Shi Min, Luo Danqing, Guo Jun, Yang Dongdong, Li Zhaoying, Zhao Huan
Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Department of Rehabilitation, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Neurosci. 2022 Apr 14;16:773321. doi: 10.3389/fnins.2022.773321. eCollection 2022.
The pathogenic mechanisms underlying the autonomic nervous system (ANS) dysfunction in patients with chronic migraine (CM) remain unclear. This study investigated the pathogenesis of ANS dysfunction in this population.
A total of 60 patients diagnosed with CM and 60 healthy subjects were recruited to participate in this study. The pupil diameter, pupil contraction velocity, latency, amplitude, and the maximum gradient recovery time were examined before, at 2 min and at 5 min after the cold pressor test, which was combined with the pupillary light reflex method. A brain 3D T1-weighted structural imaging scan, resting-state functional magnetic resonance imaging scan, and diffusion tensor imaging (DTI) scan were also acquired.
Patients with CM exhibited a longer recovery time to the maximum gradient at 2 min and at 5 min after cold pressing compared with the control group ( < 0.01 and < 0.05, respectively). There was no significant difference in the pupil diameter, pupillary contraction velocity, latency, amplitude, blood pressure, or heart rate between the two groups (all > 0.05). In the CM group, the regional homogeneity (ReHo) values of the left amygdala and left lateral hypothalamic area were significantly higher than those of other brain areas ( < 0.001, Alphasim corrected). The DTI scan of the whole brain area showed a lack of significant difference in DTI indices, including FA, MD, AD, and RD values between the two groups ( > 0.05, Alphasim corrected).
The dysfunction of the left amygdala and left lateral hypothalamic area may be related to ANS dysfunction in patients with CM.
慢性偏头痛（CM）患者自主神经系统（ANS）功能障碍的致病机制尚不清楚。本研究调查了该人群中ANS功能障碍的发病机制。
共招募60例诊断为CM的患者和60名健康受试者参与本研究。结合瞳孔对光反射方法，在冷加压试验前、试验后2分钟和5分钟检查瞳孔直径、瞳孔收缩速度、潜伏期、振幅和最大梯度恢复时间。还进行了脑部三维T1加权结构成像扫描、静息态功能磁共振成像扫描和弥散张量成像（DTI）扫描。
与对照组相比，CM患者在冷加压后2分钟和5分钟时达到最大梯度的恢复时间更长（分别为P<0.01和P<0.05）。两组之间的瞳孔直径、瞳孔收缩速度、潜伏期、振幅、血压或心率无显著差异（均P>0.05）。在CM组中，左侧杏仁核和左侧下丘脑区域的局部一致性（ReHo）值显著高于其他脑区（P<0.001，经Alphasim校正）。全脑区域的DTI扫描显示，两组之间的DTI指标，包括FA、MD、AD和RD值，无显著差异（P>0.05，经Alphasim校正）。
左侧杏仁核和左侧下丘脑区域功能障碍可能与CM患者的ANS功能障碍有关。
