Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, 02218, Boston, MA, USA.
Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, 21201, Baltimore, MD, USA.
J Headache Pain. 2021 Oct 23;22(1):127. doi: 10.1186/s10194-021-01340-5.
Migraine sufferers face difficulties getting appropriate care and treatment. Migraine is associated with reduced gray matter volume (GMV) in several brain regions, which could be related to various clinical characteristics of the disorder.
To examine differences in GMV in migraine patients with and without prior clinical care for migraine and examine differences in migraine clinical variables, psychosocial symptoms and their relationship with GMV.
We utilized the baseline MRI scan and psychosocial symptom questionnaires from a longitudinal randomized controlled trial. Prior care of migraine was determined by diagnosis by a medical practitioner or prescription of migraine specific medication.
117 patients were included in the study. Patients without prior care (n=23) had reduced GMV in the right dorsal medial prefrontal cortex (dMPFC) relative to patients who had prior care (p=0.034, FWE corrected). Both patient groups had reduced GMV compared to healthy controls (n=36). Patient groups did not differ in headache clinical variables. Regardless of care status, increasing scores on the stress (Perceived Stress Score) and depression questionnaires (Patient Health Questionnaire) were associated with increased GMV in the dMPFC.
Clinical care may impact GMV in migraine patients. Patients may need different treatment options to address this baseline deficit.
NCT02133209.
偏头痛患者在获得适当的护理和治疗方面面临困难。偏头痛与几个大脑区域的灰质体积减少有关，这可能与该疾病的各种临床特征有关。
检查有和没有偏头痛临床护理的偏头痛患者的 GMV 差异，并检查偏头痛临床变量、心理社会症状及其与 GMV 的关系的差异。
我们利用了一项纵向随机对照试验的基线 MRI 扫描和心理社会症状问卷。偏头痛的既往护理是通过医生诊断或偏头痛特定药物处方来确定的。
研究共纳入 117 名患者。与有既往护理的患者相比（n=23），无既往护理的患者右侧背内侧前额叶皮质（dMPFC）的 GMV 减少（p=0.034，FWE 校正）。与健康对照组相比（n=36），两组患者的 GMV 均减少。头痛临床变量在两组患者中无差异。无论护理状况如何，应激（感知压力评分）和抑郁问卷（患者健康问卷）的评分增加与 dMPFC 中的 GMV 增加相关。
临床护理可能会影响偏头痛患者的 GMV。患者可能需要不同的治疗方案来解决这一基线缺陷。
NCT02133209。
