between RN and SN connectivity changes and performance on neuropsychological tests in these patients. METHODS: Resting-state functional magnetic resonance imaging (fMRI) data were obtained from 30 patients with MwoA and 22 age-, sex-, and years of education-matched healthy controls (HC). The FC of the brainstem structures was analyzed using a standard seed-based whole-brain correlation method. The results of the brainstem structure FC were assessed for correlations with other clinical features. RESULTS: Patients with MwoA exhibited reduced left RN-based FC with the left middle frontal gyrus, reduced right RN-based FC with the ipsilateral superior parietal lobe, and increased FC with the ipsilateral cerebellum. Additionally, patients with MwoA demonstrated significantly decreased right SN-based FC with the right postcentral gyrus, left parietal lobule, and left superior frontal gyrus. Hypo-connectivity between the right SN and right postcentral gyrus was negatively correlated with disease duration (r = - 0.506, P = 0.004). Additionally, increased connectivity of the right RN to the ipsilateral cerebellar lobes was positively correlated with the Headache Impact Test-6 scores (r = 0.437, P = 0.016). CONCLUSIONS: The present study suggested that patients with MwoA have disruption in their RN and SN resting-state networks, which are associated with specific clinical characteristics. The changes focus on the regions associated with cognitive evaluation, multisensory integration, and modulation of perception and pain, which may be associated with migraine production, feedback, and development. Taken together, these results may improve our understanding of the neuropathological mechanism of migraine.
背景：功能连接（FC）已被用于研究偏头痛的病理生理学。越来越多的证据表明，中脑结构（即红核（RN）和黑质（SN））的功能障碍是无先兆偏头痛（MwoA）的一个重要因素。我们旨在确定 MwoA 患者中 RN 和 SN 与其他脑区之间的异常 FC，并探讨这些患者中 RN 和 SN 连接变化与神经心理学测试表现之间的关系。
方法：从 30 名 MwoA 患者和 22 名年龄、性别和教育年限匹配的健康对照者（HC）中获得静息态功能磁共振成像（fMRI）数据。使用标准的基于种子的全脑相关方法分析脑干结构的 FC。评估脑干结构 FC 的结果与其他临床特征的相关性。
结果：MwoA 患者表现出左侧 RN 与左侧额中回之间的 FC 减少，右侧 RN 与同侧顶上叶之间的 FC 减少，以及与同侧小脑之间的 FC 增加。此外，MwoA 患者表现出右侧 SN 与右侧中央后回之间的 FC 显著降低，与左侧顶叶小叶和左侧额上回之间的 FC 降低。右侧 SN 与右侧中央后回之间的连接减少与疾病持续时间呈负相关（r=-0.506，P=0.004）。此外，右侧 RN 与同侧小脑叶之间的连接增加与头痛影响测试-6 评分呈正相关（r=0.437，P=0.016）。
结论：本研究表明，MwoA 患者的 RN 和 SN 静息态网络存在中断，这与特定的临床特征有关。变化集中在与认知评估、多感觉整合以及感知和疼痛调节相关的区域，这可能与偏头痛的产生、反馈和发展有关。综上所述，这些结果可能有助于我们更好地理解偏头痛的神经病理学机制。
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