无先兆偏头痛患者脑白质弥散张量成像TBSS分析

Diffusion tensor imaging in patients with migraine without aura:An analysis using tract-based spatial statistics

目的采用DTI及基于纤维束追踪空间统计分析(TBSS)观察无先兆偏头痛患者脑白质变化。方法对性别、年龄相匹配的25例无先兆性偏头痛患者(患者组)及25名健康志愿者(对照组)行DTI检查,采用TBSS分析所有受试者脑白质纤维DTI各相关参数,包括FA、轴向弥散系数(AD)、平行弥散系数(RD)和平均弥散系数(MD),比较两组DTI各参数的差异。结果与对照组比较,患者组脑白质纤维束参量值的改变以右侧半球为主,其中双侧大脑脚、双侧内囊后肢、右侧内囊前肢、胼胝体体部及压部、右侧上放射冠、右侧后放射冠、左侧扣带、右侧上纵束的FA值显著降低(P均<0.05,FWE校正);右侧大脑脚、右侧内囊后肢、右侧内囊前肢、右侧内囊豆状核后肢、胼胝体膝部、体部及压部、双侧上放射冠、双侧后放射冠、双侧丘脑后辐射、双侧扣带、双侧上纵束的RD值显著升高(P均<0.05,FWE校正);胼胝体体部及压部、右侧上放射冠、右侧后放射冠、右侧上纵束的MD值显著增高(P均<0.05,FWE校正);两组各脑区AD值差异均无统计学意义(P均>0.05,FWE校正)。结论无先兆偏头痛患者脑白质纤维存在改变,以髓鞘脱失或完整性破坏为主。

Objective To analyze the changes of white matter （WM） in migraine patients without aura with DTI and tract-based spatial statistics （TBSS）. Methods DTI was carried out in 25 migraine patients without aura （migraine with- out aura group） and 25 healthy volunteers （control group） with matched age and sex. DTI parameters of WM, including fractional anisotropy （FA）, axial diffusivity （AD）, radial diffusivity （RD） and mean diffusivity （MD） were compared between the two groups with TBSS. Results The changes of DTI parameters in migraine without aura group were found mainly in right cerebral hemisphere. FA decreased in cerebral peduncle （CP）, posterior limb of internal capsule （PLIC）, right anterior limb of internal capsule （ALIC）, body of corpus callosum （BCC）, splenium of corpus callosum （SCC）, right superior corona radiate （SCR） and posterior corona radiate （PCR）, left cingulum, right superior longitudinal fasc-iculus （LSF）, while increased RD values mainly located not only in regions mentioned above but also in bilateral posterior thalamie radiation （PTR）, left LSF and right retrolenticular part of IC （all P〈0.05, FEW correction）. On MD maps, the increase was only found in BCC, SCC, right SCR, PCR and right LSF （all P〈0. 05, FEW correction）. On AD maps, the difference of AD in every regions were not significant between the two groups （all P〈0. 05, FEW correction）. Conclusion The changes of WM microstructures were found in patients of migraine without aura, which might reflect the deficit or degeneration of myelination.