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Mei J, Hu Y. Degree centrality-based resting-state functional magnetic resonance imaging explores central mechanisms in lumbar disc herniation patients with chronic low back pain. Front Neurol 2024; 15:1370398. [PMID: 38919971 PMCID: PMC11197982 DOI: 10.3389/fneur.2024.1370398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
Objective To investigate the central mechanism of lumbar disc herniation in patients with chronic low back pain (LDHCP) using resting-state functional magnetic resonance imaging (rs-fMRI) utilizing the Degree Centrality (DC) method. Methods Twenty-five LDHCP and twenty-two healthy controls (HCs) were enrolled, and rs-fMRI data from their brains were collected. We compared whole-brain DC values between the LDHCP and HC groups, and examined correlations between DC values within the LDHCP group and the Visual Analogue Score (VAS), Oswestry Dysfunction Index (ODI), and disease duration. Diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curve analysis. Results LDHCP patients exhibited increased DC values in the bilateral cerebellum and brainstem, whereas decreased DC values were noted in the left middle temporal gyrus and right post-central gyrus when compared with HCs. The DC values of the left middle temporal gyrus were positively correlated with VAS (r = 0.416, p = 0.039) and ODI (r = 0.405, p = 0.045), whereas there was no correlation with disease duration (p > 0.05). Other brain regions showed no significant correlations with VAS, ODI, or disease duration (p > 0.05). Furthermore, the results obtained from ROC curve analysis demonstrated that the Area Under the Curve (AUC) for the left middle temporal gyrus was 0.929. Conclusion The findings indicated local abnormalities in spontaneous neural activity and functional connectivity in the bilateral cerebellum, bilateral brainstem, left middle temporal gyrus, and right postcentral gyrus among LDHCP patients.
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Affiliation(s)
| | - Yong Hu
- Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
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Christensen RH, Ashina H, Al-Khazali HM, Zhang Y, Tolnai D, Poulsen AH, Cagol A, Hadjikhani N, Granziera C, Amin FM, Ashina M. Differences in Cortical Morphology in People With and Without Migraine: A Registry for Migraine (REFORM) MRI Study. Neurology 2024; 102:e209305. [PMID: 38630960 PMCID: PMC11175630 DOI: 10.1212/wnl.0000000000209305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/31/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Structural imaging can offer insights into the cortical morphometry of migraine, which might reflect adaptations to recurring nociceptive messaging. This study compares cortical morphometry between a large sample of people with migraine and healthy controls, as well as across migraine subtypes. METHODS Adult participants with migraine and age-matched and sex-matched healthy controls attended a single MRI session with magnetization-prepared rapid acquisition gradient echo and fluid-attenuated inversion recovery sequences at 3T. Cortical surface area, thickness, and volume were compared between participants with migraine (including subgroups) and healthy controls across the whole cortex within FreeSurfer and reported according to the Desikan-Killiany atlas. The analysis used cluster-determining thresholds of p < 0.0001 and cluster-wise thresholds of p < 0.05, adjusted for age, sex, and total intracranial volume. RESULTS A total of 296 participants with migraine (mean age 41.6 years ± 12.4 SD, 261 women) and 155 healthy controls (mean age 41.1 years ± 11.7 SD, 133 women) were included. Among the participants with migraine, 180 (63.5%) had chronic migraine, 103 (34.8%) had migraine with aura, and 88 (29.7%) experienced a migraine headache during the scan. The total cohort of participants with migraine had reduced cortical surface area in the left insula, compared with controls (p < 0.0001). Furthermore, participants with chronic migraine (n = 180) exhibited reduced surface area in the left insula (p < 0.0001) and increased surface area in the right caudal anterior cingulate cortex (p < 0.0001), compared with controls. We found no differences specific to participants with aura or ongoing migraine headache. Post hoc tests revealed a positive correlation between monthly headache days and surface area within the identified anterior cingulate cluster (p = 0.014). DISCUSSION The identified cortical changes in migraine were limited to specific pain processing regions, including the insula and caudal anterior cingulate gyrus, and were most notable in participants with chronic migraine. These findings suggest persistent cortical changes associated with migraine. TRIAL REGISTRATION INFORMATION The REFORM study (clinicaltrials.gov identifier: NCT04674020).
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Affiliation(s)
- Rune H Christensen
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Håkan Ashina
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Haidar M Al-Khazali
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Yixin Zhang
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Daniel Tolnai
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Amanda H Poulsen
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Alessandro Cagol
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Nouchine Hadjikhani
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Cristina Granziera
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Faisal Mohammad Amin
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
| | - Messoud Ashina
- From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark
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Fila M, Przyslo L, Derwich M, Pawlowska E, Blasiak J. Potential of focal cortical dysplasia in migraine pathogenesis. Cereb Cortex 2024; 34:bhae158. [PMID: 38615241 DOI: 10.1093/cercor/bhae158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/15/2024] Open
Abstract
Focal cortical dysplasias are abnormalities of the cerebral cortex associated with an elevated risk of neurological disturbances. Cortical spreading depolarization/depression is a correlate of migraine aura/headache and a trigger of migraine pain mechanisms. However, cortical spreading depolarization/depression is associated with cortical structural changes, which can be classified as transient focal cortical dysplasias. Migraine is reported to be associated with changes in various brain structures, including malformations and lesions in the cortex. Such malformations may be related to focal cortical dysplasias, which may play a role in migraine pathogenesis. Results obtained so far suggest that focal cortical dysplasias may belong to the causes and consequences of migraine. Certain focal cortical dysplasias may lower the threshold of cortical excitability and facilitate the action of migraine triggers. Migraine prevalence in epileptic patients is higher than in the general population, and focal cortical dysplasias are an established element of epilepsy pathogenesis. In this narrative/hypothesis review, we present mainly information on cortical structural changes in migraine, but studies on structural alterations in deep white matter and other brain regions are also presented. We develop the hypothesis that focal cortical dysplasias may be causally associated with migraine and link pathogeneses of migraine and epilepsy.
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Affiliation(s)
- Michal Fila
- Department of Developmental Neurology and Epileptology, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Łódzkie, Poland
| | - Lukasz Przyslo
- Department of Developmental Neurology and Epileptology, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Łódzkie, Poland
| | - Marcin Derwich
- Department of Developmental Dentistry, Medical University of Lodz, Pomorska 251, 90-647 Lodz, Łódzkie, Poland
| | - Ezbieta Pawlowska
- Department of Developmental Dentistry, Medical University of Lodz, Pomorska 251, 90-647 Lodz, Łódzkie, Poland
| | - Janusz Blasiak
- Faculty of Medicine, Collegium Medicum, Mazovian Academy in Plock, Plac Generała Dabrowskiego 2, 09-420 Plock, Mazowieckie, Poland
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Szabo E, Ashina S, Melo-Carrillo A, Bolo NR, Borsook D, Burstein R. Peripherally acting anti-CGRP monoclonal antibodies alter cortical gray matter thickness in migraine patients: A prospective cohort study. Neuroimage Clin 2023; 40:103531. [PMID: 37866119 PMCID: PMC10623369 DOI: 10.1016/j.nicl.2023.103531] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
Migraine is underpinned by central nervous system neuroplastic alterations thought to be caused by the repetitive peripheral afferent barrage the brain receives during the headache phase (cortical hyperexcitability). Calcitonin gene-related peptide monoclonal antibodies (anti-CGRP-mAbs) are highly effective migraine preventative treatments. Their ability to alter brain morphometry in treatment-responders vs. non-responders is not well understood. Our aim was to determine the effects of the anti-CGRP-mAb galcanezumab on cortical thickness after 3-month treatment of patients with high-frequency episodic or chronic migraine. High-resolution magnetic resonance imaging was performed pre- and post-treatment in 36 migraine patients. In this group, 19 patients were classified responders (≥50 % reduction in monthly migraine days) and 17 were considered non-responders (<50 % reduction in monthly migraine days). Following cross-sectional processing to analyze the baseline differences in cortical thickness, two-stage longitudinal processing and symmetrized percent change were conducted to investigate treatment-related brain changes. At baseline, no significant differences were found between the responders and non-responders. After 3-month treatment, decreased cortical thickness (compared to baseline) was observed in the responders in regions of the somatosensory cortex, anterior cingulate cortex, medial frontal cortex, superior frontal gyrus, and supramarginal gyrus. Non-responders demonstrated decreased cortical thickness in the left dorsomedial cortex and superior frontal gyrus. We interpret the cortical thinning seen in the responder group as suggesting that reduction in head pain could lead to changes in neural swelling and dendritic complexity and that such changes reflect the recovery process from maladaptive neural activity. This conclusion is further supported by our recent study showing that 3 months after treatment initiation, the incidence of premonitory symptoms and prodromes that are followed by headache decreases but not the incidence of the premonitory symptoms or prodromes themselves (that is, cortical thinning relates to reductions in the nociceptive signals in the responders). We speculate that a much longer recovery period is required to allow the brain to return to a more 'normal' functioning state whereby prodromes and premonitory symptoms no longer occur.
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Affiliation(s)
- Edina Szabo
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA
| | - Sait Ashina
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA; Comprehensive Headache Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Agustin Melo-Carrillo
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA
| | - Nicolas R Bolo
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - David Borsook
- Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Rami Burstein
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; Department of Anaesthesiology, Harvard Medical School, Boston, MA 02215, USA; Comprehensive Headache Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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Yoo C, Kim MJ. Topographical similarity of cortical thickness represents generalized anxiety symptoms in adolescence. Brain Res Bull 2023; 202:110728. [PMID: 37558098 DOI: 10.1016/j.brainresbull.2023.110728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/04/2023] [Accepted: 08/05/2023] [Indexed: 08/11/2023]
Abstract
Generalized anxiety disorder (GAD) is a common condition characterized by excessive and uncontrollable worry, along with its high comorbidity rates. Despite increasing efforts to identify the neural underpinnings of GAD, neuroimaging research using cortical thickness have yielded largely inconsistent results. To address this, we adopted an inter-subject representational similarity analysis framework to explore a potential nonlinear relationship between vertex-wise cortical thickness and generalized anxiety symptom severity. We utilized a sample of 120 adolescents (13-18 years of age) from the Healthy Brain Network dataset. Here, we found greater topographical resemblance among participants with heightened generalized anxiety symptoms in the left caudal anterior cingulate and pericalcarine cortex. These results were not driven by the effects of age, sex, ADHD diagnosis, and GAD diagnosis. Such associations were not observed when including a group of younger participants (11-12 years of age) for analyses, highlighting the importance of age range selection when considering the link between cortical thickness and anxiety. Our findings reveal a novel cortical thickness topography that represents generalized anxiety in adolescents, which is embedded within the shared geometries between generalized anxiety symptoms and cortical thickness.
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Affiliation(s)
- Chaebin Yoo
- Department of Psychology, Sungkyunkwan University, Seoul 03063, South Korea; Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon 16419, South Korea
| | - M Justin Kim
- Department of Psychology, Sungkyunkwan University, Seoul 03063, South Korea; Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon 16419, South Korea.
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6
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Messina R, Rocca MA, Goadsby PJ, Filippi M. Insights into migraine attacks from neuroimaging. Lancet Neurol 2023; 22:834-846. [PMID: 37478888 DOI: 10.1016/s1474-4422(23)00152-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/15/2023] [Accepted: 04/12/2023] [Indexed: 07/23/2023]
Abstract
Migraine is one of the most common neurological diseases and it has a huge social and personal impact. Although head pain is the core symptom, individuals with migraine can have a plethora of non-headache symptoms that precede, accompany, or follow the pain. Neuroimaging studies have shown that the involvement of specific brain areas can explain many of the symptoms reported during the different phases of migraine. Recruitment of the hypothalamus, pons, spinal trigeminal nucleus, thalamus, and visual and pain-processing cortical areas starts during the premonitory phase and persists through the headache phase, contributing to the onset of pain and associated symptoms. Once the pain stops, the involvement of most brain areas ends, although the pons, hypothalamus, and visual cortex remain active after acute treatment intake and resolution of migraine symptoms. A better understanding of the correlations between imaging findings and migraine symptomatology can provide new insight into migraine pathophysiology and the mechanisms of novel migraine-specific treatments.
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Affiliation(s)
- Roberta Messina
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Peter J Goadsby
- NIHR King's Clinical Research Facility, King's College, London, UK; Department of Neurology, University of California, Los Angeles, CA, USA
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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7
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Mitrović K, Petrušić I, Radojičić A, Daković M, Savić A. Migraine with aura detection and subtype classification using machine learning algorithms and morphometric magnetic resonance imaging data. Front Neurol 2023; 14:1106612. [PMID: 37441607 PMCID: PMC10333052 DOI: 10.3389/fneur.2023.1106612] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/22/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Migraine with aura (MwA) is a neurological condition manifested in moderate to severe headaches associated with transient visual and somatosensory symptoms, as well as higher cortical dysfunctions. Considering that about 5% of the world's population suffers from this condition and manifestation could be abundant and characterized by various symptoms, it is of great importance to focus on finding new and advanced techniques for the detection of different phenotypes, which in turn, can allow better diagnosis, classification, and biomarker validation, resulting in tailored treatments of MwA patients. Methods This research aimed to test different machine learning techniques to distinguish healthy people from those suffering from MwA, as well as people with simple MwA and those experiencing complex MwA. Magnetic resonance imaging (MRI) post-processed data (cortical thickness, cortical surface area, cortical volume, cortical mean Gaussian curvature, and cortical folding index) was collected from 78 subjects [46 MwA patients (22 simple MwA and 24 complex MwA) and 32 healthy controls] with 340 different features used for the algorithm training. Results The results show that an algorithm based on post-processed MRI data yields a high classification accuracy (97%) of MwA patients and precise distinction between simple MwA and complex MwA with an accuracy of 98%. Additionally, the sets of features relevant to the classification were identified. The feature importance ranking indicates the thickness of the left temporal pole, right lingual gyrus, and left pars opercularis as the most prominent markers for MwA classification, while the thickness of left pericalcarine gyrus and left pars opercularis are proposed as the two most important features for the simple and complex MwA classification. Discussion This method shows significant potential in the validation of MwA diagnosis and subtype classification, which can tackle and challenge the current treatments of MwA.
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Affiliation(s)
- Katarina Mitrović
- Department of Information Technologies, Faculty of Technical Sciences in Čačak, University of Kragujevac, Čačak, Serbia
| | - Igor Petrušić
- Laboratory for Advanced Analysis of Neuroimages, Faculty of Physical Chemistry, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Radojičić
- Headache Center, Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marko Daković
- Laboratory for Advanced Analysis of Neuroimages, Faculty of Physical Chemistry, University of Belgrade, Belgrade, Serbia
| | - Andrej Savić
- Science and Research Centre, School of Electrical Engineering, University of Belgrade, Belgrade, Serbia
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8
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Deng C, Li Q. Case report: A combination of mirror therapy and magnetic stimulation to the sacral plexus relieved phantom limb pain in a patient. Front Neurosci 2023; 17:1187486. [PMID: 37304023 PMCID: PMC10251437 DOI: 10.3389/fnins.2023.1187486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/03/2023] [Indexed: 06/13/2023] Open
Abstract
Phantom limb pain (PLP) is a common sequela of amputation, experienced by 50-80% of amputees. Oral analgesics as the first-line therapy have limited effects. Since PLP usually affects activities of daily living and the psychological conditions of patients, effective treatments are imperatively needed. In this case study, a 49-year-old man was admitted to our hospital because of uncontrollable paroxysmal pain in his missing and residual leg. Due to severe injuries in a truck accident, the right lower limb of the patient was surgically amputated ~5 years ago. Around 1 month after amputation, he felt pain in his lost leg and PLP was diagnosed. Then, he started taking oral analgesics, but the pain still occurred. After admission on July 9, 2022, the patient received treatments of mirror therapy and magnetic stimulation to the sacral plexus. 1-month treatments reduced the frequency and intensity of pain in the phantom limb and the stump, without any adverse events. Analysis of high-resolution three-dimensional T1-weighted brain volume images at the end of 2-month treatments showed alterations in the thickness of cortex regions related to pain processing, compared to that before treatment. This case study gives us hints that one or both interventions of mirror therapy and sacral plexus magnetic stimulation effectively relieved PLP and stump limb pain. These non-invasive, low-cost and easily conducted treatments could be good options for PLP. But randomized controlled trials with a large number of cases are required to confirm their efficacy and safety.
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9
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Yin T, Lan L, Tian Z, Li Z, Liu M, Gao Y, Liang F, Zeng F. Parahippocampus hypertrophy drives gray matter morphological alterations in migraine patients without aura. J Headache Pain 2023; 24:53. [PMID: 37193957 DOI: 10.1186/s10194-023-01588-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/27/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND The aberrance of gray matter morphology in migraineurs has been widely investigated. However, it remains largely unknown whether there are illness duration-related hierarchical changes in the gray matter structure. METHODS A total of 86 migraine without aura (MwoA) patients and 73 healthy controls were included. The Voxel-Based Morphometry approach was utilized to compare the gray matter volume (GMV) differences between MwoA patients and healthy controls. The Structural Covariance Network analysis was conducted to quantify the cross-regional synchronous alterations of gray matter structure in MwoA patients. The Causal Structural Covariance Network analysis was performed to describe the progressive and hierarchical changes in the gray matter network of patients in the pathological progression of migraine. RESULTS MwoA patients had duration-stage related GMV hypertrophy in the left parahippocampus, as well as synergistic GMV aberrance in the parahippocampus and the medial inferior temporal gyrus and cerebellum. Moreover, the GMV alteration of the parahippocampus, and the surrounding hippocampus, amygdala, and bilateral anterior cerebellum, preceded and causally influenced the morphological changes of lateral parietal-temporal-occipital gyrus, as well as the motor cortex and prefrontal gyrus with the increasing illness duration in MwoA patients. CONCLUSION The current study indicated that gray matter structural alterations in the medial inferior temporal gyrus, especially the parahippocampus, is a critical pathological characteristic in MwoA patients, which drives the gray matter structure alteration of other regions. These findings provide further evidence for understanding the progressive gray matter morphological changes in migraine and may facilitate the development of neuromodulation therapies targeting this procession.
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Affiliation(s)
- Tao Yin
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
- Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Lei Lan
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
- Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Zilei Tian
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
- Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Zhengjie Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
- Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Mailan Liu
- College of Acupuncture & Moxibustion and Tuina, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China
| | - Yujie Gao
- Traditional Chinese Medicine School, Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
- Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
| | - Fang Zeng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
- Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
- Key Laboratory of Sichuan Province for Acupuncture and Chronobiology, Chengdu, 610075, Sichuan, China.
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10
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Amin FM, De Icco R, Al-Karagholi MAM, Raghava JM, Wolfram F, Larsson HBW, Ashina M. Correction: Investigation of cortical thickness and volume during spontaneous attacks of migraine without aura: a 3-Tesla MRI study. J Headache Pain 2023; 24:22. [PMID: 36879185 PMCID: PMC9990283 DOI: 10.1186/s10194-023-01549-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Affiliation(s)
- Faisal Mohammad Amin
- Danish Headache Center, Department of Neurology, Faculty of Health and Medical Sciences, Rigshospitalet Glostrup, University of Copenhagen, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark.
| | - Roberto De Icco
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Mohammad Al-Mahdi Al-Karagholi
- Danish Headache Center, Department of Neurology, Faculty of Health and Medical Sciences, Rigshospitalet Glostrup, University of Copenhagen, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark
| | - Jayachandra M Raghava
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Faculty of Health and Medical Sciences, Rigshospitalet, University of Copenhagen, Glostrup, Denmark.,Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, 2600, Glostrup, Denmark
| | - Frauke Wolfram
- Department of Radiology, Herlev-Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Henrik B W Larsson
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Faculty of Health and Medical Sciences, Rigshospitalet, University of Copenhagen, Glostrup, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Faculty of Health and Medical Sciences, Rigshospitalet Glostrup, University of Copenhagen, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark
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11
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Liu N, Huo J, Li Y, Hao Y, Dai N, Wu J, Liu Z, Zhang Y, Huang Y. Changes in brain structure and related functional connectivity during menstruation in women with primary dysmenorrhea. Quant Imaging Med Surg 2023; 13:1071-1082. [PMID: 36819245 PMCID: PMC9929379 DOI: 10.21037/qims-22-683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/27/2022] [Indexed: 12/24/2022]
Abstract
Background Neuroimaging studies have identified altered brain structures and functions in women with primary dysmenorrhea (PDM). However, previous studies focused on either structural or functional changes in specific brain regions rather than combining structural and functional analysis. Therefore, this prospective cross-sectional study aimed to investigate the changes in whole brain structure, and functional variation along with structural abnormalities in women with PDM during menstruation. Methods In all, 31 patients with PDM (PTs) and 31 healthy controls (HCs) were recruited. Voxel-based morphometry (VBM) and surface-based morphometry (SBM) analyses were applied to investigate structural changes based on high-resolution T1-weighted magnetic resonance images. Functional connectivity (FC) analysis was performed to evaluate functional variations related to the brain regions that showed structural group differences. Pearson correlation analysis was performed to assess the relationship between neuroimaging changes and clinical measures. Results Compared to HCs, PTs had reduced gray matter volume (GMV) in the right superior temporal gyrus (STG) and reduced thickness in the bilateral orbitofrontal cortex (OFC), left postcentral gyrus (PoCG), and left superior occipital gyrus (SOG). Among these areas, the STG and PoCG are responsible for altered resting-state FC patterns in PTs. Results showed decreased FC between the STG and the left cerebellar posterior lobe (poCb), the right dorsolateral prefrontal cortex (DLPFC), and the left precentral gyrus (PrCG). Results also showed decreased FC between the PoCG and the right precuneus and the right DLPFC. We also found greater FCs between the PoCG and the bilateral poCb, the left middle temporal gyrus (MTG), and the left angular gyrus. In addition, the FCs between the STG and poCb, and DLPFC in PTs were positively correlated with history and Cox menstrual symptom scale (CMSS) scores, respectively, while the FCs between STG and PrCG were negatively correlated with the onset age of PDM. Conclusions Our research found structural abnormalities and related FC changes in several brain regions that were mainly involved in the emotional and sensory aspects of menstrual pain in PDM. These findings could help us understand the occurrence of PDM from a neuroimaging perspective.
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Affiliation(s)
- Ni Liu
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jianwei Huo
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yingqiu Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Hao
- Beijing International Center for Mathematical Research, Peking University, Beijing, China
| | - Na Dai
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Junchen Wu
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Zhidan Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yanan Zhang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yiran Huang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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12
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Liu N, Li Y, Hong Y, Huo J, Chang T, Wang H, Huang Y, Li W, Zhang Y. Altered brain activities in mesocorticolimbic pathway in primary dysmenorrhea patients of long-term menstrual pain. Front Neurosci 2023; 17:1098573. [PMID: 36793538 PMCID: PMC9922713 DOI: 10.3389/fnins.2023.1098573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/09/2023] [Indexed: 02/01/2023] Open
Abstract
Background Patients with primary dysmenorrhea (PDM) often present with abnormalities other than dysmenorrhea including co-occurrence with other chronic pain conditions and central sensitization. Changes in brain activity in PDM have been demonstrated; however, the results are not consistent. Herein, this study probed into altered intraregional and interregional brain activity in patients with PDM and expounded more findings. Methods A total of 33 patients with PDM and 36 healthy controls (HCs) were recruited and underwent a resting-state functional magnetic resonance imaging scan. Regional homogeneity (ReHo) and mean amplitude of low-frequency fluctuation (mALFF) analysis were applied to compare the difference in intraregional brain activity between the two groups, and the regions with ReHo and mALFF group differences were used as seeds for functional connectivity (FC) analysis to explore the difference of interregional activity. Pearson's correlation analysis was conducted between rs-fMRI data and clinical symptoms in patients with PDM. Results Compared with HCs, patients with PDM showed altered intraregional activity in a series of brain regions, including the hippocampus, the temporal pole superior temporal gyrus, the nucleus accumbens, the pregenual anterior cingulate cortex, the cerebellum_8, the middle temporal gyrus, the inferior temporal gyrus, the rolandic operculum, the postcentral gyrus and the middle frontal gyrus (MFG), and altered interregional FC mainly between regions of the mesocorticolimbic pathway and regions associated with sensation and movement. The anxiety symptoms are correlated with the intraregional activity of the right temporal pole superior temporal gyrus and FC between MFG and superior frontal gyrus. Conclusion Our study showed a more comprehensive method to explore changes in brain activity in PDM. We found that the mesocorticolimbic pathway might play a key role in the chronic transformation of pain in PDM. We, therefore, speculate that the modulation of the mesocorticolimbic pathway may be a potential novel therapeutic mechanism for PDM.
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Affiliation(s)
- Ni Liu
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yingqiu Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yueying Hong
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jianwei Huo
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Tai Chang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Haoyuan Wang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yiran Huang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Wenxun Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China,Wenxun Li ✉
| | - Yanan Zhang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China,*Correspondence: Yanan Zhang ✉
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13
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Guo X, Wang D, Ying C, Hong Y. Association between brain structures and migraine: A bidirectional Mendelian randomization study. Front Neurosci 2023; 17:1148458. [PMID: 36937660 PMCID: PMC10020331 DOI: 10.3389/fnins.2023.1148458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
Background Accumulating evidence of clinical and neuroimaging studies indicated that migraine is related to brain structural alterations. However, it is still not clear whether the associations of brain structural alterations with migraine are likely to be causal, or could be explained by reverse causality confounding. Methods We carried on a bidirectional Mendelian randomization analysis in order to identify the causal relationship between brain structures and migraine risk. Summary-level data and independent variants used as instruments came from large genome-wide association studies of total surface area and average thickness of cortex (33,992 participants), gray matter volume (8,428 participants), white matter hyperintensities (50,970 participants), hippocampal volume (33,536 participants), and migraine (102,084 cases and 771,257 controls). Results We identified suggestive associations of the decreased surface area (OR = 0.85; 95% CI, 0.75-0.96; P = 0.007), and decreased hippocampal volume (OR = 0.74; 95% CI, 0.55-1.00; P = 0.047) with higher migraine risk. We did not find any significant association of gray matter volume, cortical thickness, or white matter hyperintensities with migraine. No evidence supporting the significant association was found in the reverse MR analysis. Conclusion We provided suggestive evidence that surface area and hippocampal volume are causally associated with migraine risk.
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Affiliation(s)
- Xiaoming Guo
- Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Neurosurgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Dingkun Wang
- Department of Neurosurgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Caidi Ying
- Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan Hong
- Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Yuan Hong,
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Aster HC, Evdokimov D, Braun A, Üçeyler N, Kampf T, Pham M, Homola GA, Sommer C. CNS imaging characteristics in fibromyalgia patients with and without peripheral nerve involvement. Sci Rep 2022; 12:6707. [PMID: 35469050 PMCID: PMC9038916 DOI: 10.1038/s41598-022-10489-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 04/01/2022] [Indexed: 12/13/2022] Open
Abstract
We tested the hypothesis that reduced skin innervation in fibromyalgia syndrome is associated with specific CNS changes. This prospective case–control study included 43 women diagnosed with fibromyalgia syndrome and 40 healthy controls. We further compared the fibromyalgia subgroups with reduced (n = 21) and normal (n = 22) skin innervation. Brains were analysed for cortical volume, for white matter integrity, and for functional connectivity. Compared to controls, cortical thickness was decreased in regions of the frontal, temporal and parietal cortex in the fibromyalgia group as a whole, and decreased in the bilateral pericalcarine cortices in the fibromyalgia subgroup with reduced skin innervation. Diffusion tensor imaging revealed a significant increase in fractional anisotropy in the corona radiata, the corpus callosum, cingulum and fornix in patients with fibromyalgia compared to healthy controls and decreased FA in parts of the internal capsule and thalamic radiation in the subgroup with reduced skin innervation. Using resting-state fMRI, the fibromyalgia group as a whole showed functional hypoconnectivity between the right midfrontal gyrus and the posterior cerebellum and the right crus cerebellum, respectively. The subgroup with reduced skin innervation showed hyperconnectivity between the inferior frontal gyrus, the angular gyrus and the posterior parietal gyrus. Our results suggest that the subgroup of fibromyalgia patients with pronounced pathology in the peripheral nervous system shows alterations in morphology, structural and functional connectivity also at the level of the encephalon. We propose considering these subgroups when conducting clinical trials.
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Affiliation(s)
- Hans-Christoph Aster
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany. .,Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Margarate-Höppel-Platz 1, 97080, Würzburg, Germany.
| | - Dimitar Evdokimov
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Alexandra Braun
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Nurcan Üçeyler
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Thomas Kampf
- Institut für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum, Würzburg, Germany
| | - Mirko Pham
- Institut für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum, Würzburg, Germany
| | - György A Homola
- Institut für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum, Würzburg, Germany
| | - Claudia Sommer
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
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