Zhang Luping, Huang Jinwen, Zhang Zhengxiang, Cao Zhijian
Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Front Neurol. 2021 May 20;12:656349. doi: 10.3389/fneur.2021.656349. eCollection 2021.
Although there have been many magnetic resonance spectroscopy (MRS) studies of migraine, few have focused on migraines during an attack. Here, we aimed to assess metabolite changes in the brain of patients with migraine, both during an attack and in the interictal phase. Six patients (one man and five women, mean age: 39 ± 10 years) with migraine without aura during the attack (MWoA-DA), 13 patients (three men and 10 women, mean age: 31 ± 9 years) with migraine without aura during the interictal period (MWoA-DI), and 13 healthy controls (HC) (four men and nine women, mean age: 31 ± 9 years) were studied. All subjects underwent an MRS examination focusing on the occipital lobe. Metabolite changes were investigated among three groups. The MWoA-DA patients had lower glutathione/total creatine ratio (GSH/tCr) than the MWoA-DI patients and HC. Furthermore, MWoA-DI patients showed lower total choline/total creatine ratio (tCho/tCr) than those in the other two groups. The GSH/tCr ratio was positively correlated with attack frequency in the MWoA-DI group. The tCho/tCr ratio was positively correlated with attack frequency and Migraine Disability Assessment Scale (MIDAS) scores in the MWoA-DA group. The present study suggests the existence of distinct pathophysiological states between the MWoA-DA and MWoA-DI groups. Neuronal dysfunction is a possible predisposing factor for migraine attack onset, along with oxidative stress and inflammation.
尽管已有许多关于偏头痛的磁共振波谱（MRS）研究，但很少有研究聚焦于发作期的偏头痛。在此，我们旨在评估偏头痛患者在发作期和发作间期大脑中的代谢物变化。研究了6例发作期无先兆偏头痛（MWoA - DA）患者（1例男性和5例女性，平均年龄：39±10岁）、13例发作间期无先兆偏头痛（MWoA - DI）患者（3例男性和10例女性，平均年龄：31±9岁）以及13名健康对照者（HC）（4例男性和9例女性，平均年龄：31±9岁）。所有受试者均接受了以枕叶为重点的MRS检查。对三组之间的代谢物变化进行了研究。MWoA - DA患者的谷胱甘肽/总肌酸比值（GSH/tCr）低于MWoA - DI患者和HC。此外，MWoA - DI患者的总胆碱/总肌酸比值（tCho/tCr）低于其他两组。在MWoA - DI组中，GSH/tCr比值与发作频率呈正相关。在MWoA - DA组中，tCho/tCr比值与发作频率和偏头痛残疾评估量表（MIDAS）评分呈正相关。本研究表明MWoA - DA组和MWoA - DI组之间存在不同的病理生理状态。神经元功能障碍可能是偏头痛发作起始的一个易感因素，同时还伴有氧化应激和炎症。
