Neuroimaging differences between chronic migraine with and without medication overuse headache: a 7 Tesla multimodal MRI study.

IF 7.3 1区 医学 Q1 CLINICAL NEUROLOGY
Yin Sun, Longteng Ma, Song Wang, Caohui Duan, Xinyu Wang, Xiangbing Bian, Shuqing Wang, Deqi Zhai, Siyuan Xie, Shuhua Zhang, Yingyuan Liu, Xiaoxue Lin, Ruobing Wang, Xiu Liu, Shengyuan Yu, Xin Lou, Zhao Dong
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引用次数: 0

Abstract

Background: Chronic migraine (CM) patients with medication overuse headache (MOH) exhibit distinct neurobiological alterations compared to those without MOH. However, prior studies, often limited to single imaging modalities, have yielded inconsistent findings. This study employs multimodal MRI-combining structural, diffusion tensor, and functional imaging-to characterize brain abnormalities in CM patients with and without MOH, while investigating the relationship between acute analgesic use frequency and these changes.

Methods: The study employed comparative analyses to examine differences in gray matter volume, white matter integrity, and spontaneous brain activity between CM patients with (CM + MOH) and without (CM - MOH) medication overuse headache, as well as healthy controls. Additionally, brain regions associated with the frequency of acute medication use were identified and further investigated.

Results: Nineteen CM - MOH patients, twenty-five CM + MOH patients, and nineteen healthy controls were enrolled. Compared to CM - MOH patients, CM + MOH patients exhibited significantly reduced gray matter volume in the parahippocampal gyrus and middle occipital gyrus, alongside markedly lower fractional anisotropy (FA) in the left cingulum bundle. Moreover, fractional amplitude of low-frequency fluctuations (fALFF) values in the right putamen were significantly decreased and demonstrated a negative correlation with the frequency of acute pain medication use. Functional connectivity analysis further revealed significantly enhanced connectivity between the right putamen and regions such as the frontal lobe, middle cingulate gyrus, lingual gyrus, and precuneus, which positively correlated with the frequency of acute analgesic use.

Conclusion: Compared to CM - MOH patients, those with MOH exhibit distinct patterns of gray matter volume reduction in regions associated with memory and visual processing, accompanied by significant white matter disruption. Additionally, decreased spontaneous activity in the right putamen and heightened functional connectivity between the putamen and multiple brain regions are strongly correlated with the frequency of acute medication use. These results highlight the significant impact of medication overuse on brain structure and function, shedding light on the mechanisms of migraine chronification.

伴有和不伴有用药过度性头痛的慢性偏头痛的神经影像学差异:7 特斯拉多模态磁共振成像研究。
背景:与无过度用药头痛(MOH)的患者相比,患有过度用药头痛(MOH)的慢性偏头痛(CM)患者表现出明显的神经生物学改变。然而,以往的研究往往局限于单一的成像模式,得出的结果并不一致。本研究采用多模态核磁共振成像(MRI),结合结构、弥散张量和功能成像,描述患有和未患有MOH的中风患者的脑部异常特征,同时研究急性镇痛药使用频率与这些变化之间的关系:该研究采用比较分析法,研究了患有(CM + MOH)和未患有(CM - MOH)药物过度使用性头痛的CM患者以及健康对照组之间在灰质体积、白质完整性和自发脑活动方面的差异。此外,还确定并进一步研究了与急性用药频率相关的脑区:19名CM - MOH患者、25名CM + MOH患者和19名健康对照者参加了研究。与CM - MOH患者相比,CM + MOH患者的海马旁回和枕叶中回的灰质体积明显减少,左侧扣带回束的分数各向异性(FA)也明显降低。此外,右侧丘脑的低频波动分数振幅(fALFF)值明显降低,并与急性疼痛药物的使用频率呈负相关。功能连通性分析进一步显示,右侧丘脑与额叶、扣带回中部、舌回和楔前回等区域的连通性明显增强,与急性镇痛药使用频率呈正相关:结论:与CM - MOH患者相比,MOH患者在与记忆和视觉处理相关的区域表现出独特的灰质体积减少模式,同时伴有明显的白质破坏。此外,右侧丘脑自发活动的减少以及丘脑与多个脑区之间功能连接的增强与急性用药频率密切相关。这些结果凸显了过度用药对大脑结构和功能的重大影响,揭示了偏头痛慢性化的机制。
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来源期刊
Journal of Headache and Pain
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.
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