Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China.
Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
J Headache Pain. 2022 Jun 27;23(1):72. doi: 10.1186/s10194-022-01444-6.
Nucleus accumbens (NAcc) played an important role in pain mediation, and presents changes of neuronal plasticity and functional connectivity. However, less is known about altered perfusion of NAcc in chronic migraine (CM). The aim of this study is to investigate the altered perfusion of the NAcc in CM using a MR three-dimensional pseudo-continuous arterial spin labeling (3D PCASL) imaging.
Thirteen CM patients and 15 normal controls (NC) were enrolled and underwent 3D PCASL and brain structural imaging. The cerebral blood flow (CBF) images were co-registered with the brain structural images, and the volume and CBF value of NAcc were extracted from the raw brain structural images and co-registered CBF images using an individual NAcc mask, which was obtained from the AAL3 template under transformation by the inverse deformation field generated from the segmentation of the brain structural images. The independent sample t test and receiver operating characteristic (ROC) curve was used to investigate the altered volume and perfusion of the NAcc in CM patients.
There was no significant difference for the volume of bilateral NAccs between CM and NC (p > 0.05). CM presented a lower CBF value (49.34 ± 6.09 ml/100 mg/min) compared with that of NC (55.83 ± 6.55 ml/100 mg/min) in left NAcc (p = 0.01), while right NAcc showed no significant difference between CM and NC (p = 0.11). ROC analysis identified that the area under the curve was 0.73 (95CI% 0.53-0.88) with cut-off value 48.63 ml/100 mg/min with sensitivity 50.00% and specificity 93.33%. The correlation analysis found a negative correlation between the CBF value of the left NAcc and VAS score (r = -0.61, p = 0.04).
Hypoperfusion of the left NAcc was observed in CM, which could be considered as a potential diagnostic imaging biomarker in CM.
伏隔核（NAcc）在疼痛调节中起着重要作用，并且表现出神经元可塑性和功能连接的变化。然而，关于慢性偏头痛（CM）中 NAcc 灌注改变的了解较少。本研究旨在使用磁共振三维伪连续动脉自旋标记（3D PCASL）成像来研究 CM 中 NAcc 的灌注改变。
纳入 13 名 CM 患者和 15 名正常对照者（NC），并进行 3D PCASL 和脑结构成像。将脑血流（CBF）图像与脑结构图像配准，并从原始脑结构图像和配准的 CBF 图像中提取 NAcc 的体积和 CBF 值，使用从脑结构图像分割生成的反向变形场变换的 AAL3 模板获得的个体 NAcc 掩模。采用独立样本 t 检验和受试者工作特征（ROC）曲线分析 CM 患者 NAcc 体积和灌注的改变。
CM 患者双侧 NAcc 体积与 NC 无显著性差异（p＞0.05）。与 NC 相比，CM 患者左 NAcc 的 CBF 值较低（49.34±6.09 ml/100 mg/min）（p=0.01），而右 NAcc 无显著性差异（p=0.11）。ROC 分析表明，曲线下面积为 0.73（95%CI% 0.53-0.88），截断值为 48.63 ml/100 mg/min，灵敏度为 50.00%，特异性为 93.33%。相关性分析发现左 NAcc 的 CBF 值与 VAS 评分呈负相关（r=-0.61，p=0.04）。
CM 中观察到左 NAcc 灌注不足，可作为 CM 的潜在诊断影像学生物标志物。
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