Tian Zilei, Yin Tao, Xiao Qingqing, Dong Xiaohui, Yang Yunhong, Wang Menglin, Ha Guodong, Chen Jiyao, Liang Fanrong, Zeng Fang, Lan Lei
Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Neurosci. 2021 Mar 4;15:646538. doi: 10.3389/fnins.2021.646538. eCollection 2021.
Migraine without aura (MwoA) is a primary type of migraine, a common disabling disorder, and a disabling neurological condition. The headache is a complex experience, a common form of pain, in which multiple sensory information dimensions are combined to provide a unified conscious event. Migraine ictal have unique neuroimage biomarkers, but the brain is also affected during the inter-ictal phase. According to the current studies, a hypothesis was constructed that the altered integration of pain spatial and intensity information impacts headache intensity in the inter-ictal period.
In this study, we applied theory-based region-to-region functional connectivity (FC) analyses to compare the differences in resting-state FC between MwoA participants and healthy controls with the pain integration hypothesis. After the correlation matrices between FC edges and clinical symptoms were constructed, the moderating effect and simple slope tests were investigated to explain whether and how the dysfunction of pain features discrimination affects the clinical symptoms.
Functional connectivity analyses showed significantly decreased FC edges between the left dorsolateral superior frontal gyrus (SFGdor) and left insula, and an increased FC edge between the left SFGdor and bilateral angular gyrus. The correlation matrix showed no significant correlation between significantly altered FC edge and headache duration, frequency, Zung self-rating anxiety scale, and Zung self-rating depression scale. Only one significantly altered edge in the MwoA condition was significantly correlated with headache intensity. Moderating Module 1 and 2 manifested the moderator variable (altered rs-FC edge) moderated the link between the normal edges and headache intensity.
The pain features integration processes in migraineurs vary from HCs, related to the clinical symptoms during a migraine attack. Moreover, the clinical symptoms will be affected by one or more discrimination modules. And the spatial or intensity discrimination modules have a higher impact when combined with another module on clinical symptoms than the single module.
无先兆偏头痛(MwoA)是偏头痛的一种主要类型,是一种常见的致残性疾病,也是一种致残性神经疾病。头痛是一种复杂的体验,是一种常见的疼痛形式,其中多个感觉信息维度相互结合,形成一个统一的意识事件。偏头痛发作期有独特的神经影像生物标志物,但在发作间期大脑也会受到影响。根据目前的研究,构建了一个假设,即疼痛空间和强度信息整合的改变会影响发作间期的头痛强度。
在本研究中,我们应用基于理论的区域间功能连接(FC)分析,根据疼痛整合假设比较MwoA参与者与健康对照者静息态FC的差异。构建FC边与临床症状之间的相关矩阵后,进行调节效应和简单斜率检验,以解释疼痛特征辨别功能障碍是否以及如何影响临床症状。
功能连接分析显示,左侧背外侧额上回(SFGdor)与左侧脑岛之间的FC边显著减少,左侧SFGdor与双侧角回之间的FC边增加。相关矩阵显示,显著改变的FC边与头痛持续时间、频率、zung自评焦虑量表和zung自评抑郁量表之间无显著相关性。在MwoA状态下,只有一个显著改变的边与头痛强度显著相关。调节模块1和2表明,调节变量(改变的rs-FC边)调节正常边与头痛强度之间的联系。
偏头痛患者的疼痛特征整合过程与健康对照者不同,这与偏头痛发作期间的临床症状有关。此外,临床症状将受到一个或多个辨别模块的影响。与单个模块相比,空间或强度辨别模块与另一个模块结合时对临床症状的影响更大。