| Objective: Resting state functional magnetic resonance imaging was used to analyze the changes and significance of interictal brain function activity in patients with migraine without aura,which provided an objective basis for in-depth understanding of the functional characteristics of the brain of patients with Mwo A.Methods: A prospective collection of 37 Mwo A patients who attended the Neurology Outpatient Department of Taizhou People’s Hospital from September 2021 to November 2022 was screened in strict accordance with the enrollment criteria of this study,and finally 26 Mwo A patients and 26 healthy people with no history of headache disease matching the gender,age and education level of the patient group were included as the control group,and the sociodemographic data such as names,gender,age and years of education of all subjects were collected.All patients with MWo A were tested on migraine-related scales,including the Numeric Rating Scale(NRS),the Headache Impact Test-6(HIT-6)score,and the Migraine Disability Assessment Questionnaire(MIDAS)scores to assess the severity of migraine in patients with migraine,and to complete resting functional magnetic resonance examination.Regional Homogeneity(Re Ho),Amplitude of Low-frequency Fluctuation(ALFF)and Degree Centrality(DC)based on voxel level were used to evaluate spontaneous brain activity,and then brain regions with significantly abnormal signals were used as Region of Interest(ROIs).Functional Connectivity(FC)of ROIs to the whole brain was calculated to assess differences in brain network level activity between the two groups.The Re Ho value,ALFF value,DC value and FC value of brain regions with significantly different signals were extracted,and the correlation analysis was used to study the correlation between the signal values of different brain regions between the two groups and the duration of migraine,attack frequency,pain duration and clinical scale.Results: 1.Compared with the healthy control group,the sm Re Ho values of bilateral inferior temporal gyrus and right lingual gyrus were increased in MWo A patients,and the sm Re Ho values of the left insular hypofrontal gyrus decreased(P<0.001,FWE correction);2.Compared with the healthy control group,the m ALFF value of the left inferior temporal gyrus was increased,and the m ALFF value of the left insular operculum and the right medial superior frontal gyrus decreased(P<0.001,FWE correction);3.Compared with the healthy control group,the right inferior temporal gyrus m DC value was increased in the MWo A patient group(P<0.001,FWE correction).4.Two groups of differential brain regions were selected as ROIs for network-level functional connection analysis,and it was found that compared with healthy controls:(1)the right inferior temporal gyrus was used as ROI: the z FC value of the right inferior temporal gyrus and the left anterior central gyrus and the left perifissure cortex was increased(P<0.001,FWE correction);(2)The left inferior temporal gyrus was used as the ROI: the z FC value of the left inferior temporal gyrus and bilateral perifissure cortex,the left anterior central gyrus,and the left paracentral lobule increased(P<0.001,FWE correction);(3)The right lingual gyrus was used as the ROI: the z FC value of the right lingual gyrus and the left anterior wedge lobe increased(P<0.001,FWE correction);(4)The left insular subfrontal gyrus was used as the ROI: the z FC value of the inferior frontal gyrus of the left insular operculum and the left anterior leaf of the left wedge increased(P<0.001,FWE correction);(5)The right medial superior frontal gyrus was used as the ROI: the z FC value of the right medial frontal superior gyrus and the right middle frontal gyrus increased(P<0.001,FWE correction);5.The correlation analysis showed that the MIDAS score was positively correlated with the left insular subfrontal gyrus sm Re Ho value(r=0.407,P=0.039)and the right inferior temporal gyrus sm Re Ho value(r=0.431,P=0.028)in the MWo A patient group.The frequency of seizures was positively correlated with the m ALFF value of the left insular subfrontal gyrus in the left insular cap group(r=0.605,P=0.001).The duration of headache was positively correlated with the value of m ALFF in the right medial superior frontal gyrus in the group of MWo A patients(r=0.475,P=0.014).Pain intensity was positively correlated with the m DC value of the right inferior temporal gyrus in the MWo A patient group(r=0.786,P<0.001).The length of disease was positively correlated with the right inferior temporal gyrus m DC value in the MWo A patient group(r=0.515,P=0.007).Conclusions: 1.The presence of multiple brain regions with abnormal functional activity in MWo A in the interictal phase and overlapping parts(bilateral inferior temporal gyrus,left insular operculum and inferior frontal gyrus),sm Re Ho value,m ALFF value,m DC value and z FC value may be effective imaging marker parameters for the diagnosis of MWo A patients.2.The correlation between abnormal sm Re Ho values,m ALFF values and m DC values of bilateral inferior temporal gyrus,right lingual gyrus,left insular operculum and right medial superior frontal gyrus and attack frequency,disease duration,and clinical scale may be clinical evaluation indicators of MWo A disease severity.3.The abnormal spontaneous changes in the spontaneous activity of bilateral inferior temporal gyrus,right lingual gyrus,left insular operculum and right medial superior frontal gyrus and abnormal connection to whole brain function found in patients with MWo A provide new ideas for the study of the neuropathological mechanism of migraine in the later stage. |
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