Atrophy of hypothalamic subregions increases migraine risk: cross-sectional study and mendelian randomization analysis.

IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY
Zhonghua Xiong, Lei Zhao, Geyu Liu, Dong Qiu, Yanliang Mei, Xiaoshuang Li, Zhi Guo, Peng Zhang, Mantian Zhang, Tianshuang Gao, Jinju Sun, Xin Liu, Yonggang Wang
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引用次数: 0

Abstract

Background: The hypothalamus is a versatile structure comprising several nuclei that play key roles in regulating various biological processes associated with migraine, including hormone secretion, metabolism, circadian rhythm, and autonomic nervous system functions. However, the involvement of hypothalamic subregions in migraine remains unclear.

Methods: Based on T1-weighted MRI data from 76 migraine patients (23 episodic migraine [EM], 53 chronic migraine [CM]) and 35 healthy controls (HCs), we examined group differences in the volume of five hypothalamic subregions. To clarify causal relationships between migraine and hypothalamic volume, we conducted Mendelian randomization (MR) analyses. Mediation analysis was further performed to assess the role of gut microbiota composition in this association.

Results: Compared to HCs, migraine patients exhibited significantly reduced total hypothalamic volume (813.53 ± 66.46 mm³ vs. 831.86 ± 57.91 mm³; FDR q = 0.048) and inferior tuberal hypothalamic volume (255.26 ± 30.17 mm³ vs. 265.29 ± 23.32 mm³; FDR q = 0.046). These reductions were particularly pronounced in patients with CM, whereas no significant differences were observed in those with EM. MR analysis revealed causal effects of total hypothalamic volumes (OR = 0.80, FDR q = 7.28 × 10-5) and inferior tuberal hypothalamic volumes (OR = 0.85, FDR q = 2.61 × 10-2) on migraine, providing causal evidence to support the observational findings from the cross-sectional study. Furthermore, specific gut microbiome (genus DefluviitaleaceaeUCG011, genus Eubacteriumruminantiumgroup, and family FamilyXIII) were identified as partial mediators of the hypothalamus-migraine link (FDR q < 0.05).

Conclusions: This study suggests that atrophy of the inferior tuberal subregion of the hypothalamus plays a pivotal role in increasing migraine risk, and that this effect is partially mediated through alterations in gut microbiome composition.

下丘脑亚区萎缩增加偏头痛风险:横断面研究和孟德尔随机化分析。
背景:下丘脑是一个多功能结构,由几个核组成,在调节与偏头痛相关的各种生物过程中起关键作用,包括激素分泌、代谢、昼夜节律和自主神经系统功能。然而,下丘脑亚区在偏头痛中的作用尚不清楚。方法:基于76例偏头痛患者(23例发作性偏头痛[EM], 53例慢性偏头痛[CM])和35例健康对照(hc)的t1加权MRI数据,研究下丘脑5个亚区体积的组间差异。为了阐明偏头痛和下丘脑体积之间的因果关系,我们进行了孟德尔随机化(MR)分析。进一步进行中介分析以评估肠道菌群组成在这种关联中的作用。结果:与hc相比,偏头痛患者下丘脑总体积明显减少(813.53±66.46 mm³vs. 831.86±57.91 mm³;FDR q = 0.048)、下丘脑结节下容积(255.26±30.17 mm³vs. 265.29±23.32 mm³;FDR q = 0.046)。这些减少在CM患者中尤为明显,而在EM患者中没有观察到显著差异。MR分析显示,下丘脑总体积(OR = 0.80, FDR q = 7.28 × 10-5)和下结节下丘脑体积(OR = 0.85, FDR q = 2.61 × 10-2)对偏头痛有因果关系,为横断面研究的观察结果提供了因果证据。此外,特定的肠道微生物群(DefluviitaleaceaeUCG011属,Eubacteriumruminantiumgroup属和FamilyXIII家族)被确定为下丘脑-偏头痛联系的部分介质(FDR q)。结论:本研究表明,下丘脑下结核亚区萎缩在增加偏头痛风险中起关键作用,并且这种作用部分通过肠道微生物群组成的改变来介导。
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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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