Diffusion Tensor Imaging Of Chronic Migraine With Hyperactivity Of Liver Yang And Deficiency Of Qi And Blood

Objective:By cranial mri diffusion tensor imaging(coursing together tensor imaging,DTI)technology,through the processing software,please track the spatial statistical analysis based on fiber bundle(tract-based spatial statis-tics,TBSS)analysis,and based on whole brain DTI data analysis,to explore the chronic migraine(chronic migraine,CM)in patients with headache remission and healthy control group(healthy controls.HC),and the differences in the microstructural characteristics of the white matter of the patients with hyperactivity of liver Yang and deficiency of qi and blood in the CM subgroup.Meanwhile,the correlation between the structural characteristics of different brain areas and their clinical symptoms in the CM patients was explored,providing a new direction for the clinical diagnosis and treatment of CM and the judgment of the course of disease.Methods: In September 2018-September 2019 in chengdu university of traditional Chinese medicine in the neurology clinic recruited 60 subjects,in which 30 patients with CM(15 patients with liver Yang syndrone card type,15 patients with qi deficiency syndrome),match the CM patients age,gender of 30 cases of healthy volunteers line 3.0 T mri brain check,get the subjects brain DTI,3 d-T1 image.With the help of PANDA nuclear magnetic image processing software,TBSS white matter skeleton analysis was carried out and SPSS 26.0 software was used for whole brain data analysis.To observe the differences in the white matter microstructure of the brain between the CM patients group,HC group,the subgroup,the hyperactivity of liver Yang syndrome group and the qi-blood deficiency syndrome group,and the correlation between the clinical symptoms and DTI related parameters(FA,AD,RD,MD)in the CM group.Result:1.In the analysis of DTI data in the whole brain region,in the headache remission period of chronic migraine,the mean FA value in the left blanket(sagittal layer within the corpus callosum)brain region was significantly different in the CMTCM syndrome-type hyperactivity syndrome group compared with the HC group(P <0.05).There were significant differences in the average MD values in the right medial colliculus and the right inferior cerebellar regions(P < 0.05).There was a significant difference in the average AD value between the right cingulate gyrus and the left funicular region(P < 0.05).There were significant differences in the mean RD values in the right cerebellum inferior foot and the left blanket(sagittal layer within the corpus callosum)(P < 0.05).Compared with HC group,there was a significant difference in the average AD value in the right cerebellar superior crural region(P <0.05).The mean FA value in the left blanket(sagittal layer within the corpus callosum)was significantly different between the hyperactivity syndrome group and the qi-blood deficiency syndrome group(P < 0.05).2.By the analysis of TBSS white matter skeleton,there was no difference in the FA,MD,AD and RD values of diffusion tensor imaging in the headache remission period of chronic migraine patients compared with the healthy control group(P >0.05).There was no difference in FA,MD,AD and RD values of diffusion tensor imaging between the hyperactivity syndrome group of liver Yang and the deficiency syndrome group of qi and blood compared with the healthy control group(P > 0.05).3.Correlation analysis of FA values in the whole brain region: the monthly frequency of headache in CM was negatively correlated with FA values of the callosum compressors,the left internal sacs forelimb,and the right blanket(the sagittal layer of the corpus callosum)(P < 0.05).The duration of CM headache was negatively correlated with the FA value of bilateral cingulate band(hippocampus)(P< 0.05).The course of CM was negatively correlated with the FA values of the right cerebellum,the right forelimb of the internal capsule,the left endplate,the left anterior radiative crown,and the right superior frontal occipital tract(P < 0.05).Whole brain area MD value correlation analysis: CM per month headache frequency and corpus callosum,the right cerebral peduncle,bilateral internal capsule forelimb,internal capsule on the right leg,bilateral internal capsule of the lens,right before the corona radiata,on the right side of back corona radiata,bilateral thalamusafter radiation,sagittal layer on the right side,right side of the strap(hippocampus),on the right side of the longitudinal fasciculus,right frontal pillow beam under the MD value of significant positive correlation(P < 0.05);The duration of CM headache was negatively correlated with the MD values of the callosum compressor,bilateral cerebellar upper foot,right posterior limb of internal capsule,right cerebellar foot,and left posterior thalamus(P < 0.05).Correlation analysis of the AD value in the whole brain region: the monthly headache frequency of CM was positively correlated with the AD value of the pontine cross tract,the right corticospinal tract,the right anterior limb of the right internal capsule,the right lens part of the internal capsule,the right anterior radiative crown,the right posterior thalamic radiation,and the bilateral cingulate band(hippocampus)(P < 0.05).The duration of CM headache was negatively correlated with the AD value of bilateral cingulate band(hippocampus)(P <0.05).The course of CM was negatively correlated with the AD values of the fornix column and body,the bilateral medial colliculus,and the left endplate(P < 0.05).Correlation analysis of RD value in the whole brain region: the incidence of headache in CM per month was positively correlated with the RD value of the callosum compressors,the left forelimb of the internal capsule,the right posterior limb of the internal capsule,the right anterior radiating crown,the right posterior radiating crown,the bilateral subfrontal and occipital tracts,and the bilateral blankets(sagittal layer of the corpus callosum)(P < 0.05).The duration of CM headache was negatively correlated with the RD value of the callosum compressors,bilateral cerebellar upper foot,and left posterior thalamus radiation(P < 0.05).The course of CM was positively correlated with RD values of the fornix column and body,right cerebellum,and left anterior radiating crown(P < 0.05).Conclusion:Based on the analysis of DTI data in the whole brain region,it was found that the white matter microstructures of CM patients with hyperactivity of liver Yang and blood deficit syndrome had changes in the headache remission stage,which may be related to the frequency,duration and course of headache.The damage of whitematter microstructure in CM patients with different TCM syndromes may be inconsistent.