Department of Neurology, Kunshan Hospital, Affiliated to Jiangsu University, Kunshan, People's Republic of China.
Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, People's Republic of China.
J Headache Pain. 2020 Jul 11;21(1):89. doi: 10.1186/s10194-020-01158-7.
Voxel-based morphometry (VBM) is a popular non-invasive magnetic resonance imaging technique to investigate brain gray matter (GM) differences between groups. Recently, two VBM studies in migraine have been published in The Journal of Headache and Pain. Reviewing the two and those previous published VBM studies, we found considerable variations of the results. Spatially diverse brain regions with decreased and increased GM alterations and null findings have been reported. It is interesting to know whether there is a reliable brain morphological signature for migraine. Coordinate-based meta-analysis (CBMA) is increasingly used to quantitatively pool individual neuroimaging studies to identify consistent and reliable findings. Several CBMA have been conducted, however, their results were inconsistent. The algorithms for CBMA have evolved and more eligible VBM studies in migraine have been published. We therefore conducted an updated CBMA using the latest algorithms for CBMA, seed-based d mapping with permutation of subject images (SDM-PSI). The present CBMA of 32 VBM studies (41 datasets comprising 1252 patients and 1025 healthy controls) found no evidence of consistent GM alterations in migraine. Sensitivity analysis, subgroup meta-analyses, and meta-regression analyses revealed that the result was robust. This negative result indicates that there is no reliable brain morphological signature for migraine. VBM investigations in migraine remain a heterogeneous field. Many potential confounding factors, such as underpowered sample sizes, variations in demographic and clinical characteristics, and differences in MRI scanners, head coils, scanning parameters, preprocessing procedures, and statistical strategies may cause the inconsistences of the results. Future VBM studies are warranted to enroll well-characterized and homogeneous subtype samples with appropriate sample sizes, comprehensively assess comorbidities and medication status, and use well-validated and standardized imaging protocols and processing and analysis pipelines to produce robust and replicable results in migraine.
体素基形态测量学（VBM）是一种流行的非侵入性磁共振成像技术，用于研究组间大脑灰质（GM）差异。最近，《头痛和疼痛杂志》发表了两篇偏头痛的 VBM 研究。回顾这两篇以及之前发表的 VBM 研究，我们发现结果存在相当大的差异。报道了空间上不同的大脑区域存在 GM 减少和增加的改变以及无效的发现。有趣的是，是否存在偏头痛的可靠脑形态学特征。基于坐标的荟萃分析（CBMA）越来越多地用于定量汇集个体神经影像学研究，以确定一致和可靠的发现。已经进行了几项 CBMA，但是它们的结果不一致。CBMA 的算法已经发展，并且发表了更多符合条件的偏头痛 VBM 研究。因此，我们使用最新的 CBMA 算法，基于种子的 d 映射与受试者图像置换（SDM-PSI）进行了更新的 CBMA。本次对 32 项 VBM 研究（41 个数据集，包括 1252 名患者和 1025 名健康对照者）的 CBMA 未发现偏头痛存在一致的 GM 改变的证据。敏感性分析、亚组荟萃分析和元回归分析表明，结果是稳健的。这一阴性结果表明，偏头痛没有可靠的脑形态学特征。偏头痛的 VBM 研究仍然是一个异质领域。许多潜在的混杂因素，如样本量不足、人口统计学和临床特征的变化，以及 MRI 扫描仪、头线圈、扫描参数、预处理程序和统计策略的差异，可能导致结果的不一致。未来的 VBM 研究需要招募具有适当样本量、全面评估合并症和药物状况、使用经过充分验证和标准化的成像协议以及处理和分析管道的特征明确且同质的亚组样本，以产生偏头痛的稳健和可复制的结果。
