Yang Ying, Wei Kai, Zhang Hongchun, Hu Hongyun, Yan Li, Gui Wei, Liu Ying, Chen Xin
Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Department of Neurology, Fourth Affiliated Hospital of Anhui Medical University, Hefei, China.
Quant Imaging Med Surg. 2022 Apr;12(4):2288-2302. doi: 10.21037/qims-21-667.
Migraine and major depressive disorder (MDD) are both highly prevalent brain disorders and are often comorbid. However, the common and distinctive neural mechanisms underlying these disorders and the brain function alterations associated with their comorbidity are largely unknown. We aimed to explore the functional abnormalities of the brain associated with the co-occurrence of migraine and depression.
High-resolution T1-weighted and resting-state functional magnetic resonance images (MRI) were acquired from 93 well-matched patients with comorbid migraine and depression, patients with migraine, patients with MDD, and healthy controls. Voxel-wise analysis of variance (ANOVA) and a two-sample -test of multiple functional variables were performed among the groups. Furthermore, correlation analysis was conducted to detect the clinical significance of the altered functional regions in the brain.
Migraine patients with and without depression revealed widely shared regional networks of functional changes. Brain function changes in the right paracentral lobule and fusiform were specific to patients with comorbid migraine and depression [P<0.05, cluster-level familywise error (FWE)-corrected], while changes in the left thalamus, medial orbital of superior frontal gyrus and triangular part of the inferior frontal gyrus were specific to patients with migraine (P<0.05, cluster-level FWE-corrected). Importantly, the brain activity of the right paracentral lobule, left calcarine, and left dorsolateral superior frontal gyrus was associated with emotional symptoms in the pooled migraine data (P<0.05).
These findings help to identify the neural correlates underlying patients with migraine and those with comorbid migraine and depression. These shared and distinct brain changes could be used as potential image markers to decipher the comorbidity of the 2 disorders.
偏头痛和重度抑郁症(MDD)都是高度流行的脑部疾病,且常常合并出现。然而,这些疾病背后共同的和独特的神经机制以及与其合并症相关的脑功能改变在很大程度上尚不清楚。我们旨在探讨与偏头痛和抑郁症共病相关的脑功能异常。
从93例匹配良好的偏头痛合并抑郁症患者、偏头痛患者、MDD患者和健康对照者中获取高分辨率T1加权和静息态功能磁共振成像(MRI)。在各群组之间进行基于体素的方差分析(ANOVA)和多个功能变量的双样本检验。此外,进行相关性分析以检测大脑中功能改变区域的临床意义。
有抑郁症和无抑郁症的偏头痛患者显示出广泛共享的功能变化区域网络。右侧中央旁小叶和梭状回的脑功能变化是偏头痛合并抑郁症患者特有的[P<0.05,聚类水平家族性错误(FWE)校正],而左侧丘脑、额上回内侧眶部和额下回三角部的变化是偏头痛患者特有的(P<0.05,聚类水平FWE校正)。重要的是,在汇总的偏头痛数据中,右侧中央旁小叶、左侧距状裂和左侧额上回背外侧的脑活动与情绪症状相关(P<0.05)。
这些发现有助于确定偏头痛患者以及偏头痛合并抑郁症患者潜在的神经关联。这些共享的和独特的脑变化可作为潜在的影像标志物来解读这两种疾病的合并症。