Chen Wen, Zhao Hongru, Dai Lingling, Xiong Xing, Feng Qifang, Ke Jun, Hu Chunhong
Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Institute of Medical Imaging, Soochow University, Soochow, Jiangsu Province, People's Republic of China.
CNS Neurosci Ther. 2025 Sep;31(9):e70599. doi: 10.1111/cns.70599.
The high heterogeneity in vestibular migraine (VM) complicates understanding its precise pathophysiological mechanisms and identifying potential biomarkers. This study investigated the heterogeneity in VM using a newly proposed method called Individualized Differential Structural Covariance Network (IDSCN) analysis.
Structural T1-weighted MRI scans were performed on 55 patients with VM and 65 healthy controls, and an IDSCN was constructed for each patient. We studied the extent of heterogeneity in the IDSCNs, summarized the distribution of differential edges, and clustered the patients into subtypes with the shared differential edges. Imaging-clinical association analyses were conducted on both the subtype classification and the differential edges exhibiting significant inter-subtype differences.
Patients with VM demonstrated notable heterogeneity in the number of significantly altered IDSCN edges, while sharing several common differential connections that were mainly distributed among the parietal, subcortical, and cerebellar regions. Two robust and distinct neuroanatomical subtypes of VM were identified, which were associated with headache frequency. The differential edge between the left paracentral lobule and right pallidum was associated with both headache frequency and occurrence.
These findings indicate the importance of considering individual differences in VM research and may offer insights for precise diagnosis and individualized treatment of the disease.
前庭性偏头痛（VM）的高度异质性使得理解其精确的病理生理机制和识别潜在生物标志物变得复杂。本研究使用一种新提出的称为个体化差异结构协方差网络（IDSCN）分析的方法来研究VM中的异质性。
对55例VM患者和65名健康对照者进行了结构T1加权MRI扫描，并为每位患者构建了IDSCN。我们研究了IDSCN中的异质性程度，总结了差异边的分布，并将患者聚类为具有共享差异边的亚型。对亚型分类和表现出显著亚型间差异的差异边进行了影像-临床关联分析。
VM患者在IDSCN显著改变的边的数量上表现出明显的异质性，同时共享几个主要分布在顶叶、皮质下和小脑区域的共同差异连接。确定了两种稳健且不同的VM神经解剖学亚型，它们与头痛频率相关。左中央旁小叶和右苍白球之间的差异边与头痛频率和发作均相关。
这些发现表明在VM研究中考虑个体差异的重要性，并可能为该疾病的精确诊断和个体化治疗提供见解。
