| ?Background?Migraine can be comorbid with many diseases,of which depression has been most studied.The mechanism of its pathogenesis is unclear.At present,neuroimaging studies for migraine and depression have made great progress,but there is a lack of multi-modal magnetic resonance imaging studies of the comorbidity.?Objective?We aimed to explore the possible neural mechanism of migraine comorbid depression.Hope to discover stable brain imaging markers and their correlation with clinical indicators.?Methods?Multi-modal magnetic resonance images were acquired from subjects with22 migraine with depression(EMw D),22 migraine(EM),20 major depressive disorder(MDD)and 18 healthy controls(HC).(1)Voxel-based morphometry(VBM)was used to compare the volume of gray matter(GMV)in EMw D,EM,MDD and HC.(2)Tract-based spatial statistics(TBSS)was used to compare the difference of white matter integrity among EMw D,EM,MDD and HC groups(3)The differences of the local brain activity,the resting state functional connectivity(rs FC)and the brain function network indicators(including the global indicators,local indicators and functional connectivity strength)were compared by using resting state BOLD f MRI between the four groups.(4)The correlation analyses between the mean value extracted by brain regions with intergroup differences and clinical indicators was conducted to explore the relationship between brain changes and clinical symptoms in migraine with depression patients.?Results?Results of brain structure:(1)There was no significant difference in gray matter volume among EMw D,EM,MDD,HC groups.(2)Compared with EM group,mean diffusivity(MD)of EMw D was increased in the areas of the left superior and anterior corona radiata,the left and right anterior cingulate,the left anterior limb internalcapsule,the right superior corona radiata.Results of resting state brain function:(1)Compared with EM group,EMw D group exhibited higher Alff in the right cerebellar 9 and lower ALFF in the midbrain.Compared with MDD group,EMw D group exhibited higher ALFF in the right middle frontal gyrus,the left lingual gyrus and suboccipital gyrus and the right suboccipital gyrus.Compared with HC group,EMw D group exhibited higher ALFF in left lingual gyrus and the left suboccipital gyrus,lower ALFF in left precuneus,the right middle frontal gyrus.(2)The mean value of ALFF in right middle frontal gyrus,left lingual gyrus,and right superior occipital gyrus were positively correlated with HAMD and HAMA scorses.(3)There was no statistical difference in f ALFF value between the four groups.(4)Compared with EM group,the value of Re Ho in EMw D group increased in the left middle occipital gyrus and left precuneus.Compared with MDD group,EMw D group exhibited lower Re Ho in left middle and inferior temporal gyrus,higher Re Ho in the left middle temporal and right inferior temporal gyrus.Compared with HC group,Re Ho in EMw D group increased in left superior occipital gyrus,left superior lingual gyrus and right superior temporal gyrus.(5)The Re Ho of left middle occipital gyrus,right superior frontal gyrus were negatively correlated with HAMD and HAMA scores.And the left precuneus is positively correlated with HAMD score,positively correlated with HAMA score.(6)The brain regions with differences between Re Ho groups were selected as seed points.Results:(1)The left precuneus as ROI: Compared with the EM group,the functional connectivity of the left cerebellum 9 in the EMw D group was reduced.Compared with the HC group,functional connectivity of the left cerebellum 8was reduced in the MDD group;(2)The left middle occipital gyrus as ROI:Compared with the EM group,the functional connectivity of the right hippocampal was reduced in the EMw D group;Compared with the MDD group,the functional connectivity of the right superior occipital gyrus in the EMw D group was enhanced;(3)The right superior temporal gyrus as ROI: Compared with the MDD group,the functional connectivity of the right superior frontal gyrus in EMw D group was enhanced.(7)Compared with MDD group,EMw D group had lower FCS in the right medial frontal gyrus and lower FCS in right lateral angular gyrus,and EM group had lower FCS in left medial occipital gyrus compared with HC group.(8)FCS of the right angular gyrus and HAMD/HAMA scores were positively correlated.(9)There was no significant difference in 5 small world properties(clustering coefficient(CP),shortest path length(LP),standardized clustering coefficient ?,standardized shortest path length ?,small world ?)and 2 network(efficiency global efficiency(Eglob)and local efficiency(Eloc))between four groups.(10)Local index:(1)node efficiency: Compared with the EM group,EMw D group had higher node efficiency in the left dorsolateral and left caudate nucleus,and lower node efficiency in the left occipital middle gyrus.Compared with the MDD group,EMw D group had lower node efficiency in left middle occipital gyrus,the right angular gyrus and cerebellar vermis 6.Compared with HC group,the node efficiency of EMw D was higher in the DLPFC,and lower in the left middle occipital gyrus,cerebellar vermis6.(2)degree centrality: Compared with EM group,DC in left DFPFC and left caudate nucleus in EMw D group increased,while in left middle occipital cyrus,left superior marginal gyrus,right cerebellum 3 and cerebellar vermis 3 decreased.Compared with the MDD group,the EMw D group had lower DC in the left middle occipital gyrus,right angular gyrus and cerebellar vermis 6,and higher DC in the DLPFC compared with the HC group,the DC was decreased in the left middle occipital gyrus and cerebellar vermis 6.(3)node local efficiency: Compared with EM group,EMw D group had lower node local efficiency in left inferior frontal gyrus,triangular part,right lingual gyrus,left posterior central gyrus,left superior marginal gyrus,left cerebellum 9 and right cerebellum 9.In EMw D group,the node local efficiency increased in left inferior frontal gyrus,opercular part,right cune lobe and right lenticular nucleus,but decreased in left and right parahippocampal gyrus,left superior marginal gyrus,the left and right cerebellar 9 compared to MDD group.Compared with HC group,EMw D group had lower node local efficiency in left superior marginal gyrus and right cerebellum 9.(4)nodal clust coefficient: The nodal clust coefficient and the node local efficiency had the same regions.?Conclusion?(1)VBM was used to analyze the structure of gray matter,and TBSS was used to analyze the structure of white matter fibers.(2)The results of rs-f MRI suggest that migraine comorbid depression is characterized by dysfunction of frontal-parietal network,default network,visual network,and cortical-limbic system network and cerebellar network.(3)The functional changes of visual network and default network were correlated with depression and anxiety,and the decreased nodal efficiency of caudate nucleus was correlated with VAS.In this study,the neural mechanisms of depression in Migraine comorbidity were investigated using multimodality MRI.In the future,Migraine studies should consider the impact of complications as much as possible.In the clinical for accurate diagnosis of Comorbidity and more accurate treatment to provide some basis. |
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