偏头痛患者与非偏头痛患者皮质形态差异的研究：偏头痛登记研究（REFORM）MRI 研究。
Differences in Cortical Morphology in People With and Without Migraine: A Registry for Migraine (REFORM) MRI Study.
机构信息
From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark.
出版信息
Neurology. 2024 May;102(9):e209305. doi: 10.1212/WNL.0000000000209305. Epub 2024 Apr 17.
BACKGROUND AND OBJECTIVES
Structural imaging can offer insights into the cortical morphometry of migraine, which might reflect adaptations to recurring nociceptive messaging. This study compares cortical morphometry between a large sample of people with migraine and healthy controls, as well as across migraine subtypes.
METHODS
Adult participants with migraine and age-matched and sex-matched healthy controls attended a single MRI session with magnetization-prepared rapid acquisition gradient echo and fluid-attenuated inversion recovery sequences at 3T. Cortical surface area, thickness, and volume were compared between participants with migraine (including subgroups) and healthy controls across the whole cortex within FreeSurfer and reported according to the Desikan-Killiany atlas. The analysis used cluster-determining thresholds of < 0.0001 and cluster-wise thresholds of < 0.05, adjusted for age, sex, and total intracranial volume.
RESULTS
A total of 296 participants with migraine (mean age 41.6 years ± 12.4 SD, 261 women) and 155 healthy controls (mean age 41.1 years ± 11.7 SD, 133 women) were included. Among the participants with migraine, 180 (63.5%) had chronic migraine, 103 (34.8%) had migraine with aura, and 88 (29.7%) experienced a migraine headache during the scan. The total cohort of participants with migraine had reduced cortical surface area in the left insula, compared with controls ( < 0.0001). Furthermore, participants with chronic migraine (n = 180) exhibited reduced surface area in the left insula ( < 0.0001) and increased surface area in the right caudal anterior cingulate cortex ( < 0.0001), compared with controls. We found no differences specific to participants with aura or ongoing migraine headache. Post hoc tests revealed a positive correlation between monthly headache days and surface area within the identified anterior cingulate cluster ( = 0.014).
DISCUSSION
The identified cortical changes in migraine were limited to specific pain processing regions, including the insula and caudal anterior cingulate gyrus, and were most notable in participants with chronic migraine. These findings suggest persistent cortical changes associated with migraine.
TRIAL REGISTRATION INFORMATION
The REFORM study (clinicaltrials.gov identifier: NCT04674020).
背景与目的
结构成像可以提供偏头痛皮质形态学的见解，这可能反映了对反复发作的伤害性信息传递的适应。本研究比较了大量偏头痛患者和健康对照者之间以及偏头痛各亚型之间的皮质形态学。
方法
参加者为年龄和性别匹配的健康对照者和偏头痛患者，他们在 3T 磁共振扫描仪上接受了磁化准备快速获取梯度回波和液体衰减反转恢复序列的单次 MRI 扫描。使用 FreeSurfer 在整个皮质内比较偏头痛患者（包括亚组）和健康对照者的皮质表面积、厚度和体积，并根据 Desikan-Killiany 图谱进行报告。分析使用聚类确定阈值 < 0.0001 和聚类阈值 < 0.05，调整年龄、性别和总颅内体积。
结果
共纳入 296 名偏头痛患者（平均年龄 41.6 岁 ± 12.4 标准差，261 名女性）和 155 名健康对照者（平均年龄 41.1 岁 ± 11.7 标准差，133 名女性）。在偏头痛患者中，180 名（63.5%）为慢性偏头痛，103 名（34.8%）为有先兆偏头痛，88 名（29.7%）在扫描期间出现偏头痛头痛。与对照组相比，偏头痛患者的总队列左侧岛叶皮质表面积减少（<0.0001）。此外，与对照组相比，慢性偏头痛患者（n = 180）的左侧岛叶皮质表面积减少（<0.0001），右侧后扣带回皮质表面积增加（<0.0001）。我们没有发现与先兆或持续偏头痛头痛相关的特定差异。事后检验显示，在确定的前扣带回簇内，每月头痛天数与表面面积呈正相关（= 0.014）。
讨论
偏头痛中发现的皮质变化仅限于特定的疼痛处理区域，包括岛叶和后扣带皮质，在慢性偏头痛患者中最为明显。这些发现表明偏头痛与持续的皮质变化有关。
试验注册信息
REFORM 研究（clinicaltrials.gov 标识符：NCT04674020）。
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