| Objective:The first part aim of the study was to compare the characteristics of headache and accompanyingsymptomsduring headache attackin migraine patients stratified by attack frequency;The second part aims to examine resting-state abnormalities in migraine cases without aura(MWoA)withfunctional magnetic resonace,who were stratified byattack frequency.Method:334 migraine patients were collected and divided into three subgroups by attack frequency:Infrequent episodic migraine group(IEM,Headache attacks were less than 2 days per month),Frequent episodic migraine group(FEM,Headache attacks were 3-14 days per month)and chronic migraine group(CM,Headache attacks were 15 or more days per month formore than 3 months,which have the features of migraineheadache on at least 8 days per month.)Collected the clinic data,and compared the following data:headache symptoms characteristics:unilateral headache,throbbing inquality,aggravated bydaily actives and taking painkillers;accompanying symptoms:nausea,vomiting,photophobia,phonophobia,osmophobia and allodynia;The quality of life respectively through the extensive anxiety scale(Generalized Anxiety Disorder Scale,GAD-7)score,PHQ-9 depression self-assessment scale,Athens Insomnia Scale-AIS assessment,and Migraine disability assessment scale(MIDAS)Joint assessment.Then fifty-six eligible MWoA patients who was selected by the group and 32 matched healthy volunteers were included in this study.MWoA patients were divided into three groups according to the attack frequency per month within 3months:infrequentepisodic migraine group,frequent episodic migraine group and chronic migraine group.Data collection and rest-fMRI examination were performed in all cases.The ReHo method was used to analyze the blood oxygen level dependent(BLOD)signals of the adjacent voxels in the brain of each patient,and the consistency of their fluctuations in the same time series.Results:1.The result of characteristics of headache and accompanying symptoms in different groupsTherewere no significant differences in headache symptoms and accompanying symptoms between IEM group and EM group(P>0.05).Compared with IEM and FEM group,the proportion of patients with pulsatile quality and aggravation by daily activitieswas decreased in CM group(P<0.05);and there was no significant difference in nausea,vomiting and phonophobiabetween CM and EMgroups(P>0.05);the rates of photophobia,olfactory and allodynia were increasedsignificantlyin CM group(P<0.05);there was no significant difference indepression and sleep disorder scores between IEM group and FEMgroup(P>0.05),but the difference in anxiety and headache disabilitywas marked between CM group and EM group.Compared with FEM group and IEM group,all the scores of quality of life were significantly increased in CM group(P<0.01 for all).2.The result of brain regions with increased functional connectivity of bilateral amygdala in different groupsThe functional regions' changes in infrequent group focus on the coding,conduction and regulation of pain signals.Withincreasing of headache frequency,the functional regions changes in the frequent group focus on the pain regulation,emotion cognition and correlation ofpain.Functional regions' changes in chronic migraine focus on spatial attention and cognition,affective disorders,pain feedback,which may be associated with migraine production,development and chronification.Conclusions:1.There was no significant difference in headache symptoms and accompanying symptoms between FEM and IEM;Compared with IEM and FEM groups,Headache symptoms are less typical in CM group,but anxiety,depression,sleep disorder and disabilitywere more serious,and photophobia,osmophobia and abnormal pain are more common.2.The functional regions' changes in infrequent group focus on the coding,conduction and regulation of pain signals.Withincreasing of headache frequency,the functional regions changes in the frequent group focus on the pain regulation,emotion cognition and correlation ofpain.Functional regions' changes in chronic migraine focus on spatial attention and cognition,affective disorders,pain feedback,which may be associated with migraine production,development and chronification. |
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