偏头痛患者静息态功能磁共振自发脑活动改变的Meta分析

Altered spontaneous brain activity in migraine patients:Meta-analysis of resting-state fMRI

目的通过Meta分析了解偏头痛患者的静息态功能磁共振成像(rs-f MRI)自发性脑活动改变的特点。方法检索Pub Med、Science Direct、EBSCO Host Medline、Web of Knowledge、Ovid(AMED)、Embase、Cochrane Library、中国生物医学文献数据库(CBMdise)、中国知网、万方数据库和维普中文科技期刊数据库中已收录的有关rs-f MRI研究偏头痛患者自发性脑活动改变的文献,并进行文献筛选及资料提取。采用SDM软件对纳入研究的低频振幅(ALFF)值进行基于体素的Meta分析(P≤0.005,阈值范围>10)。结果共有7项研究符合纳入标准,包括191例偏头痛患者和166例正常对照者,各项研究间无异质性(P>0.05)。Meta分析结果显示,与正常对照组对比,偏头痛患者双侧岛叶(BA48)、左侧丘脑腹前核ALFF值增高,胼胝体、左侧额下回(含部分眶回)(BA47)、右侧枕中回(BA19)、左侧顶下小叶(除外缘上回、角回)(BA40)ALFF值减低。结论偏头痛患者在静息状态下存在自发的脑活动改变。双侧岛叶、左侧丘脑腹前核、左侧额下回(含部分眶回)、左侧顶下小叶(除外缘上回、角回)的自发脑活动改变可能是偏头痛发作的重要机制,右侧枕中回的自发性脑活动改变为进一步阐明静息性CSD假说提供了依据。

Objective To explore the characteristic of altered spontaneous brain activity in migraine patients using meta-analysis of resting-state f MRI studies. Method The included literatures of resting-state f MRI study for migraine patients with altered spontaneous brain activity were searched in Pubmed, Science Direct, EBSCO host medline, web of knowledge, Ovid（AMED）, Embase, Cochrane Library, CBMdisc, CNKI, Wanfang, CQVIP databases. After literature screening and data extraction, signed differential mapping（SDM） software was used for voxel based pooled meta—analysis（P≤0.005, extent threshold〉10） involving amplitude of low-frequency fluctuations（ALFF）. Result Seven articles met the standard, including 191 migraine patients and 166 healthy controls. The heterogeneity differences between the seven studies was not statistically significant（P〉0.05）. Meta-analysis showed ALFF increased in migraine patients compared with healthy controls, it was mainly distributed in bilateral insula, left anterior thalamic projections. While ALFF decreased in migraine patients＇ corpus callosum, left inferior frontal gyrus（including orbital part）, right middle occipital gyrus, left inferior parietal（excluding supramarginal and angular） gyri. Conclusion Migraine patients have abnormal altered brain activityes in resting-state. The changes of spontaneous brain activity in bilateral insula, left anterior thalamic projections, left inferior frontal gyrus（including orbital part） and left inferior parietal（excluding supramarginal and angular） gyri may be involved in pain of important pathogenesis during migraine attack, the change of brain activity in right middle occipital gyrus may provide some evidence to further research work in resting-state cortical spreading depression（CSD） hypothesis.