{"title":"偏头痛患者血管周围间隙增大:一项基于3T MRI的病例对照研究","authors":"Ziyu Yuan, Wei Li, Hefei Tang, Yanliang Mei, Dong Qiu, Min Zhang, Qian Sun, Wei Wang, Peng Zhang, Zhaochao Ma, Xueyan Zhang, Yaqing Zhang, Yonggang Wang, Xueying Yu","doi":"10.1002/acn3.51798","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To explore whether MRI-visible enlarged perivascular spaces (EPVS) are associated with migraine and may serve as a predictor of migraine. Then further explore its correlation with migraine chronification.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 231 participants (healthy control [HC] = 57, episodic migraine [EM] = 59, chronic migraine [CM] = 115) were included in this case–control study. A 3T MRI device and the validated visual rating scale were used to assess the grades of EPVS in centrum semiovale (CSO), midbrain (MB), and basal ganglia (BG). Comparisons between the two groups were made using the chi-square or Fisher's exact tests to initially determine whether high-grade EPVS were associated with migraine and migraine chronification. A multivariate logistic regression model was constructed to further investigate the role of high-grade EPVS in migraine.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The prevalence of high-grade EPVS in CSO and MB were significantly higher in patients with migraine than in HCs (CSO: 64.94% vs. 42.11%, <i>P</i> = 0.002; MB: 55.75% vs. 29.82%, <i>P</i> = 0.001). Subgroup analysis showed no statistical difference between patients with EM and CM (CSO: 69.94% vs. 62.61%, <i>P</i> = 0.368; MB: 50.85% vs. 58.26%, <i>P</i> = 0.351). Individuals with high-grade EPVS in CSO (odds ratio [OR]: 2.324; 95% confidence interval [CI]: 1.136–4.754; <i>P</i> = 0.021) and MB (OR: 3.261; 95% CI: 1.534–6.935; <i>P</i> = 0.002) were more likely to suffer from migraine.</p>\n </section>\n \n <section>\n \n <h3> Interpretation</h3>\n \n <p>This case–control study showed that high-grade EPVS in CSO and MB in clinical practice with the underlying mechanism of dysfunction of the glymphatic system could be a predictor of migraine, but no significant correlation had been found with migraine chronification.</p>\n </section>\n </div>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":"10 7","pages":"1160-1169"},"PeriodicalIF":4.4000,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acn3.51798","citationCount":"0","resultStr":"{\"title\":\"Enlarged perivascular spaces in patients with migraine: a case–control study based on 3T MRI\",\"authors\":\"Ziyu Yuan, Wei Li, Hefei Tang, Yanliang Mei, Dong Qiu, Min Zhang, Qian Sun, Wei Wang, Peng Zhang, Zhaochao Ma, Xueyan Zhang, Yaqing Zhang, Yonggang Wang, Xueying Yu\",\"doi\":\"10.1002/acn3.51798\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To explore whether MRI-visible enlarged perivascular spaces (EPVS) are associated with migraine and may serve as a predictor of migraine. 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引用次数: 0
摘要
目的探讨mri可见的血管周围间隙增大(EPVS)是否与偏头痛相关，并可作为偏头痛的预测指标。然后进一步探讨其与偏头痛慢性化的相关性。方法本研究共纳入231例患者，其中健康对照[HC] = 57例，发作性偏头痛[EM] = 59例，慢性偏头痛[CM] = 115例。采用3T MRI设备和经验证的视觉评定量表评估半椎体(CSO)、中脑(MB)和基底节区(BG) EPVS的分级。两组之间的比较使用卡方检验或Fisher精确检验来初步确定高级别EPVS是否与偏头痛和偏头痛慢性化相关。建立多元logistic回归模型，进一步探讨高分级EPVS在偏头痛中的作用。结果偏头痛患者中重度EPVS在CSO和MB组的发生率明显高于hc组(CSO: 64.94% vs. 42.11%， P = 0.002;MB: 55.75% vs. 29.82%， P = 0.001)。亚组分析显示EM与CM患者间差异无统计学意义(CSO: 69.94% vs. 62.61%， P = 0.368;MB: 50.85% vs. 58.26%， P = 0.351)。CSO高级别EPVS个体(优势比[OR]: 2.324;95%置信区间[CI]: 1.136-4.754;P = 0.021)和MB (OR: 3.261;95% ci: 1.534-6.935;P = 0.002)更容易患偏头痛。本病例对照研究表明，临床实践中CSO和MB的高级别EPVS与淋巴系统功能障碍的潜在机制可能是偏头痛的预测因子，但未发现与偏头痛的慢性化有显著相关性。
Enlarged perivascular spaces in patients with migraine: a case–control study based on 3T MRI
Objective
To explore whether MRI-visible enlarged perivascular spaces (EPVS) are associated with migraine and may serve as a predictor of migraine. Then further explore its correlation with migraine chronification.
Methods
A total of 231 participants (healthy control [HC] = 57, episodic migraine [EM] = 59, chronic migraine [CM] = 115) were included in this case–control study. A 3T MRI device and the validated visual rating scale were used to assess the grades of EPVS in centrum semiovale (CSO), midbrain (MB), and basal ganglia (BG). Comparisons between the two groups were made using the chi-square or Fisher's exact tests to initially determine whether high-grade EPVS were associated with migraine and migraine chronification. A multivariate logistic regression model was constructed to further investigate the role of high-grade EPVS in migraine.
Results
The prevalence of high-grade EPVS in CSO and MB were significantly higher in patients with migraine than in HCs (CSO: 64.94% vs. 42.11%, P = 0.002; MB: 55.75% vs. 29.82%, P = 0.001). Subgroup analysis showed no statistical difference between patients with EM and CM (CSO: 69.94% vs. 62.61%, P = 0.368; MB: 50.85% vs. 58.26%, P = 0.351). Individuals with high-grade EPVS in CSO (odds ratio [OR]: 2.324; 95% confidence interval [CI]: 1.136–4.754; P = 0.021) and MB (OR: 3.261; 95% CI: 1.534–6.935; P = 0.002) were more likely to suffer from migraine.
Interpretation
This case–control study showed that high-grade EPVS in CSO and MB in clinical practice with the underlying mechanism of dysfunction of the glymphatic system could be a predictor of migraine, but no significant correlation had been found with migraine chronification.
期刊介绍：
Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.
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