Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
Department of Neurology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
J Headache Pain. 2020 Sep 14;21(1):111. doi: 10.1186/s10194-020-01176-5.
Resting-state functional magnetic resonance imaging (Rs-fMRI) has confirmed sensorimotor network (SMN) dysfunction in migraine without aura (MwoA). However, the underlying mechanisms of SMN effective functional connectivity in MwoA remain unclear. We aimed to explore the association between clinical characteristics and effective functional connectivity in SMN, in interictal patients who have MwoA.
We used Rs-fMRI to acquire imaging data in 40 episodic patients with MwoA in the interictal phase and 34 healthy controls (HCs). Independent component analysis was used to profile the distribution of SMN and calculate the different SMN activity between the two groups. Subsequently, Granger causality analysis was used to analyze the effective functional connectivity between the SMN and other brain regions.
Compared to the HCs, MwoA patients showed higher activity in the bilateral postcentral gyri (PoCG), but lower activity in the left midcingulate cortex (MCC). Moreover, MwoA patients showed decreased effective functional connectivity from the SMN to left middle temporal gyrus, right putamen, left insula and bilateral precuneus, but increased effective functional connectivity to the right paracentral lobule. There was also significant effective functional connectivity from the primary visual cortex, right cuneus and right putamen to the SMN. In the interictal period, there was positive correlation between the activity of the right PoCG and the frequency of headache. The disease duration was positively correlated with abnormal effective functional connectivity from the left PoCG to right precuneus. In addition, the headache impact scores were negatively correlated with abnormal effective functional connectivity from the left MCC to right paracentral lobule, as well as from the right precuneus to left PoCG.
These differential, resting-state functional activities of the SMN in episodic MwoA may contribute to the understanding of migraine-related intra- and internetwork imbalances associated with nociceptive regulation and chronification.
静息态功能磁共振成像（Rs-fMRI）已经证实无先兆偏头痛（MwoA）患者存在感觉运动网络（SMN）功能障碍。然而，MwoA 患者 SMN 有效功能连接的潜在机制尚不清楚。我们旨在探讨 MwoA 间歇期患者的临床特征与 SMN 有效功能连接之间的关系。
我们使用 Rs-fMRI 采集了 40 例发作间期 MwoA 患者和 34 例健康对照者（HCs）的影像学数据。采用独立成分分析（ICA）对 SMN 的分布进行分析，并计算两组之间的不同 SMN 活性。随后，采用格兰杰因果分析（Granger causality analysis）分析 SMN 与其他脑区之间的有效功能连接。
与 HCs 相比，MwoA 患者双侧后中央回（PoCG）的活性更高，但左中央扣带回（MCC）的活性更低。此外，MwoA 患者的 SMN 与左颞中回、右壳核、左岛叶和双侧楔前叶之间的有效功能连接降低，而与右旁中央小叶之间的有效功能连接增加。从初级视觉皮层、右楔叶和右壳核到 SMN 的有效功能连接也显著增加。在间歇期，右 PoCG 的活性与头痛频率呈正相关。病程与左 PoCG 至右楔前叶异常有效功能连接呈正相关。此外，头痛影响评分与左 MCC 至右旁中央小叶以及右楔前叶至左 PoCG 的异常有效功能连接呈负相关。
这些发作性 MwoA 中 SMN 的静息状态功能活动差异可能有助于理解与伤害性调节和慢性化相关的偏头痛相关内网络和外网络失衡。
