偏头痛患者基于体素形态学与功能连接分析

Analysis of voxel-based morphometry and functional connectivity in migraine patients

目的 探讨偏头痛患者脑结构、脑功能、认知和情绪的变化情况。方法 采集33例偏头痛患者(偏头痛组)及27例相匹配的健康对照者(健康对照组)的高分辨T结构相及静息态功能相数据,利用基于体素的形态学(VBM)方法分析偏头痛患者大脑灰质体积变化,继而利用静息态功能连接分析技术分析有结构变化的脑区与大脑其他区域功能连接的差异,结果采用GRF校正(体素水平P<0.001,簇水平P<0.05)。采用蒙特利尔认知评估量表(MoCA)及情绪量表[焦虑自评表(SAS)及抑郁自评量表(SDS)]评估偏头痛患者认知功能及焦虑、抑郁水平。分析偏头痛患者脑灰质体积变化与临床变量及量表评分的相关关系。结果 与健康对照组比较,偏头痛组SAS、SDS评分显著升高,MoCA评分显著降低(均P<0.05)。与健康对照组比较,偏头痛组左侧枕中回及左侧距状裂周围皮质灰质体积显著增大(GRF校正,体素水平P<0.001,簇水平P<0.05),偏头痛组左侧枕中回与多个脑区功能连接减弱,包括双侧脑岛、双侧颞上回、右侧缘上回、右侧中央后回、右侧额下回等脑区(GRF校正,体素水平P<0.001,簇水平P<0.05)。偏头痛组与健康对照组相比左侧距状裂周围皮质与全脑其他区域功能连接差异无统计学意义(GRF校正,体素水平P>0.001,簇水平P>0.05)。偏头痛组两个差异脑区的灰质体积值与病程、发作频率、头痛评分、MoCA评分、SAS评分及SDS评分均无相关性(均P>0.05)。结论 偏头痛患者认知功能轻度下降,且伴有焦虑、抑郁倾向。偏头痛发作对患者脑部灰质体积和功能连接都造成了影响,灰质体积变化主要集中于左侧枕叶(包括左侧枕中回及左侧距状裂周围皮质),而左侧枕中回与多个脑区的功能连接减弱。

Objective To investigate the changes in the brain structure,brain function,cognition and mood of migraine patients.Methods The high-resolution Tstructural image data and resting-state functional image data were collected for 33 migraine patients(migraine group) and 27 matched healthy controls(healthy control group).Using voxel-based morphology(VBM) method to analyze the changes in brain gray matter volume of migraine patients.Then the resting-state functional connectivity analysis was used to analyze the functional connectivity differences between the structurally changed brain areas and other brain regions.The results were corrected by GRF(voxel-level P<0.001,cluster level P<0.05).The cognitive assessment scale(MoCA) and the psychology assessment scale [self-rating anxiety scale(SAS) and self-rating depression scale(SDS)] were adopted to evaluate the cognitive function,the anxiety and depression levels of migraine patients.The correlations of clinical variables and scales scores with the changed brain gray matter volume in migraine patients were analyzed.Results Compared with those in the healthy control group,the SAS score and SDS score in the migraine group were significantly higher,and the MoCA score in the migraine group was significantly lower(all P<0.05).Compared with those in the healthy control group,the gray matter volume of the left middle occipital gyrus and the left calcarine in the migraine group were significantly larger(GRF correction,voxel-level P<0.001,cluster level P<0.05),and the left middle occipital gyrus had reduced functional connectivity with several brain regions in migraine group,including the bilateral insula,bilateral superior temporal gyrus,right supramarginal gyrus,right postcentral gyrus,right inferior frontal gyrus(GRF correction,voxel-level P<0.001,cluster level P<0.05).There was no significant difference in the functional connectivity of the left calcarine with other brain regions between the migraine group and the healthy control group(GRF correction,voxel-level P>0.001,cluster level P>0.05).In the migraine group,there were no correlations of the changed brain gray matter with disease duration,frequency,headache score,MoCA score,SAS score and SDS score( all P > 0.05).Conclusions The cognitive function of migraine patients is slightly decreased,and the migraine patients tend to combine with anxiety and depression.Migraine attacks have effects both on the gray matter volume and functional connectivity in patients,the brain regions with changed brain gray matter are mainly concentrated in the left occipital lobe( the left middle occipital gyrus and the left calcarine),and the left middle occipital gyrus has changed functional connectivity with multiple brain regions.