Piervincenzi Claudia, Petsas Nikolaos, Viganò Alessandro, Mancini Valentina, Mastria Giulio, Puma Marta, Giannì Costanza, Di Piero Vittorio, Pantano Patrizia
Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
IRCCS NEUROMED, Pozzilli, IS, Italy.
Neurol Sci. 2023 Jan;44(1):305-317. doi: 10.1007/s10072-022-06404-1. Epub 2022 Sep 17.
Alice in Wonderland syndrome (AIWS) is a neurological disorder characterized by erroneous perception of the body schema or surrounding space. Migraine is the primary cause of AIWS in adults. The pathophysiology of AIWS is largely unknown, especially regarding functional abnormalities. In this study, we compared resting-state functional connectivity (FC) of migraine patients experiencing AIWS, migraine patients with typical aura (MA) and healthy controls (HCs).
Twelve AIWS, 12 MA, and 24 HCs were enrolled and underwent 3 T MRI scanning. Independent component analysis was used to identify RSNs thought to be relevant for AIWS: visual, salience, basal ganglia, default mode, and executive control networks. Dual regression technique was used to detect between-group differences in RSNs. Finally, AIWS-specific FC alterations were correlated with clinical measures.
With respect to HCs, AIWS and MA patients both showed significantly lower (p < 0.05, FDR corrected) FC in lateral and medial visual networks and higher FC in salience and default mode networks. AIWS patients alone showed higher FC in basal ganglia and executive control networks than HCs. When directly compared, AIWS patients showed lower FC in visual networks and higher FC in all other investigated RSNs than MA patients. Lastly, AIWS-specific FC alterations in the executive control network positively correlated with migraine frequency.
AIWS and MA patients showed similar FC alterations in several RSNs, although to a different extent, suggesting common pathophysiological underpinnings. However, AIWS patients showed additional FC alterations, likely due to the complexity of AIWS symptoms involving high-order associative cortical areas.
爱丽丝梦游仙境综合征（AIWS）是一种神经障碍，其特征为对身体图式或周围空间的感知错误。偏头痛是成人AIWS的主要病因。AIWS的病理生理学在很大程度上尚不清楚，尤其是关于功能异常方面。在本研究中，我们比较了经历AIWS的偏头痛患者、伴有典型先兆的偏头痛患者（MA）和健康对照者（HCs）的静息态功能连接（FC）。
纳入12例AIWS患者、12例MA患者和24例HCs，并进行3T磁共振成像扫描。采用独立成分分析来识别被认为与AIWS相关的静息态网络（RSNs）：视觉、突显、基底神经节、默认模式和执行控制网络。使用双回归技术检测RSNs中的组间差异。最后，将AIWS特异性的FC改变与临床指标进行关联。
与HCs相比，AIWS和MA患者在外侧和内侧视觉网络中的FC均显著降低（p < 0.05，经FDR校正），而在突显和默认模式网络中的FC较高。仅AIWS患者在基底神经节和执行控制网络中的FC高于HCs。直接比较时，AIWS患者在视觉网络中的FC低于MA患者，而在所有其他研究的RSNs中的FC高于MA患者。最后，执行控制网络中AIWS特异性的FC改变与偏头痛频率呈正相关。
AIWS和MA患者在几个RSNs中表现出相似的FC改变，尽管程度不同，这表明存在共同的病理生理基础。然而，AIWS患者表现出额外的FC改变，可能是由于AIWS症状涉及高阶联合皮质区域的复杂性所致。
