Liu Chengxiang, Duan Gaoxiong, Zhang Shuming, Wei Yichen, Liang Lingyan, Geng Bowen, Piao Ruiqing, Xu Ke, Li Pengyu, Zeng Xiao, Deng Demao, Liu Peng
Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.
Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China.
Quant Imaging Med Surg. 2023 Feb 1;13(2):835-851. doi: 10.21037/qims-22-506. Epub 2023 Jan 2.
Premenstrual syndrome (PMS) is a menstrual-related disorder, characterized by physical, emotional, behavioral and cognitive symptoms. However, the neuropathological mechanisms of PMS remain unclear. This study aimed to investigate the frequency-specific functional connectivity density (FCD) and structural covariance in PMS.
Functional and T1-weighted structural data were obtained from 35 PMS patients and 36 healthy controls (HCs). This study was a cross-sectional and prospective design. The local/long-range FCD (LFCD/LRFCD) across slow-4 (0.027-0.073 Hz) and slow-5 (0.01-0.027 Hz) bands were computed, and two-way analysis of variance (ANOVA) was performed to ascertain the main effects of group and interaction effects between group and frequency band. Receiver operating characteristic (ROC) curve was performed to investigate reliable biomarkers for identifying PMS from HCs. Based on the ROC results, characterized the changes of whole-brain structural covariance patterns of striatum subregions in two groups. Correlation analysis was applied to examine relationships between the clinical symptoms and abnormal brain regions.
Compared with HCs, PMS patients exhibited: (I) aberrant functional communication in the middle cingulate cortex and precentral gyrus; (II) significant frequency band-by-group interaction effects of the striatum, thalamus and orbitofrontal cortex; (III) the better classification ability of the LFCD in the striatum in ROC analysis (slow-5); (IV) decreased gray matter volumes in the caudate subregions and decreased structural associations of between the caudate subregions and frontal cortex; (V) the LFCD value in thalamus were significantly negatively correlated with the sleep problems (slow-5).
Based on multi-modal magnetic resonance imaging (MRI) analysis, this study might imply the aberrant emotional regulation and cognitive function related to menstrual cycle in PMS and improve our understanding of the pathophysiologic mechanism in PMS from novel perspective.
经前综合征（PMS）是一种与月经相关的疾病，其特征为身体、情绪、行为和认知症状。然而，PMS的神经病理学机制仍不清楚。本研究旨在调查PMS中频率特异性功能连接密度（FCD）和结构协方差。
从35名PMS患者和36名健康对照（HCs）获取功能和T1加权结构数据。本研究为横断面和前瞻性设计。计算慢4（0.027 - 0.073 Hz）和慢5（0.01 - 0.027 Hz）频段的局部/远程FCD（LFCD/LRFCD），并进行双向方差分析（ANOVA）以确定组的主效应以及组与频段之间的交互效应。进行受试者操作特征（ROC）曲线分析以研究从HCs中识别PMS的可靠生物标志物。基于ROC结果，表征两组纹状体亚区域全脑结构协方差模式的变化。应用相关分析来检查临床症状与异常脑区之间的关系。
与HCs相比，PMS患者表现出：（I）扣带回中部和中央前回的异常功能连通性；（II）纹状体、丘脑和眶额皮质显著的频段×组交互效应；（III）ROC分析中纹状体LFCD在慢5频段具有更好的分类能力；（IV）尾状核亚区域灰质体积减少以及尾状核亚区域与额叶皮质之间的结构关联减少；（V）丘脑的LFCD值与睡眠问题在慢5频段显著负相关。
基于多模态磁共振成像（MRI）分析，本研究可能提示PMS中与月经周期相关的异常情绪调节和认知功能，并从新的角度增进我们对PMS病理生理机制的理解。
