Wang Lu, Dai Chenyang, Gao Manman, Geng Zhi, Hu Panpan, Wu Xingqi, Wang Kai
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
Brain Behav. 2024 Jan;14(1):e3367. doi: 10.1002/brb3.3367.
This study aimed to explore decision-making impulsivity and its neural mechanisms in patients with episodic migraine without aura (EMoA).
Previous evidence indicates increased impulsivity and altered reward processing in patients with chronic migraine and medication overuse; however, whether the same holds true for those with EMoA is unclear.
Patients newly diagnosed with EMoA (n = 51) and healthy controls (HC, n = 45) were recruited. All participants completed delay discounting task, cognitive assessments, a questionnaire for headache profile, and resting-state function magnetic resonance imaging scans. Resting-state functional connectivity (RSFC) between the regions of interest and the entire brain was explored.
Patients with EMoA showed a steeper subjective discount rate than HCs (F = 4.74, p = .032), which was positively related to a history of migraines (r = .742, p < .001). RSFC among the ventral striatum (vSTR), ventromedial prefrontal cortex, and occipital cortex was lower in patients with EMoA than in control groups, which was correlated with history (r' = .294, p = .036) and subjective discount rate (r' = .380, p = .006). Additionally, discounting rates and RSFC between the vSTR and occipital regions were significantly abnormal in the triptan group than the non-triptan group. Mediating effect analysis indicated a significant mediating effect in the change in RSFC between the vSTR and occipital status, history of triptan use, and subjective discount rate.
This study further elucidated that an increase in delayed discounting rate exists in patients with EMoA and is related to the abnormality of the value processing network.
本研究旨在探讨无先兆发作性偏头痛（EMoA）患者的决策冲动性及其神经机制。
先前的证据表明，慢性偏头痛和药物过度使用患者的冲动性增加且奖赏处理改变；然而，EMoA患者是否也是如此尚不清楚。
招募新诊断为EMoA的患者（n = 51）和健康对照者（HC，n = 45）。所有参与者完成延迟折扣任务、认知评估、头痛情况问卷以及静息态功能磁共振成像扫描。探索感兴趣区域与全脑之间的静息态功能连接（RSFC）。
EMoA患者的主观折扣率比健康对照者更陡峭（F = 4.74，p = 0.032），这与偏头痛病史呈正相关（r = 0.742，p < 0.001）。EMoA患者腹侧纹状体（vSTR）、腹内侧前额叶皮层和枕叶皮层之间的RSFC低于对照组，这与病史（r' = 0.294，p = 0.036）和主观折扣率（r' = 0.380，p = 0.006）相关。此外，曲坦类药物组的折扣率以及vSTR与枕叶区域之间的RSFC比非曲坦类药物组显著异常。中介效应分析表明，vSTR与枕叶状态之间的RSFC变化、曲坦类药物使用史和主观折扣率存在显著中介效应。
本研究进一步阐明，EMoA患者存在延迟折扣率增加的情况，且与价值处理网络的异常有关。
