Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, 1 Jianshe Dong Rd, Zhengzhou, 450000, Henan, China.
Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Brain Imaging Behav. 2023 Dec;17(6):715-724. doi: 10.1007/s11682-023-00802-5. Epub 2023 Sep 30.
The neurobiological heterogeneity in migraine is poorly studied, resulting in conflicting neuroimaging findings. This study used a newly proposed method based on gray matter volumes (GMVs) to investigate objective neuroanatomical subtypes of migraine. Structural MRI and clinical measures of 31 migraine patients without aura and 33 matched healthy controls (HCs) were explored. Firstly, we investigated whether migraine patients exhibited higher interindividual variability than HCs in terms of GMVs. Then, heterogeneity through discriminative analysis (HYDRA) was applied to categorize migraine patients into distinct subtypes by regional volumetric measures of GMVs. Voxel-wise volume and clinical characteristics among different subtypes were also explored. Migraine patients without aura exhibited higher interindividual GMVs variability. Two distinct and reproducible neuroanatomical subtypes of migraine were revealed. These two subtypes exhibited opposite neuroanatomical aberrances compared to HCs. Subtype 1 showed widespread decreased GMVs, while Subtype 2 showed increased GMVs in limited regions. The total intracranial volume was significantly positively correlated with cognitive function in Subtype 2. Subtype 1 showed significantly longer illness duration and less cognitive scores compared to Subtype 2. The present study shows that migraine patients without aura have high structural heterogeneity and uncovers two distinct and robust neuroanatomical subtypes, which provide a possible explanation for conflicting neuroimaging findings.
偏头痛的神经生物学异质性研究甚少，导致神经影像学研究结果相互矛盾。本研究采用一种新的基于灰质体积（GMV）的方法，旨在探讨偏头痛的客观神经解剖亚型。共纳入 31 例无先兆偏头痛患者和 33 例匹配的健康对照者（HCs），进行了结构 MRI 和临床评估。首先，我们探讨了偏头痛患者的 GMV 是否比 HCs 具有更高的个体间变异性。然后，通过基于 GMV 的区域容积测量，应用鉴别分析（HYDRA）将偏头痛患者分为不同的亚型。此外，还探讨了不同亚型之间的全脑体积和临床特征。偏头痛患者的 GMV 个体间变异性较高。偏头痛患者存在两种不同且可重复的神经解剖亚型。与 HCs 相比，这两种亚型的神经解剖异常相反。亚型 1 表现为广泛的 GMV 减少，而亚型 2 仅局限于某些区域的 GMV 增加。全脑体积与亚型 2 的认知功能呈显著正相关。与亚型 2 相比，亚型 1 具有更长的病程和更低的认知评分。本研究表明，无先兆偏头痛患者具有较高的结构异质性，并揭示了两种不同且稳健的神经解剖亚型，这为神经影像学研究结果的矛盾提供了可能的解释。
