Institute for Systems and Robotics - Lisboa and Department of Bioengineering, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal.
Learning Health, Hospital da Luz, Lisbon, Portugal.
J Headache Pain. 2024 Sep 18;25(1):154. doi: 10.1186/s10194-024-01854-8.
The pathophysiology of migraine remains poorly understood, yet a growing number of studies have shown structural connectivity disruptions across large-scale brain networks. Although both structural and functional changes have been found in the cerebellum of migraine patients, the cerebellum has barely been assessed in previous structural connectivity studies of migraine. Our objective is to investigate the structural connectivity of the entire brain, including the cerebellum, in individuals diagnosed with episodic migraine without aura during the interictal phase, compared with healthy controls.
To that end, 14 migraine patients and 15 healthy controls were recruited (all female), and diffusion-weighted and T1-weighted MRI data were acquired. The structural connectome was estimated for each participant based on two different whole-brain parcellations, including cortical and subcortical regions as well as the cerebellum. The structural connectivity patterns, as well as global and local graph theory metrics, were compared between patients and controls, for each of the two parcellations, using network-based statistics and a generalized linear model (GLM), respectively. We also compared the number of connectome streamlines within specific white matter tracts using a GLM.
We found increased structural connectivity in migraine patients relative to healthy controls with a distinct involvement of cerebellar regions, using both parcellations. Specifically, the node degree of the posterior lobe of the cerebellum was greater in patients than in controls and patients presented a higher number of streamlines within the anterior limb of the internal capsule. Moreover, the connectomes of patients exhibited greater global efficiency and shorter characteristic path length, which correlated with the age onset of migraine.
A distinctive pattern of heightened structural connectivity and enhanced global efficiency in migraine patients compared to controls was identified, which distinctively involves the cerebellum. These findings provide evidence for increased integration within structural brain networks in migraine and underscore the significance of the cerebellum in migraine pathophysiology.
偏头痛的病理生理学仍知之甚少，但越来越多的研究表明，在大规模脑网络中存在结构连接中断。尽管在偏头痛患者的小脑中已经发现了结构和功能变化，但小脑在以前的偏头痛结构连接研究中几乎没有得到评估。我们的目的是在发作间期无先兆偏头痛患者中，与健康对照者相比，研究整个大脑（包括小脑）的结构连接。
为此，招募了 14 名偏头痛患者和 15 名健康对照者（均为女性），并采集了弥散加权和 T1 加权 MRI 数据。基于两种不同的全脑分割，包括皮质和皮质下区域以及小脑，为每位参与者估计了结构连接组。使用基于网络的统计学和广义线性模型（GLM），分别比较了两种分割方法中患者和对照组之间的结构连接模式以及全局和局部图论度量。我们还使用 GLM 比较了特定白质束内的连接组流线数量。
我们发现，使用两种分割方法，与健康对照组相比，偏头痛患者的结构连接增加，且小脑区域明显受累。具体来说，与对照组相比，患者小脑后叶的节点度更大，且内囊前肢内的流线数量更多。此外，患者的连接组具有更高的全局效率和更短的特征路径长度，这与偏头痛的发病年龄有关。
与对照组相比，偏头痛患者存在明显的结构连接增强和全局效率增加的独特模式，这明显涉及小脑。这些发现为偏头痛患者的结构脑网络中存在更高的整合提供了证据，并强调了小脑在偏头痛病理生理学中的重要性。
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