Preventive treatment effects on brain structures and functions in patients with chronic migraine: A multimodel magnetic resonance imaging study.

The Kaohsiung journal of medical sciences Pub Date : 2024-12-01 Epub Date: 2024-10-23 DOI:10.1002/kjm2.12903
Tai-Yuan Chen, Ching-Chung Ko, Poh-Shiow Yeh, Te-Chang Wu, Yun-Ju Shih, Chun-Ming Yang, Ju-Chi Lee, Ming-Chung Chou, Kao-Chang Lin
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Abstract

Patients with chronic migraine (CM) often exhibit structural and functional alterations in pain-matrix regions, but it remains unclear how preventive treatment affects these changes. Therefore, this study aimed to investigate the structural and functional changes in pain-matrix regions in CM patients after 6-month treatment. A total of 24 patients with CM and 15 healthy controls were recruited for this study. Patients were divided into responder group (N = 9) and non-responder group (N = 15). After completing the Migraine Disability Assessment (MIDAS) questionnaire, all patients underwent whole-brain high-resolution T1-weighted images, diffusion-weighted imaging, and resting-state functional magnetic resonance imaging at baseline and 6-month follow-up. Whole brain gray matter volume and white matter diffusion indices were analyzed using voxel-based analysis. Structural and functional connectivity analyses were performed to understand brain changes in patients after 6-month preventive treatment. The responder group exhibited significantly higher MIDAS scores than the non-responder group at baseline, but no significant difference between the two groups at follow-up. No significant interval change was noted in gray matter volume, white matter diffusion indices, and structural connectivity in CM patients after 6-month treatment. Nonetheless, the functional connectivity was significantly increased between occipital, temporal lobes and cerebellum, and was significantly decreased between parietal and temporal lobes after 6-month preventive treatment. We concluded that resting-state functional connectivity was suitable for investigating the preventive treatment effect on CM patients.

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预防性治疗对慢性偏头痛患者大脑结构和功能的影响:多模型磁共振成像研究。
慢性偏头痛(CM)患者经常表现出疼痛基质区域的结构和功能改变,但预防性治疗如何影响这些改变仍不清楚。因此,本研究旨在探讨慢性偏头痛患者经过6个月治疗后疼痛基质区域的结构和功能变化。本研究共招募了 24 名 CM 患者和 15 名健康对照者。患者分为应答组(9 人)和非应答组(15 人)。所有患者在填写偏头痛残疾评估(MIDAS)问卷后,分别在基线和6个月随访期间接受了全脑高分辨率T1加权成像、弥散加权成像和静息状态功能磁共振成像检查。采用基于体素的分析方法对全脑灰质体积和白质弥散指数进行了分析。此外,还进行了结构和功能连接分析,以了解患者在接受 6 个月预防性治疗后的脑部变化。基线时,有反应组的 MIDAS 评分明显高于无反应组,但随访时两组间无明显差异。经过 6 个月的治疗后,CM 患者的灰质体积、白质弥散指数和结构连通性没有明显的间隔变化。然而,经过 6 个月的预防性治疗后,枕叶、颞叶和小脑之间的功能连接明显增加,顶叶和颞叶之间的功能连接明显减少。我们认为,静息态功能连接适合用于研究预防性治疗对 CM 患者的影响。
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