Phasic perfusion dynamics among migraine subtypes: a multimodel arterial spin labeling investigation.

IF 7.3 1区医学 Q1 CLINICAL NEUROLOGY Journal of Headache and Pain Pub Date : 2024-10-03 DOI:10.1186/s10194-024-01880-6

Chia-Hung Wu, Pei-Lin Lee, Yen-Feng Wang, Jiing-Feng Lirng, Shu-Ting Chen, Chung-Jung Lin, Shuu-Jiun Wang, Kun-Hsien Chou, Shih-Pin Chen

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Abstract

Background: Migraine-related perfusion changes are documented but inconsistent across studies due to limited sample size and insufficient phenotyping. The phasic and spatial dynamics across migraine subtypes remains poorly characterized. This study aimed to determine spatiotemporal dynamics of gray matter (GM) perfusion in migraine.

Methods: We prospectively recruited episodic (EM) and chronic migraine (CM) patients, diagnosed with the International Headache Society criteria and healthy controls (HCs) between 2021 and 2023 from the headache center in a tertiary medical center, and adjacent communities. Magnetic resonance (3-tesla) arterial spin labeling (ASL) was conducted for whole brain cerebral blood flow (CBF) in all participants. The voxel-wise and whole brain gray matter (GM) CBF were compared between subgroups. Spatial pattern analysis of CBF and its correlations with headache frequency were investigated regarding different migraine phases and subtypes. Sex- and age-adjusted voxel-wise and whole brain GM comparisons were performed between HCs and different EM and CM phases. Spatial pattern analysis was conducted by CBF clusters with phasic differences and spin permutation test. Correlations between headache frequency and CBF were investigated regarding different EM and CM phases.

Results: Totally 344 subjects (172 EM, 120 CM, and 52 HCs) were enrolled. Higher CBF in different anatomical locations was identified in ictal EM and CM. The combined panels of the specific locations with altered CBF in ictal EM on receiver operating characteristic curve analysis demonstrated areas under curve of 0.780 (vs. HCs) and 0.811 (vs. preictal EM). The spatial distribution of ictal-interictal CBF alteration of EM and CM were not correlated with each other (p = 0.665; r = - 0.018). Positive correlations between headache frequency and CBF were noted in ictal EM and CM regarding whole GM and specific anatomical locations.

Conclusions: Patients with migraine exhibited unique spatiotemporal CBF dynamics across different phases and distinct between subtypes. The findings provide neurobiological insights into how selected anatomical structures engage in a migraine attack and adapt to plastic change of repeated attacks along with chronicity.

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偏头痛亚型的相位灌注动力学：多模型动脉自旋标记研究。

背景：偏头痛相关的灌注变化已有文献记载，但由于样本量有限和表型分析不足，各项研究的结果并不一致。不同偏头痛亚型的阶段性和空间动态特征仍然不甚明了。本研究旨在确定偏头痛患者灰质（GM）灌注的时空动态：我们前瞻性地从一家三级医疗中心的头痛中心和邻近社区招募了2021年至2023年间根据国际头痛协会标准确诊的发作性偏头痛（EM）和慢性偏头痛（CM）患者以及健康对照组（HCs）。对所有参与者的全脑脑血流（CBF）进行了磁共振（3特斯拉）动脉自旋标记（ASL）。对不同亚组的体素和全脑灰质（GM）CBF进行了比较。针对不同偏头痛阶段和亚型，研究了 CBF 的空间模式分析及其与头痛频率的相关性。在偏头痛患者与不同的EM和CM阶段之间进行了性别和年龄调整后的体素和全脑GM比较。通过CBF簇的阶段性差异和自旋置换检验进行了空间模式分析。研究了不同EM和CM阶段的头痛频率与CBF之间的相关性：共有 344 名受试者（172 名 EM、120 名 CM 和 52 名 HC）参加了研究。在发作期 EM 和 CM 中，不同解剖位置的 CBF 均较高。根据接收器操作特征曲线分析，在发作期 EM 中，CBF 发生变化的特定位置的组合面板显示曲线下面积为 0.780（与 HCs 相比）和 0.811（与发作前 EM 相比）。EM和CM发作间期CBF改变的空间分布互不相关（p = 0.665; r = - 0.018）。在整个GM和特定解剖位置上，头痛频率与发作期EM和CM的CBF呈正相关：偏头痛患者在不同阶段表现出独特的时空CBF动态，不同亚型的CBF动态也各不相同。这些发现从神经生物学角度揭示了某些解剖结构是如何参与偏头痛发作并适应反复发作和慢性发作的塑性变化的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Headache and Pain 医学-临床神经学

CiteScore

11.80

自引率

13.50%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data. With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.