Chen Tai-Yuan, Ko Ching-Chung, Yeh Poh-Shiow, Wu Te-Chang, Shih Yun-Ju, Yang Chun-Ming, Lee Ju-Chi, Chou Ming-Chung, Lin Kao-Chang
Department of Radiology, Chi Mei Medical Center, Tainan, Taiwan.
Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, Taiwan.
Kaohsiung J Med Sci. 2024 Dec;40(12):1077-1085. doi: 10.1002/kjm2.12903. Epub 2024 Oct 23.
Patients with chronic migraine (CM) often exhibit structural and functional alterations in pain-matrix regions, but it remains unclear how preventive treatment affects these changes. Therefore, this study aimed to investigate the structural and functional changes in pain-matrix regions in CM patients after 6-month treatment. A total of 24 patients with CM and 15 healthy controls were recruited for this study. Patients were divided into responder group (N = 9) and non-responder group (N = 15). After completing the Migraine Disability Assessment (MIDAS) questionnaire, all patients underwent whole-brain high-resolution T1-weighted images, diffusion-weighted imaging, and resting-state functional magnetic resonance imaging at baseline and 6-month follow-up. Whole brain gray matter volume and white matter diffusion indices were analyzed using voxel-based analysis. Structural and functional connectivity analyses were performed to understand brain changes in patients after 6-month preventive treatment. The responder group exhibited significantly higher MIDAS scores than the non-responder group at baseline, but no significant difference between the two groups at follow-up. No significant interval change was noted in gray matter volume, white matter diffusion indices, and structural connectivity in CM patients after 6-month treatment. Nonetheless, the functional connectivity was significantly increased between occipital, temporal lobes and cerebellum, and was significantly decreased between parietal and temporal lobes after 6-month preventive treatment. We concluded that resting-state functional connectivity was suitable for investigating the preventive treatment effect on CM patients.
慢性偏头痛(CM)患者的疼痛基质区域常出现结构和功能改变,但预防性治疗如何影响这些变化尚不清楚。因此,本研究旨在调查CM患者经过6个月治疗后疼痛基质区域的结构和功能变化。本研究共招募了24例CM患者和15名健康对照者。患者被分为反应者组(N = 9)和无反应者组(N = 15)。完成偏头痛残疾评估(MIDAS)问卷后,所有患者在基线和6个月随访时均接受了全脑高分辨率T1加权成像、扩散加权成像和静息态功能磁共振成像。使用基于体素的分析方法分析全脑灰质体积和白质扩散指数。进行结构和功能连接性分析以了解6个月预防性治疗后患者的脑变化。反应者组在基线时的MIDAS评分显著高于无反应者组,但在随访时两组之间无显著差异。6个月治疗后,CM患者的灰质体积、白质扩散指数和结构连接性未发现显著的组间变化。尽管如此,经过6个月的预防性治疗后,枕叶、颞叶与小脑之间的功能连接性显著增加,顶叶与颞叶之间的功能连接性显著降低。我们得出结论,静息态功能连接性适用于研究对CM患者的预防性治疗效果。