Multimodal Magnetic Resonance Study Of Brain Structure And Function Changes In Migraine Without Aura

Objective: Migraine is a common chronic neurovascular disease.As a typical primary headache,it is mainly characterized by repeated attacks,moderate to severe pulsating headache on one side or both sides.It generally lasted about 4-72 hours,and may be accompanied by nausea,vomiting and other discomfort.The cause of migraine is not clear.Light,electrical stimulation,or daily activities can induce or aggravate migraine,and quiet environment and rest can relieve the pain.In addition to the damage caused by the disease itself,migraine can also cause abnormalities such as visual,sensory and speech.In addition,migraine can also coexist with white matter lesions,cerebrovascular diseases,mental and emotional abnormalities.This suggests that migraine sufferers may also have abnormalities in brain function and anatomical structure during inter attack.Diffusion Tensor Imaging(DTI)can display the structure of white matter,mainly the axon of nerve cells,due to the free diffusion motion of water molecules inside and outside the cell.Resting state-functional magnetic reasonance imaging(rs-f MRI)reflects the spontaneous neuronal activity of the change through the resting state cerebral blood oxygen level signal changes.This study is to observe the differences between migraine without aura patients and healthy control group in their structure and function by DTI and rs-f MRI.Method:Collected all patients,data from September 2019 to December2020 in Taizhou People hospital.A total of 51 patients are collected,according to inclusion criteria and exclusion criteria,eventually 36 patients(7males and 29 females)into the experimental group,record the baseline information(name,gender,age,handedness,onset age,disease,drug abuse situation).Then,all these patients were divided into three subgroups according to the location of the disease :13 in the left migraine group(LMWoA),12 in the right migraine group(RMWoA),and 11 in the bilateral migraine group,and 28 volunteers(8 males and 20 females)matched with the age and gender of the patients were selected as the healthy control group.By two fixed professional inspectors to achieve Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)score and record.And for all groups of migraine sufferers visual analogue scale(VAS),degree of disability assessment scale(MIDAS)score,migraine migraine impact factor 6(HIT-6)score were to evaluate disease severity.All was scanned with T2 WI,FLAIR,DTI and RS-f MRI using Siemens3.0TMR scanner under the condition of closed eyes,keeping awake and avoiding thinking activities.FA was used to evaluate the cellular structure of white matter fibers and mALFF was to evaluate spontaneous brain activity.Then the obvious different regions in mALFF signal were taken as the seed region of interest,and the FC between the index region and the whole brain was calculated to evaluate the changes of network level.Then,the mALFF values,MIDAS and HIT-6 in the different brain regions were analyzed.SPSS26.0 statistical software was used for statistical analysis of general data and their correlation.Results:1.Compared with healthy control group DTI,the difference among FA in MWoA group,LMWoA group and RMWoA group were not significant;2.Compared with the healthy control group,mALFF decreased in MWoA patients included: the left paracercial lobule(P <0.01,FDR corrected);The increased cerebral regions were left rectus and right orbitofrontal gyrus(P<0.01,FDR corrected);3.Compared with the healthy control group,the brain regions with decreased mALFF in LMWoA patients included: the right supplementary motor area and the left paracental central lobule(P <0.01,FDR corrected);The increased cerebral regions were: left superior frontal gyrus(P <0.01,FDR corrected);4.No significant decrease or increase in mALFF was found in the RMWoA group compared to the healthy control group(P <0.01,FDR corrected);5.At the network level,the FC was weakened among the left paracentral lobule,the right insula and the left cuneus in the MWoA group;No obvious Fc enhancement(P <0.01,Alphsim correction);6.MIDAS was negatively correlated with mALFF of the left rectus gyrus,not correlated with mALFF of the left paracentral lobes and the right orbital middle frontal gyrus.HIT-6 was negatively correlated with mALFF of the left rectus gyrus,positively correlated with mALFF of the left parastal central lobule and the right orbital middle frontal gyrus.Conclusion:1.Through DTI,There is no obvious structural abnormity in the brain region between migraine attacks without aura,which was related to the reversible development of the disease.2.By ALFF,Abnormal activity in brain areas exist in the left paracentral lobule,left rectus,left superior frontal gyrus,right intraorbital middle frontal gyrus,and right supplementary motor area during the interictal period in MWoA Patients.The weakened functional connection between the left paracentral lobule and the right insula and the left cuneiform lobe,which was an important pathological basis for the onset of MWoA patients.3.The mALFF value of the left paracentral lobule,the left rectus,and the right intraorbital middle frontal gyrus,were correlated with the severity of migraine to a certain extent,which had guiding significance for the evaluation of the clinical severity of migraine.