Christensen Rune H, Al-Khazali Haidar M, Iljazi Afrim, Szabo Edina, Ashina Håkan
Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Valdemar Hansens Vej 5, Entrance 1A, 2600 Glostrup, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Curr Pain Headache Rep. 2025 Jan 8;29(1):20. doi: 10.1007/s11916-024-01341-4.
To evaluate the available studies on structural magnetic resonance imaging (MRI) of post-traumatic headache (PTH).
A systematic search of PubMed and Embase databases (from inception to February 1, 2024) identified nine relevant structural MRI studies. These studies included adult participants diagnosed with acute or persistent PTH in adherence with any edition of the International Classification of Headache Disorders. Eight studies focused on PTH attributed to mild traumatic brain injury (TBI), while one examined PTH after whiplash injury. The comparison groups consisted of healthy individuals, people with mild TBI (without PTH), and/or individuals with migraine. The eligible studies assessed brain morphometry (n = 7), both cortical morphometry and diffusion tensor imaging (n = 1), or used structural brain images for machine learning (n = 1). The main findings indicated alterations in brain regions involved in affective pain processing and cognitive functions. However, the results were largely incongruent, likely due to small sample sizes and methodologic issues. Structural MRI has shown alterations in the brains of people with PTH, particularly in regions responsible for affective pain processing, cognitive control, and visual processing. These findings align well with the clinical features commonly observed in PTH. Nevertheless, most findings were inconsistent across studies, highlighting the need for methodologic standardization and investigations with larger sample sizes.
评估关于创伤后头痛（PTH）的结构磁共振成像（MRI）的现有研究。
对PubMed和Embase数据库（从创建到2024年2月1日）进行系统检索，确定了9项相关的结构MRI研究。这些研究纳入了符合任何版本《国际头痛疾病分类》诊断为急性或持续性PTH的成年参与者。8项研究聚焦于归因于轻度创伤性脑损伤（TBI）的PTH，而1项研究考察了挥鞭伤后的PTH。对照组包括健康个体、轻度TBI患者（无PTH）和/或偏头痛患者。符合条件的研究评估了脑形态学（n = 7）、皮质形态学和扩散张量成像（n = 1），或使用脑结构图像进行机器学习（n = 1）。主要发现表明，涉及情感性疼痛处理和认知功能的脑区存在改变。然而，结果在很大程度上不一致，可能是由于样本量小和方法学问题。结构MRI已显示PTH患者的大脑存在改变，特别是在负责情感性疼痛处理、认知控制和视觉处理的区域。这些发现与PTH中常见的临床特征非常吻合。然而，大多数研究结果并不一致，这凸显了方法学标准化和更大样本量研究的必要性。
