The Rs-f Mri Study Of Different TCM Syndrome Types In Patients With Migraine Without Aura

Objective: Migraine is one of the most common primary headache,in which migraine without aura is more common.Because of its serious affects the patient's daily life,study and work,but also bring huge economic burden for the society,it has become one of the hot diseases to study in current neurology scholars.At present,the study on migraine at home and abroad mainly focuses on the pathogenesis and drug therapy.With the development of neuroimaging,a growing body of evidence suggests that migraine is a central nervous system disease.Resting-state functional magnetic resonance imaging(fMRI)with its unique advantage has been applied in migraine pathophysiological mechanism research,and found that the presence of brain dysfunction in migraine patients,showing the potential pathogenesis of migraine.As migraine pathogenesis is not fully clear,western medicine therapy are more inclined to ease the acute symptoms,but a lack of long-term therapeutic effect.Studies have shown that the traditional Chinese medicine syndrome differentiation treatment of migraine curative effect is distinct,and it can reduce the patient's attack frequency and pain degree.But the mechanism is still unclear.This study compares different TCM syndrome types of the resting brain state function in patients with migraine without aura whether there is a difference,in order to help us better understand the pathogenesis of migraine.Method: Seventeen eligible MwoA patients,including ten liver-Yang hyperactivity syndrome Mwo A patients and seven phlegm disturbing syndrome MwoA patients,and nine gendr-,age-and education-matched healthy volunteers were recruited in this study.The general data,clinical characteristics,epidemiological data and brain resting state functional magnetic resonance imaging results were collected and analyzed.The software called Data Processing Assistant for Resting-State(DPARSFA2.2)was applied to preprocess and post-process the resting state functional magnetic resonance imaging data.Regional homogeneity(ReHo)method was applied to anayze the ReHo results of the liver-Yang hyperactivity syndrome MwoA group(LYHM),the phlegm disturbing syndrome Mwo A group(PDM)and the healthy controls(HC).For the LYHM group,the PDM group and HC,a one-sample t-test was used to extract the ReHo result of each group to observe the default mode network(DMN).Then,a one-way anova analysis was performed to compare the differences among the three groups.At last,a two-sample t-test was used to compare the ReHo results 1)between LYHM and HC,2)between PDM and HC and 3)between LYHM and PDM to explore the differences between diffrent TCM syndrome types of the resting brain state function in patients with migraine without aura.Results:1 In the resting state,the three groups all showed significantly higher ReHo values in the medial prefrontal cortex(mPFC),anterior cingulate cortex(ACC),posterior cingulate cortex(PCC),precuneus,medial temporal lobe(MTL)and inferior parietal lobe(IPL),which belonged to the default mode network,than each mean value of the whole brain reegions.2 The results of the one-way anova analysis revealed that these three groups displayed not completely equal in ReHo values in the right side of the hippocampus,parahippocampal gyrus,fusiform gyrus,superior temporal gyrus(STG),temporal pole,middle temporal gyrus(MTG)and IPL,and the left side of the midbrain,anterior lobe of cerebellum,IPL,insula,middle frontal gyrus(MFG),inferior frontal gyrus(IFG)and postcentral gyrus(P < 0.05,Alphasim corrected).3 Compared to HC,the LYHM group showed significantly higher ReHo values in the right uncinate gyrus,and significantly decreases in the ReHo values in the left orbitofrontal cortex(OFC),occipital lobe,cuneus,precuneus,and right IPL,STG,supramarginal gyrus and postcentral gyrus(P < 0.05,Alphasim corrected).4 Compared to HC,the PDM group displayed significantly higher ReHo values in the right pons,MTG,parahippocampal gyrus,hippocampus,fusiform gyrus,STG,inferior temporal gyrus(ITG),temporal pole,angular gyrus,caudatum,puteman,thalamus and left midbrain regions.While the MTG,IFG,MFG,IPL,postcentral gyrus in the left side and cuneus,precuneus,postcentral gyrus in the right side showed significantly lower ReHo values(P<0.05,Alphasim corrected).5 Finally,compared with LYHM group,increased ReHo values in the hippocampus,parahippocampal gyrus,fusiform gyrus,ITG,MTG,IPL,posterior lobe of cerebellum,midbrain of right side,and posterior lobe of cerebellum and the brainstem of the left side were shown in PDM group.While,the decreased ReHo values in the MTG,MFG,IFG,insula,putamen,precentral gyrus,postcentral gyrus,IPL,cingulate cortex regions of the left side were displayed in the PDM group compared to the LYHM group.(P<0.05,Alphasim corrected)Conclusion: Our study suggest that there really has differences of the brain function in some regions in the resting state between different TCM syndrome types in Mwo A patients during intervals of the attacks,and these regions are associated with pain processing and modulation.The diffenreces may be related to two different TCM syndrome types of the phenotypic characteristics and mechanism of related MwoA patients.This finding may help us to further understanding the pathophysiology of migraine,and help us better understand migraine of traditional Chinese medicine.