Nikolova Simona, Chong Catherine, Li Jing, Wu Teresa, Dumkrieger Gina, Esterov Dmitry, Ross Katherine, Starling Amaal, Thomas Aaron, Leonard Michael, Smith Dani, Schwedt Todd J
Department of Neurology, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA.
ASU-Mayo Center for Innovative Imaging, Tempe, AZ, USA.
J Neurol. 2025 Apr 23;272(5):356. doi: 10.1007/s00415-025-13098-w.
The purpose of this study was to investigate pain network and periaqueductal gray matter (PAG) functional connectivity (FC) in participants with acute post-traumatic headache (PTH) due to mild traumatic brain injury (mTBI) compared to healthy controls (HC).
Ninety-eight participants with acute PTH and 85 HC underwent 3 T magnetic resonance imaging. Static FC among regions of the pain matrix and between PAG to the rest of the brain were examined. Correlations between FC and clinical parameters were investigated using linear regression. PTH outcomes (improved or not improved) were determined at 3 months post-enrollment.
Stronger FC between the PAG and right somatosensory and left lingual areas, and weaker FC between left thalamus and left caudate were found in the PTH group compared to HC. Whole-brain analysis showed increased PAG FC, primarily with somatosensory, motor, and occipital areas of participants with PTH relative to HC. These differences had associations with headache frequency, state anxiety, and time since mTBI. A PAG FC model for PTH improvement at 3 months had a sensitivity of 82% and a specificity of 100%. Participants with PTH who did not improve at 3 months had stronger baseline FC from the PAG to the right temporal region and the left insula relative to the improved group or to HC.
PAG FC could serve as an early biomarker identifying participants with acute PTH at risk of developing persistent PTH.
本研究旨在调查与健康对照者（HC）相比，因轻度创伤性脑损伤（mTBI）导致急性创伤后头痛（PTH）的参与者的疼痛网络和导水管周围灰质（PAG）功能连接（FC）。
98名急性PTH参与者和85名HC接受了3T磁共振成像检查。检查了疼痛矩阵区域之间以及PAG与大脑其他部分之间的静态FC。使用线性回归研究FC与临床参数之间的相关性。在入组后3个月确定PTH结果（改善或未改善）。
与HC相比，PTH组中PAG与右侧体感区和左侧舌区之间的FC更强，左侧丘脑与左侧尾状核之间的FC更弱。全脑分析显示，与HC相比，PTH参与者的PAG FC增加，主要与体感、运动和枕叶区域有关。这些差异与头痛频率、状态焦虑和mTBI后的时间有关。3个月时PTH改善的PAG FC模型的敏感性为82%，特异性为100%。在3个月时未改善的PTH参与者相对于改善组或HC，从PAG到右侧颞叶区域和左侧岛叶的基线FC更强。
PAG FC可作为一种早期生物标志物，用于识别有发展为持续性PTH风险的急性PTH参与者。
