Department of Neurology, Second Affiliated Hospital of Xuzhou Medical University, No. 32, Meijian Road, Xuzhou, 221006, Jiangsu Province, China.
Medical Imaging Department, Second Affiliated Hospital of Xuzhou Medical University, No. 32, Meijian Road, Xuzhou, 221006, Jiangsu Province, China.
Eur Arch Otorhinolaryngol. 2023 Jun;280(6):2993-3003. doi: 10.1007/s00405-023-07847-8. Epub 2023 Jan 28.
PURPOSE: This study aimed to investigate changes in dynamic functional network connectivity (FNC) in patients with vestibular migraine (VM) and explore their relationship with clinical manifestations. METHODS: Resting-state functional magnetic resonance imaging (rs-fMRI) data were scanned from 35 VM patients without peripheral vestibular lesion and 40 age-, sex- and education-matched healthy controls (HC). Independent component analysis (ICA), sliding window (SW) and k-means clustering analysis were performed to explore the difference in FNC and temporal characteristics between two groups. Additionally, Pearson's partial correlation analysis was adopted to investigate the relationship between clinical manifestations and rs-fMRI results in patients with VM. RESULTS: Compared with HC, patients with VM showed increased FNC in pairs of extrastriate visual network (eVN)-ventral attention network (VAN), eVN-default mode network (DMN) and eVN-left frontoparietal network (lFPN), and exhibited decreased FNC in pairs of VAN-auditory network (AuN). The altered FNC was correlated with clinical manifestations of patients with VM. Additionally, we found increased mean dwell time and fractional windows in state 2 in VM patients compared with HC. Mean dwell time was positively correlated with headache impact test-6 (HIT-6) scores, fractional windows was positively associated with dizziness handicap inventory (DHI) scores. CONCLUSION: Our results indicated that patients with VM showed altered FNC primarily between sensory networks and networks related to cognitive, emotional and attention implementation, with more time spent in a state characterized by positive FNC between sensor cortex system and dorsal attention network (DAN). These findings could help reinforce the understanding on the neural mechanisms of VM.
目的:本研究旨在探讨前庭性偏头痛(VM)患者静息态功能网络连接(FNC)的变化,并探讨其与临床表现的关系。
方法:对 35 例无周围前庭病变的 VM 患者和 40 名年龄、性别和教育程度相匹配的健康对照者(HC)进行静息态功能磁共振成像(rs-fMRI)扫描。采用独立成分分析(ICA)、滑动窗口(SW)和 k-均值聚类分析方法探讨两组间 FNC 的差异及时间特征。此外,采用 Pearson 部分相关分析探讨 VM 患者临床症状与 rs-fMRI 结果的关系。
结果:与 HC 相比,VM 患者在外侧视觉网络(eVN)-腹侧注意网络(VAN)、eVN-默认模式网络(DMN)和 eVN-左侧额顶网络(lFPN)对之间表现出增强的 FNC,在 VAN-听觉网络(AuN)对之间表现出降低的 FNC。改变的 FNC与 VM 患者的临床症状有关。此外,我们发现 VM 患者的平均停留时间和状态 2 的分数窗口较 HC 增加。平均停留时间与头痛影响测试-6(HIT-6)评分呈正相关,分数窗口与头晕残疾量表(DHI)评分呈正相关。
结论:我们的研究结果表明,VM 患者主要表现为感觉网络和与认知、情感和注意力执行相关的网络之间的 FNC 改变,感觉皮质系统和背侧注意网络(DAN)之间以正 FNC 为特征的状态停留时间增加。这些发现有助于加强对 VM 神经机制的理解。
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