Department of Neurology, Second Affiliated Hospital of Xuzhou Medical University, No.32, Meijian Road, Xuzhou, Jiangsu, 221006, China.
J Headache Pain. 2024 May 21;25(1):84. doi: 10.1186/s10194-024-01792-5.
Prior neuroimaging studies on vestibular migraine (VM) have extensively certified the functional and structural alterations in multiple brain regions and networks. However, few studies have assessed the cerebral blood flow (CBF) in VM patients using arterial spin labeling (ASL). The present study aimed to investigate CBF and functional connectivity (FC) alterations in VM patients during interictal periods.
We evaluated 52 VM patients and 46 healthy controls (HC) who received resting-state pseudo-continuous ASL and functional magnetic resonance imaging (fMRI) scanning. Comparisons of voxel-based CBF and seed-based FC were performed between the two groups. Brain regions showed significant group differences in CBF analyses were chosen as seeds in FC analyses. Additionally, the associations between abnormal imaging results and clinical features were explored.
Compared with HC, VM patients showed higher normalized CBF in the right precentral gyrus (PreCG), left postcentral gyrus (PostCG), left superior frontal gyrus and bilateral insular (p < 0.05, FDR corrected). Furthermore, VM patients exhibited increased FC between the right PreCG and areas of the left PostCG, left cuneus and right lingual gyrus (p < 0.05, FDR corrected). In addition, we observed decreased FC between the left insular and regions of the left thalamus and right anterior cingulate cortex, as well as increased FC between the left insular and right fusiform gyrus in VM patients (p < 0.05, FDR corrected). Moreover, these variations in brain perfusion and FC were significantly correlated with multiple clinical features including frequency of migraine symptoms, frequency of vestibular symptoms and disease duration of VM (all p < 0.05).
Patients with VM during interictal period showed hyperperfusion and abnormal resting-state FC in brain regions potentially contributed to disrupted multi-sensory and autonomic processing, as well as impaired ocular motor control, pain modulation and emotional regulation. Our study provided novel insights into the complex neuropathology of VM from a CBF perspective.
先前关于前庭性偏头痛（VM）的神经影像学研究广泛证实了多个脑区和网络的功能和结构改变。然而，很少有研究使用动脉自旋标记（ASL）评估 VM 患者的脑血流（CBF）。本研究旨在探讨 VM 患者发作间期的 CBF 和功能连接（FC）改变。
我们评估了 52 例 VM 患者和 46 例健康对照者（HC），他们接受了静息状态伪连续 ASL 和功能磁共振成像（fMRI）扫描。对两组之间的基于体素的 CBF 和基于种子的 FC 进行了比较。在 CBF 分析中显示出与组间差异有统计学意义的脑区被选为 FC 分析中的种子。此外，还探讨了异常影像学结果与临床特征之间的相关性。
与 HC 相比，VM 患者右侧中央前回（PreCG）、左侧中央后回（PostCG）、左侧额上回和双侧岛叶的归一化 CBF 较高（p<0.05，经 FDR 校正）。此外，VM 患者右侧 PreCG 与左侧 PostCG、左侧楔前叶和右侧舌回之间的 FC 增加（p<0.05，经 FDR 校正）。此外，我们还观察到 VM 患者左侧岛叶与左侧丘脑和右侧前扣带回的 FC 减少，以及左侧岛叶与右侧梭状回的 FC 增加（p<0.05，经 FDR 校正）。此外，这些脑血流灌注和 FC 的变化与偏头痛症状频率、前庭症状频率和 VM 病程等多种临床特征显著相关（均 p<0.05）。
VM 患者在发作间期表现出脑区的高灌注和异常静息状态 FC，这可能与多感觉和自主处理的中断、眼动控制障碍、疼痛调节和情绪调节受损有关。我们的研究从 CBF 角度提供了关于 VM 复杂神经病理学的新见解。
