偏头痛亚型之间的时相灌注动力学：多模型动脉自旋标记研究。

Phasic perfusion dynamics among migraine subtypes: a multimodel arterial spin labeling investigation.

机构信息

Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.

School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

出版信息

J Headache Pain. 2024 Oct 3;25(1):167. doi: 10.1186/s10194-024-01880-6.

DOI:10.1186/s10194-024-01880-6

PMID:39363159

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11448297/

Abstract

BACKGROUND

Migraine-related perfusion changes are documented but inconsistent across studies due to limited sample size and insufficient phenotyping. The phasic and spatial dynamics across migraine subtypes remains poorly characterized. This study aimed to determine spatiotemporal dynamics of gray matter (GM) perfusion in migraine.

METHODS

We prospectively recruited episodic (EM) and chronic migraine (CM) patients, diagnosed with the International Headache Society criteria and healthy controls (HCs) between 2021 and 2023 from the headache center in a tertiary medical center, and adjacent communities. Magnetic resonance (3-tesla) arterial spin labeling (ASL) was conducted for whole brain cerebral blood flow (CBF) in all participants. The voxel-wise and whole brain gray matter (GM) CBF were compared between subgroups. Spatial pattern analysis of CBF and its correlations with headache frequency were investigated regarding different migraine phases and subtypes. Sex- and age-adjusted voxel-wise and whole brain GM comparisons were performed between HCs and different EM and CM phases. Spatial pattern analysis was conducted by CBF clusters with phasic differences and spin permutation test. Correlations between headache frequency and CBF were investigated regarding different EM and CM phases.

RESULTS

Totally 344 subjects (172 EM, 120 CM, and 52 HCs) were enrolled. Higher CBF in different anatomical locations was identified in ictal EM and CM. The combined panels of the specific locations with altered CBF in ictal EM on receiver operating characteristic curve analysis demonstrated areas under curve of 0.780 (vs. HCs) and 0.811 (vs. preictal EM). The spatial distribution of ictal-interictal CBF alteration of EM and CM were not correlated with each other (p = 0.665; r = - 0.018). Positive correlations between headache frequency and CBF were noted in ictal EM and CM regarding whole GM and specific anatomical locations.

CONCLUSIONS

Patients with migraine exhibited unique spatiotemporal CBF dynamics across different phases and distinct between subtypes. The findings provide neurobiological insights into how selected anatomical structures engage in a migraine attack and adapt to plastic change of repeated attacks along with chronicity.

摘要

背景

偏头痛相关的灌注变化在研究中已有记录，但由于样本量有限和表型不足，结果并不一致。偏头痛亚型之间的时相和空间动力学仍描述不足。本研究旨在确定偏头痛患者的灰质（GM）灌注的时空动态。

方法

我们前瞻性地招募了 2021 年至 2023 年期间在三级医学中心头痛中心和附近社区诊断为国际头痛协会标准的发作性偏头痛（EM）和慢性偏头痛（CM）患者以及健康对照者（HCs）。所有参与者均进行了磁共振（3 特斯拉）动脉自旋标记（ASL）全脑脑血流（CBF）。在亚组之间比较了脑区和全脑 GM 的 CBF。针对不同偏头痛阶段和亚型，研究了 CBF 与头痛频率的空间模式分析。对 HCs 和不同 EM 和 CM 阶段之间进行了性别和年龄调整后的脑区和全脑 GM 比较。通过 CBF 簇的相位差异和自旋置换检验进行空间模式分析。针对不同的 EM 和 CM 阶段，研究了头痛频率与 CBF 的相关性。

结果

共纳入 344 名受试者（172 名 EM、120 名 CM 和 52 名 HCs）。在发作期 EM 和 CM 中发现了不同解剖部位的 CBF 升高。基于发作期 EM 中 CBF 改变的特定位置的组合面板在受试者工作特征曲线分析中，曲线下面积为 0.780（与 HCs 相比）和 0.811（与发作前期 EM 相比）。EM 和 CM 的发作期-发作间期 CBF 改变的空间分布彼此不相关（p=0.665；r=−0.018）。在整个 GM 和特定解剖部位，发作期 EM 和 CM 中头痛频率与 CBF 呈正相关。