Department of Neurology, University Hospital of Toulouse, Toulouse, France.
ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France.
Headache. 2020 Apr;60(4):752-760. doi: 10.1111/head.13771. Epub 2020 Feb 17.
The locus coeruleus (LC) is one of the brainstem nuclei that may be activated during migraine attack. As LC contains neuromelanin, a by-product of norepinephrine synthesis, it can be delineated in vivo using neuromelanin sensitive magnetic resonance imaging (MRI). The neuromelanin content in LC has been suggested to reflect previous LC activation. We investigated LC MRI contrast in patients with migraine with aura (MWA) and its correlation with migraine features.
This matched cohort study compared 23 MWA patients aged 30-55 and without comorbidity, to 23 sex- and age-matched healthy controls. The study was conducted in a University Hospital. LC contrast was measured with T1 neuromelanin-sensitive-weighted 3T MRI. Voxels were manually selected by 2 independent researchers and comparison was made twice using intersection and union of the voxels selected by the 2 observers.
No difference was found in neuromelanin LC contrast between MWA patients and controls with both the INTER method (0.224 ± 0.042 vs 0.228 ± 0.048; difference: 0.0001 (95%CI: -0.032 to 0.026), P = .799) and UNION method (0.218 ± 0.043 vs 0.222 ± 0.047; difference: -0.0012 (95%CI: -0.031 to 0.026), P = .775). Global LC volume was also similar between the 2 groups with INTER method (15.087 ± 3.965 vs 13.739 ± 3.583; difference: 2 (95%CI: -1 to 4), P = .233) and UNION method (17.522 ± 4.440 vs 16.087 ± 4.274; difference: 1 (95%CI: -2 to 4), P = .270). Moreover, no correlations were found between neuromelanin LC contrast and migraine features (duration of migraine and frequency of attacks).
These negative findings do not support the use of neuromelanin LC contrast as a biomarker of MA.
蓝斑（LC）是可能在偏头痛发作期间被激活的脑干部位之一。由于 LC 含有儿茶酚胺合成的副产物神经黑色素，因此可以使用神经黑色素敏感磁共振成像（MRI）对其进行体内描绘。LC 中的神经黑色素含量被认为反映了先前的 LC 激活。我们研究了偏头痛伴先兆（MWA）患者的 LC MRI 对比及其与偏头痛特征的相关性。
这项匹配队列研究比较了 23 名年龄在 30-55 岁且无合并症的 MWA 患者和 23 名性别和年龄匹配的健康对照者。该研究在一所大学医院进行。使用 T1 神经黑色素敏感加权 3T MRI 测量 LC 对比。两个独立的研究人员手动选择体素，并通过比较两个观察者选择的体素的交集和并集进行两次比较。
使用 INTER 方法（0.224±0.042 对 0.228±0.048；差异：0.0001（95%CI：-0.032 至 0.026），P=0.799）和 UNION 方法（0.218±0.043 对 0.222±0.047；差异：-0.0012（95%CI：-0.031 至 0.026），P=0.775），MWA 患者和对照组之间的神经黑色素 LC 对比无差异。使用 INTER 方法（15.087±3.965 对 13.739±3.583；差异：2（95%CI：-1 至 4），P=0.233）和 UNION 方法（17.522±4.440 对 16.087±4.274；差异：1（95%CI：-2 至 4），P=0.270），两组之间的总 LC 体积也相似。此外，神经黑色素 LC 对比与偏头痛特征（偏头痛持续时间和发作频率）之间未发现相关性。
这些阴性结果不支持将神经黑色素 LC 对比用作 MA 的生物标志物。
