Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Neurol Res. 2023 Jul;45(7):603-609. doi: 10.1080/01616412.2023.2170938. Epub 2023 Jan 24.
Migraine is commonly seen as a cyclic disorder with variable cortical excitability at different phases. Herein, we investigated the cortical excitability in migraine without aura patients during an attack (MWoA-DA) and interictal period (MWoA-DI) and further explored the functional connectivity (FC) in brain regions with cortical excitability abnormalities in patients.
Seven MWoA-DA patients, twenty-seven MWoA-DI patients, and twenty-nine healthy controls (HC) underwent resting-state functional magnetic resonance imaging (rs-fMRI) scan. The amplitude of low-frequency fluctuations (ALFF) was assessed to identify spontaneous brain activity. Then, brain regions showing significant differences across groups were identified as regions of interest (ROI) in FC analysis.
Compared with MWoA-DI patients and HC, the ALFF in the trigeminocervical complex (TCC) was higher in the MWoA-DA patients. Decreased FC in MWoA-DA patients was found between TCC and left postcentral gyrus compared with MWoA-DI patients. Compared with HC, ALFF was lower in the right cuneus but higher in the right rolandic operculum of MWoA-DI patients. Additionally, the ALFF in the right cuneus was negatively correlated with the Migraine Disability Assessment Scale (MIDAS) in MWoA-DI patients.
The trigeminovascular system and impairments in descending pain modulatory pathways participate in the pathophysiology of migraine during the ictal period. The defense effect exists in the interictal phase, and the dysfunction in the cuneus may be related to the disease severity. This dynamic change in different brain regions could deepen our understanding of the physiopathology underlying migraine.
偏头痛通常被视为一种周期性疾病，在不同阶段皮质兴奋性不同。在此，我们研究了发作期（MWoA-DA）和间歇期（MWoA-DI）偏头痛无先兆患者的皮质兴奋性，并进一步探讨了皮质兴奋性异常患者脑区的功能连接（FC）。
7 例 MWoA-DA 患者、27 例 MWoA-DI 患者和 29 例健康对照者（HC）接受静息态功能磁共振成像（rs-fMRI）扫描。评估低频振幅（ALFF）以识别自发脑活动。然后，将组间差异有统计学意义的脑区确定为功能连接分析的感兴趣区（ROI）。
与 MWoA-DI 患者和 HC 相比，MWoA-DA 患者的三叉神经颈复合体（TCC）ALFF 更高。与 MWoA-DI 患者相比，MWoA-DA 患者 TCC 与左侧中央后回之间的 FC 降低。与 HC 相比，MWoA-DI 患者右侧楔叶的 ALFF 较低，右侧 Rolandic 脑回的 ALFF 较高。此外，MWoA-DI 患者右侧楔叶的 ALFF 与偏头痛残疾评估量表（MIDAS）呈负相关。
三叉血管系统和下行疼痛调节通路的损伤参与了发作期偏头痛的病理生理学过程。在间歇期存在防御效应，楔叶功能障碍可能与疾病严重程度有关。不同脑区的这种动态变化可以加深我们对偏头痛病理生理学的理解。
