Li Xinyu, Au Lisa W C, Hao Huifen, Li Yingying, Gao Xiuju, Yan Junqiang, Tong Raymond K Y, Lou Wutao
Imaging Centre, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
Hum Brain Mapp. 2025 Aug 1;46(11):e70289. doi: 10.1002/hbm.70289.
Menstrual-related migraine (MRM) is a neurovascular disorder associated with decreased sex hormone levels. The menstrual cycle influences both cerebrovascular function and functional brain connectivity, with accumulating evidence linking migraine to altered connectivity, particularly in the insula. However, the neuropathological mechanisms underlying MRM during the menstrual cycle remain poorly understood. In this longitudinal study, 36 MRM patients and 29 healthy controls were recruited. Sex hormone levels and resting-state functional magnetic resonance imaging (fMRI) were collected during both the late-follicular phase (LFP) and the perimenstrual phase (PMP). Neurovascular function was assessed using voxel-wise hemodynamic response function (HRF) parameters. The subregions of insula-to-whole-brain phase synchronization were estimated using the HRF variations corrected phase information. Our results showed that hormone level decreases from the LFP to the PMP modulated HRF response heights. Changes in the HRF width were reversed between MRM patients and controls, with hormone fluctuations particularly affecting the superior temporal gyrus in the MRM group. Additionally, MRM patients exhibited increased insular phase synchronization in the LFP and reduced synchronization in the PMP. These findings suggest that menstrual cycle-related hormone fluctuations contribute to dysregulated neurovascular coupling in MRM. The reduced insular phase synchronization in the PMP may not be directly driven by these hormone changes.
月经相关性偏头痛（MRM）是一种与性激素水平降低相关的神经血管疾病。月经周期会影响脑血管功能和大脑功能连接，越来越多的证据表明偏头痛与连接性改变有关，尤其是在脑岛。然而，月经周期中MRM潜在的神经病理机制仍知之甚少。在这项纵向研究中，招募了36名MRM患者和29名健康对照。在卵泡晚期（LFP）和围经期（PMP）期间收集性激素水平和静息态功能磁共振成像（fMRI）数据。使用体素级血流动力学反应函数（HRF）参数评估神经血管功能。利用校正了HRF变化的相位信息估计脑岛与全脑的相位同步子区域。我们的结果表明，从LFP到PMP激素水平的降低调节了HRF反应高度。MRM患者和对照组之间HRF宽度的变化相反，激素波动对MRM组颞上回的影响尤为明显。此外，MRM患者在LFP时脑岛相位同步增加，而在PMP时同步性降低。这些发现表明，月经周期相关的激素波动导致了MRM中神经血管耦合失调。PMP时脑岛相位同步性降低可能并非直接由这些激素变化驱动。
