| Background and ObjectiveMigraine is a common headache in clinic.It is the most common neurological disease in adults.Its incidence is about 12%.In foreign countries,the age of the disease is more than 25~45 years old.China is 20~45 years old.The ratio of women to men and women was 1:2 to 3,and China was 1:4.Recurrent episodes of headache are the main clinical manifestations,often accompanied by autonomic nervous dysfunction.It is related to the sensitivity to certain stimuli or the periodic changes of the central nervous system with hereditary or congenital neurovascular responses.Some specific conditions such as menstrual cycle,lack of sleep,excessive or irregular,excessive pressure,pressure relief(weekends,holidays begin),certain foods(such as cheese,fermented wine,containing glutamic acid substances),sensory stimulation(light,flash,strong smell or noise)and anxiety factors may induce migraine.Because of the migraine attack,the patient can not live a normal life,learning and work and so on,so it has a great influence on the individual and the society.The WHO has set a serious migraine as one of the most likely to reduce the ability to work.In the 2010global disease survey,migraine ranked third in the epidemic spectrum,and ranked seventh in disabling diseases.It is generally believed that migraine has no other positive signs and imaging changes except for long-term recurrent attacks.However,with the continuous improvement of medical imaging technology,especially the popularity of MRI,the recurrent episodes of migraine have led to more and more reports of imaging changes.For example,cerebral white matter lesion,enlarged perivascular space,infarct like brain injury.The perivascular spaces also known as the space of Virchow-Robin is brain perforating vessels into the brain parenchyma from the subarachnoid space,near the pial invagination surrounding small vessels(not including capillaries)between the gap formed between the two layers of the pia mater.The perivascular space,as an immune gap,is located in the microglia and participates in the local immune modulatory function.In recent years,the perivascular space has been the focus of people’s research.With the development and clinical application of MRI and other imaging techniques,many studies have reported that there are correlations between perivascular spaces,dilated perivascular spaces and dilated vascular spaces.There are a small number of reports abroad that migraine may be associated with VRS,but there is also an objection to it.In this study,magnetic resonance imaging(MRI)was used to observe the imaging findings of 50 migraine patients and 50 healthy subjects,and to analyze the distribution characteristics of Virchow-Robin spaces(VRS)in migraine patients and study the effects of the duration of the disease,the frequency of occurrence and the with or without of aura on the number of VRS in order to provide imaging support for migraine diagnosis.Materials and MethodsFifty cases of migraine patients were enrolled as migraine group and 50 cases healthy people as control group in Jan 2013 to Dec 2016 from Department of Neurology,the Second Affiliated Hospital of Zhengzhou University.The number of perivascular spaces in the fronto-parietal subcortical white matter,semioval central,and basal ganglia areas was calculated and compared between groups and within the group by performing a MRI scan of the same sequence,further research on the impact of the history of migraine patients,the attack frequency and the with or without of aura on the number of VRS.Results(1)The perivascular spaces in migraine group found in 48 cases accounting for96%were significantly higher than the control group(41 cases),accounting for 82%,the difference was statistically significant(χ~2=5.00,P<0.05).(2)In the migraine group,the sum of the number of perivascular spaces 13.00(6.75,20.00)was significantly higher than that of the control group 8.00(5.00,12.00)(Z=3.33,P<0.01).In the migraine group the VRS numbers in the fronto-parietal subcortical white matter,semioval central and basal ganglia areas were6.00(4.00,12.00),2.00(0.00,4.00)and 4.00(2.00,6.00)respectively,while the numbers of VRS in the same areas of the control group were 0.00(0.00,2.00),2.00(0.75,4.00)and 4.00(3.50,6.00).The total number of perivascular space of two sets was significantly different between the two groups(χ~2=39.86,P<0.01;χ~2=40.15,P<0.01).In the migraine group,the perivascular space was mainly located in fronto-parietal subcortical white matter,the control group perivascular space was mainly distributed in the basal ganglia.(3)The total number of VRS in the migraine with aura group was 20.00(14.50,26.00)than that in the migraine without aura group 11.00(6.00,20.00)(t=2.52,P=0.02),the numbers of VRS in the fronto-parietal subcortical white matter,semioval central and basal ganglia areas of the migraine with aura group were 12.00(9.00,14.00),2.00(2.00,6.00)and 4.00(2.50,7.50)respectively;the numbers of VRS in the same areas of the migraine without aura group were 6.00(4.00,10.00),1.00(0.00,4.00)and 4.00(2.00,6.00),and the number of VRS in the two groups was different statistical significance(χ~2=16.31,P<0.01;χ~2=29.48,P<0.01).(4)There were statistically significant differences in the number of VRS among MO patients with different duration and frequency of episodes.Conclusions(1)The incidence rate of perivascular space in migraineur is high,and mainly distributed in the fronto-parietal subcortical white matter,which may provide an imaging assistant basis for the diagnosis of migraine.(2)Migraine with aura is more prone to VRS than those without aura migraine.(3)Disease course,the frequency of the occurrence of VRS have a certain impact. |
PDF Full Text Request