Abnormalities Of Whole Brain Perfusion And Gray Matter Volume In Patients With Vestibular Migraine During Interictal Period

Objective By analyzing the changes of brain perfusion and gray matter volume in patients with vestibular migraine during the interictal period,we can understand the imaging characteristics of VM,so as to further explore the pathogenesis of vestibular migraine.Methods From July 2018 to December 2019,19 patients with vestibular migraine(VM)and 17 patients with migraine without aura(MWo A)who were hospitalized in the Department of Neurology,the Affiliated Hospital of Qingdao University were collected,as well as 19 healthy volunteers whose general information(age,gender,education level,etc.)matched the previous two groups of subjects in the same period were collected.Three groups of subjects underwent magnetic resonance scanning to acquire 3D ASL and3 D T1WI sequence images.SPM12 software based on Matlab platform was used to preprocess the image data,and the data of total cerebral blood flow(CBF)and gray matter volume(GMV)were obtained.Finally,analysis of variance via SPM software and various correction methods was used to obtain the brain areas with significant differences in blood flow and gray matter volume among the three groups.Also,the CBF value and GMV value of the region of interest in VM group were extracted and correlated with the course of VM,the number of attacks per month and the duration of each attack.Results 1.CBF: Compared with healthy volunteers,VM patients and MWo A patients showed a significantly decrease of CBF in the left medial superior frontal gyrus and right dorsolateral superior frontal gyrus(voxel P<0.001,cluster P<0.05).And the CBF of left medial superior frontal gyrus in VM group was negatively correlated with the course of VM(r=-0.707,P=0.001).Compared with VM patients,MWo A patients showed a significantly decrease of CBF in the eft medial superior frontal gyrus.2.Gray matter volume: Compared with healthy volunteers,VM patients and MWo A patients showed a significantly decrease of GMV in the vermis of cerebellum(voxel P<0.001,cluster P<0.05).And the reduction of GMV of cerebellar vermis in VM group was negatively related to the number of VM attacks per month(r=-0.777,P<0.001).What's more,there is no obvious abnormality in GMV between the two groups of patients.Conclusions 1.VM patients showed a significantly decrease of CBF in the left medial frontal gyrus and right dorsolateral frontal gyrus during the interictal period,and the longer the course of VM,the lower the left medial frontal gyrus CBF value.2.VM patients showed a significantly decrease of GMV of the cerebellar vermis during the interictal period,and the more frequent the VM attacks,the more obvious the decrease in the gray matter volume of the cerebellar vermis.There are abnormal cerebral blood flow and gray matter volume in the brain areas associated with pain and multisensory vestibular processing in VM patients during the interictal period.It is suggested that VM is not only a paroxysmal disease,but also has changes in function and structure during the interictal period.So we indicate that VM is a complex central neuropathy involving multiple systems,which is conducive to a more comprehensive understanding of the pathophysiological mechanism of vestibular migraine.