偏头痛并发抑郁/焦虑障碍患者胼胝体磁共振弥散张量成像分析

Analysis of the diffusion tensor magnetic resonance imaging of corpus callosum in patients with migraine complicated with depressive/anxious disorder

目的对偏头痛并发抑郁/焦虑障碍患者胼胝体磁共振弥散张量成像(DT-MRI)进行分析,观察其神经纤维微细结构。方法单纯无先兆性偏头痛患者24例(单纯组),无先兆性偏头痛并抑郁/焦虑障碍患者24例(并发组),同期健康体检者24例(对照组),三组均进行DT-MRI检查,测取胼胝体膝部、体部及压部部分各向异性值(FA值)和表观弥散系数值(ADC值)。结果与对照组比较,单纯组、并发组胼胝体各部FA值均降低(P均<0.01);与单纯组比较,并发组胼胝体各部FA值均降低(P均<0.01)。相关性分析显示,并发组患者病程与胼胝体膝部、体部FA值呈负相关(r=-0.415、-0.336,P=0.003、0.020);近6个月头痛频率与胼胝体各部位FA值呈负相关(r分别为-0.644、-0.553、-0.327,P分别为0.000、0.000、0.023);HAM-A评分与胼胝体各部FA值呈负相关(r分别为-0.839、-0.826、-0.695,P分别为0.000、0.000、0.000);HAM-D评分与胼胝体各部FA值呈负相关(r分别为-0.837、-0.826、-0.685,P分别为0.000、0.000、0.000)。结论偏头痛并发抑郁/焦虑障碍患者胼胝体神经纤维微细结构的完整性受损害,这种损害可能是偏头痛患者并发抑郁/焦虑障碍的神经解剖学基础。

Objective To analyze the diffusion tensor magnetic resonance imaging（DT-MRI） of corpus callosum （CC） in patients with migraine complicated with depressive/anxious disorder and to observe the possible nficrostructural abnormali- ties of CC. Methods DT-MRI was carried out in 24 adult patients with migraine without aura （the simple group）, 24 with migraine without aura complicated with depressive/anxious disorder （the complicated group）, and 24 age- and sex- matched healthy controls （the control group）. Fractional anisotropy （FA） and apparent diffusion coefficient （ADC） were measured at genu, body, and splenium of the CC, respectively. Results There were significant differences in the FA values at the ge- nu, body, and splenium of the CC among the three groups. The FA values both in the simple group and complicated group were significantly lower than the control group （ all P 〈 0. O1 ） ; compared with the simple group, the FA values in the compli- cated group were significantly lower （p 〈 0. 01 ）. Correlation analysis showed that there were negative correlations between disease course and the FA values of genu and body of the CC in the complicated group （r = -0. 415, -0.336 ;P = 0. 003, 0.020）. Six-month headache frequency was negatively correlated with the FA values at all locations of the CC （r = -0. 644, -0. 553, and -0.327; P =0.000, 0.000 and 0.023, respectively）. Negative correlations were also found between FA val- ues at all locations of the CC and Hamilton anxiety scores （r = - 0. 839, - 0. 826, - 0.695 ; P = 0. 000, 0＂ 000, 0.000, re- spectively） and Hamilton depression scores （r = - 0.837, - 0. 826, - 0. 685 ; P = 0. 000, 0.000, 0.000, respectively）. Conclusion There is an integrity change of neurofibrotic microstructures existing as a possible neuroanatomical basis in the CC of migraine patients complicated with depressive/anxious disorder.