| Objective: To observe changes in prefrontal oxyhemoglobin in patients with migraine without aura during cognitive tasks and the changes of cerebral blood flow in migraine patients in the phase of attacking and intermittment by near-infrared spectroscopy(NIRS).To study the functional changes of the prefrontal lobe in patients with migraine without aura during the phase of attacking and intermittment.Methods: The migraine without aura patients were enrolled in the neurology inpatient and outpatient of the First Affiliated Hospital of Dalian Medical Universityof the department of neurology from Jan,2017 to Oct,2018.All the patients were diagnosed according to the diagnostic criteria of the third edition of the international classification of headache diseases(ICHD-III beta)developed by IHS in 2013.The patients were performed functional near-infrared spectroscopy(functional near-infrated spectroscopy,fNIRS)examination.Patients were selected strictly in accordance with the inclusion criteria and exclusion criteria.Finally selected 14 patients with migraine without aura in the phase of attacking(3 males,11 females),16 patients with migraine without aura in the phase of intermittent(3 males,13 females)were selected,meanwhile,14 volunteers(3males and 11 females)matched patient group with the age,sex and years of education.Then we analyzed the general patient data(gender,age,years of education,age of onset,hand,abuse),visual analogue scale(VAS),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Montreal Cognitive Assessment Scale(MOCA).In this study,a 52-channel near-infrared imager was used to observe changes in the oxyhemoglobin concentration in the prefrontal cortex when the patient performing the Verbal Fluency Task(VFT).The parameters analyzed included the mean oxyhemoglobin concentration(mean),the reaction peak(max),the peak time(max-time),the integral value,the center of gravity value,and the initial activation during the task.All data were statistically analyzed by SPSS20.0 statistical software.Results:1.A total of 30 migraine patients met the inclusion criteria,including 14 patients in the phase of attacking,16 patients in the phase of intermittent,and 14 healthy controls.The three groups were compared between the two groups.General data including age,gender,years of education,course of disease,HADA,HAMA,MOCA and the number of the words were not statistically different.2.The 11 channels of prefrontal lobe were selected as the whole as the region of interest ROIA,and find out:(1)There was no statistical difference between the parameters of the the phase of attacking and the phase of intermittent;(2)Compared with the control group,the peak value of the reaction,the center of gravity,and the initial activation of the phase of attacking were decreased,there was a statistical difference between the two groups;(3)Compared with the control group,the initial activation of the phase of intermittent was decreased,and there was a statistical difference between the two groups.3.We defined 11 channels of prefrontal lobe as ROI(1-11)area,and compared the two groups to find:(1)Comparison between the two groups in the phase of attacking and the phase of intermittent of migraine,the center of gravity of channel 4 and the peak time,the center of gravity value,the initial activation of channel 8 have statistical differences;(2)Comparison between the two groups in the phase of attacking and the control group,the response peak,the peak time,the center of gravity value,the initial activation of channel 1,the reaction peak of the channel 2,the reaction peak,the integral value,the center of gravity value of channel 3,the response peak,the initial activation of the channel 7,the average oxyhemoglobin concentration,the reaction peak,the peak time,the center of gravity value,the initial activation of the channel 8,the reaction peak of the channel 10,the initial activation of the channel 11 have statistical differences;(3)Comparison between the two groups in the phase of intermittent of migraine and the control group,the average oxyhemoglobin concentration,the reaction peak,the integral value,the center of gravity value,the initial activation of the channel 1,the reaction peaks of the channel 5,6,8,10 have statistical differences.Conclusion:1.Neuronal activity reduced when performing cognitive tasks in patients with migraine without aura.2.In the patients with migraine without aura,extensive prefrontal neuron activity reduced during the the phase of attacking,and the phase of intermittent mainly reduced in right prefrontal neuron activity.3.The peak response and the initial activation of f NIRS during VFT can be used as a biomarker to evaluate impaired cognitive function in migraine without aura.4.fNIRS can be used as a tool to assess early cognitive changes in patients with migraine without aura. |
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