A Study On The Correlation Between Brainstem Raphe Echogenicity Alterations And Depression In Patients With Migraine

Background: Transcranial sonography(TCS)is a promising and non-invasive neuroimaging technique for detecting small deep brain parenchyma.Sonographic hypoechogenicity of brainstem raphe(BR)has been depicted in patients with major depression(MD)and depressed patients with different neurodegenerative disease such as PD and Huntington disease.But,up to date,the association of BR echogenicity alterations in TCS with depression in migraineurs has never been reported.This study was to investigate the possible role of BR examination via TCS in migraineurs with depression.Methods: 42 migraine without aura(Mwo A)patients and 40 healthy controls were recruited.TCS was performed by an experienced sonographer.Echogenicity of lentiform nuclei(LN),caudate nuclei(CN),substantia nigra(SN),brainstem raphe(BR)and width of the third ventricle and the frontal horns of the lateral ventricles,were assessed according to an internationally established consensus of TCS.The diagnosis of depression was based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV(DSM –IV),and the severity of depression was measured by Hamilton Rating Scale for Depression(HAM-D)and Hospital Anxiety and Depression Scale depression subscale(HADS-D).Results: There were no significant differences between migraineurs and controls in the width of third ventricle(p = 0.129),width of frontal horn of the lateral ventricle(p=0.955)as well as in the echogenicity of SN(p = 0.942),CN(p = 0.053),LN(p = 0.052)and BR(p = 0.677).Here,it seems that more migraineurs were detected with increased echogenecity of CN and LN compared with controls(33.3% versus 15.0% for CN,19.0% versus 5.0% for LN)though they had no statistical significance.We found that patients with hypoechogenic BR had significantly higher HAM-D and HADS-D scores than those with normal BR signal(p = 0.000 for both HAM-D and HADS-D),and most(83.33%)migraineurs with depression exhibited hypoechogenic raphe but none of(0.00%)of the migraineurs without depression exhibited hypoechogenic raphe(p = 0.000).Conlusions: TCS signal alteration of BR can be a biomarker for depression in migraine but not be associated with migraine headache itself.LN and CN alterations in TCS may reflect a potential role of them in the pathogenesis of migraine,which needs to be further elucidated.