Dong Liang, Fan Xiaoping, Fan Yulan, Li Ximao, Li Hui, Zhou Jiying
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Hospice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Mol Neurosci. 2023 Jul 3;16:1153641. doi: 10.3389/fnmol.2023.1153641. eCollection 2023.
Migraine is often combined with vestibular dysfunction, particularly in patients with chronic migraine (CM). However, the pathogenesis of migraine chronification leading to vestibular dysfunction is not fully understood. The current study investigated whether structural or functional impairments to the brain during migraine chronification could be associated with vestibular dysfunction development.
The eligible participants underwent clinical assessment and magnetic resonance imaging (MRI) scans. Voxel-based morphometry (VBM) determined structural impairment by evaluating alterations in gray matter volume (GMV). Functional impairment was assessed by the mean amplitude of low-frequency fluctuation (mALFF). Furthermore, the resting-state functional connectivity (rsFC) of regions possessing impairment was examined with a seed-based approach. We also analyzed the correlations between altered neuroimaging features with clinical variables and performed multiple linear regression.
Eighteen CM patients, 18 episodic migraine (EM) patients, and 18 healthy controls (HCs) were included in this study. A one-way ANOVA indicated the group differences in mALFF. These were located within right supramarginal gyrus (SMG), left angular gyrus (AG), middle frontal gyrus (MFG), left middle occipital gyrus (MOG), right rolandic operculum (Rol) and left superior parietal gyrus (SPG). During rsFC analysis, the CM group had more enhanced rsFC of left SPG with left MOG than the EM and HC groups. The EM group revealed enhanced rsFC of left SPG with left AG than the CM and HC groups. In multiple linear regression, after controlling for age, body mass index (BMI) and disease duration, the rsFC of left SPG with left MOG (β = 48.896, = 0.021) was found to predict the total Dizziness Handicap Inventory (DHI) score with an explained variance of 25.1%. Moreover, the rsFC of left SPG with left MOG (β = 1.253, = 0.003) and right SMG (β = -1.571, = 0.049) were significant predictors of migraine frequency, accounting for a total explained variance of 73.8%.
The functional impairments due to migraine chronification are primarily concentrated in the multisensory integration-related brain regions. Additionally, the rsFC of SPG with MOG can predict the frequency of migraine and the degree of vestibular dysfunction. Therefore, these neuroimaging features could be potential mechanisms and therapeutic targets for developing vestibular dysfunction in migraine.
偏头痛常与前庭功能障碍合并存在，尤其是在慢性偏头痛（CM）患者中。然而，导致前庭功能障碍的偏头痛慢性化发病机制尚未完全明确。本研究调查了偏头痛慢性化过程中大脑的结构或功能损伤是否与前庭功能障碍的发生有关。
符合条件的参与者接受了临床评估和磁共振成像（MRI）扫描。基于体素的形态学测量（VBM）通过评估灰质体积（GMV）的变化来确定结构损伤。功能损伤通过低频波动平均振幅（mALFF）进行评估。此外，采用基于种子点的方法检查存在损伤区域的静息态功能连接（rsFC）。我们还分析了神经影像学特征改变与临床变量之间的相关性，并进行了多元线性回归分析。
本研究纳入了18例CM患者、18例发作性偏头痛（EM）患者和18名健康对照者（HCs）。单因素方差分析表明mALFF存在组间差异。这些差异位于右侧缘上回（SMG）、左侧角回（AG）、额中回（MFG）、左侧枕中回（MOG）、右侧中央 operculum（Rol）和左侧顶上小叶（SPG）。在rsFC分析中，CM组左侧SPG与左侧MOG的rsFC增强程度高于EM组和HC组。EM组左侧SPG与左侧AG的rsFC增强程度高于CM组和HC组。在多元线性回归分析中，在控制年龄、体重指数（BMI）和病程后，发现左侧SPG与左侧MOG的rsFC（β = 48.896，P = 0.021）可预测头晕残障量表（DHI）总分，解释方差为25.1%。此外，左侧SPG与左侧MOG的rsFC（β = 1.253，P = 0.003）和右侧SMG的rsFC（β = -1.571，P = 0.049）是偏头痛发作频率的显著预测因素，总解释方差为73.8%。
偏头痛慢性化导致的功能损伤主要集中在与多感觉整合相关的脑区。此外，SPG与MOG的rsFC可预测偏头痛发作频率和前庭功能障碍程度。因此，这些神经影像学特征可能是偏头痛患者前庭功能障碍发生的潜在机制和治疗靶点。
