Adrian Scutelnic, Tomas Klail, Diego Moor, Nedelina Slavova, Valentina Petroulia, Simon Jung, Mattia Branca, Urs Fischer, Franz Riederer, Roland Wiest, Christoph J Schankin
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引用次数: 0
摘要
背景：MRI敏感性加权成像（SWI）显示的皮质静脉不对称可能是偏头痛先兆和皮质扩张性抑制（CSD）的生物标志物。这项研究的目的是评估人类是否可以在没有先兆的偏头痛发作患者中发现SWI不对称。方法：我们纳入了来自急诊室的患者（每组n = 100），当他们(i)出现急性神经功能障碍或头痛；（ii）有偏头痛先兆、无先兆偏头痛或两者均无的出院诊断（没有中风或癫痫的对照组）；（iii）在急性情况下进行SWI脑MRI。结果：与无先兆偏头痛患者（3%,[95% CI 1-8], p < 0.001）和对照组（7% [95% CI 3-14], p < 0.001）相比，有先兆偏头痛组的SWI不对称发生率为26% （95% CI 18-35）。无先兆偏头痛患者与对照组之间无差异（p = 0.19）。结论：伴有和不伴有先兆的偏头痛患者SWI的明显变化提示CSD可能与无先兆偏头痛的病理生理无关。
Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case-Control Study.
Background: The asymmetry of cortical veins in susceptibility weighted imaging (SWI) in MRI might be a biomarker for migraine auras and cortical spreading depression (CSD). The aim of this study was to assess in humans if SWI asymmetry can be found in patients who have migraine attacks without auras.
Methods: We included patients (n = 100 per group) from the emergency room setting when they (i) presented with an acute neurological deficit or headache; (ii) had a discharge diagnosis of a migraine aura, a migraine without an aura, or neither (controls without stroke or epilepsy); and (iii) had a brain MRI with SWI in the acute setting.
Results: In the migraines with auras group, SWI asymmetry was found in 26% (95% CI 18-35) compared to patients with migraines without auras (3%, [95% CI 1-8], p < 0.001) and controls 7% [95% CI 3-14], p < 0.001). There was no difference between patients with migraines without auras and controls (p = 0.19).
Conclusions: The distinct SWI changes in migraines with and without auras suggest that CSD might not be involved in the pathophysiology of migraines without auras.
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