Zhang YiShui, Liu Ying, Han Ruoyun, Liu Kangding, Xing Yingqi
Neuroscience Centre, Department of Neurology, The First Hospital of Jilin University, Changchun, China.
Neuroscience Centre, Department of Neurology, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, China.
Ther Adv Neurol Disord. 2021 Apr 12;14:17562864211007708. doi: 10.1177/17562864211007708. eCollection 2021.
The high comorbidity of migraine and depression is suggestive of shared risk factors or common mechanisms between the two diseases. In individuals with a depressive disorder, there is a high prevalence of altered midbrain raphe (MBR) echogenicity, detectable transcranial sonography (TCS), that is suggested to be linked with a dysfunction of the serotoninergic system. In patients with migraine, this alteration has seldom been explored in earlier studies, and conclusions are often lacking. Our study aimed to elucidate whether this alteration is specific to migraine and to determine whether it is related with depression.
This study enrolled patients with migraine ( = 100, 72% female) and patients with tension-type headache disorders (TTH) ( = 62, 78.5% female) from a headache clinic. In addition, 79 healthy subjects (79.7% female) were recruited as controls. All participants underwent a standard interview to evaluate headache information and an interview with psychiatrists for depression evaluation. TCS examinations were performed on all participants.
Patients with migraine had a higher rate of MBR hypoechogenicity (28%) compared with that of healthy controls (15.2%) and that of patients with TTH (12.9%). In patients with migraine, reduced MBR echogenicity was associated with depressive symptoms assessed using the Hamilton Depression Rating Scale (HAM-D). No association between migraine self-medication and MBR echogenicity was found.
Reduced-echoic MBR detected by TCS is prevalent in migraine patients and is associated with depressive symptoms. TCS-detected hypoechogenic MBR abnormality could be an imaging biomarker of depressive symptoms in patients with migraine.
偏头痛与抑郁症的高共病率提示这两种疾病之间存在共同的风险因素或共同机制。在患有抑郁症的个体中，经颅多普勒超声（TCS）检测到中脑缝际核（MBR）回声改变的患病率很高，这被认为与血清素能系统功能障碍有关。在偏头痛患者中，早期研究很少探讨这种改变，且往往缺乏结论。我们的研究旨在阐明这种改变是否是偏头痛所特有的，并确定它是否与抑郁症有关。
本研究招募了头痛门诊的偏头痛患者（n = 100，女性占72%）和紧张型头痛障碍（TTH）患者（n = 62，女性占78.5%）。此外，还招募了79名健康受试者（女性占79.7%）作为对照。所有参与者都接受了标准访谈以评估头痛信息，并接受了精神科医生的访谈以进行抑郁症评估。对所有参与者进行了TCS检查。
与健康对照组（15.2%）和TTH患者（12.9%）相比，偏头痛患者的MBR低回声发生率更高（28%）。在偏头痛患者中，MBR回声降低与使用汉密尔顿抑郁量表（HAM-D）评估的抑郁症状相关。未发现偏头痛自我用药与MBR回声之间存在关联。
TCS检测到的MBR回声降低在偏头痛患者中很常见，且与抑郁症状相关。TCS检测到的低回声MBR异常可能是偏头痛患者抑郁症状的一种影像学生物标志物。
