前庭性偏头痛患者顶叶岛盖2功能连接异常的静息态fMRI研究  

Altered functional connectivity of parietal opercular 2 in patients with vestibular migraine:a resting-state fMRI study

作　　者：陈正威 林存鑫 刘月季 刘丹 荣良群 刘海艳 魏秀娥 肖利杰 Chen Zhengwei;Lin Cunxin;Liu Yueji;Liu Dan;Rong Liangqun;Liu Haiyan;Wei Xiue;Xiao Lijie(Department of Neurology,Second Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学第二附属医院(徐州矿务集团总医院)神经内科,徐州221006

出　　处：《中华耳鼻咽喉头颈外科杂志》2024年第8期812-819,共8页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：徐州市卫生健康委科技项目(XWKYHT20200010)。

摘　　要：目的探讨前庭性偏头痛(Vestibular migraine,VM)与无先兆偏头痛(Migraine without aura,MwoA)患者静息态功能连接之间的差异,以推断VM发病可能的神经影像学机制。方法选取2019年12月至2022年12月在徐州医科大学第二附属医院神经内科就诊的30例VM患者作为试验组(男6例,女24例,平均年龄38.3岁),26例MwoA患者作为对照组(男7例,女19例,平均年龄35.5岁)。收集全部患者性别、年龄、教育年限、病程、发作频率等一般人口学及临床资料,以及汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)、头痛视觉模拟量表(VAS)、头痛影响测试问卷(Headache Impact Test-6,HIT-6)、偏头痛残疾程度评估问卷(Migraine Disability Assessment Questionnaire,MIDAS)资料。VM患者同时还接受眩晕障碍量表(Dizziness Handicap Inventory,DHI)、头晕VAS及日常活动前庭功能障碍等级量表(Vestibular Disorders Activities of Daily Living Scale,VADL)评估。所有患者均接受静息态功能磁共振成像(fMRI)扫描。以双侧顶叶岛盖2(Parietal opercular 2,OP2)和双侧初级视觉皮层(Primary visual cortex,V1)为感兴趣区,计算OP2及V1与全脑其他区域的功能连接在两组患者之间的差异。针对显著差异脑区,提取试验组患者每例被试功能连接z值,将功能连接z值与患者临床特征进行Pearson偏相关分析。应用SPSS 22.0进行统计学分析。结果VM组和MwoA组患者在性别、年龄、教育年限、病程、发作频率及MoCA、HAMA、HAMD评分上差异均无统计学意义(P值均>0.05)。VM患者头痛VAS、HIT-6及MIDAS评分显著低于MwoA患者,差异具有统计学意义(P值均<0.05)。和MwoA患者相比,VM患者左侧OP2与双侧楔前叶、左侧丘脑之间的功能连接显著增强,右侧OP2与左侧丘脑、右侧前扣带回之间的功能连接显著增强,P值均<0.05(错误发现率校正)�ObjectiveTo investigate the differences in resting-state functional connectivity(FC)between patients with vestibular migraine(VM)and migraine without aura(MwoA)in order to infer the possible neuroimaging mechanisms of VM.MethodsThirty VM patients admitted to the Department of Neurology of the Second Affiliated Hospital of Xuzhou Medical University from December 2019 to December 2022 were selected as the experimental group(EG)(6 males and 24 females,with mean age of 38.3 years)and 26 MwoA patients as the control group(7 males and 19 females,mean age 35.5 years).General demographic and clinical data such as gender,age,year of education,course of disease and frequency of attacks were collected for all the patients,as well as data of Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Montreal Cognitive Assessment(MoCA),headache Visual Arialogue Scale(VAS),Headache Impact Test 6(HIT-6)and Migraine Disability Assessment Questionnaire(MIDAS).VM patients were also assessed by Dizziness Handicap Inventory(DHI),dizziness VAS and Vestibular Disorders Activities of Daily Living(VADL)scales.All patients underwent resting-sate functional Magnetic Resonance Imaging(fMRI)scans.Bilateral parietal opercular cortex 2(OP2)and primary visual cortex(V1)were used as regions of interests(ROIs).Differences in FC between ROIs and other brain regions were calculated between the two groups.In view of the brain regions with significant differences,z-values of FC were extracted for each subject in the EG,and Pearson partial correlation analysis was conducted between z-values of FC and clinical characteristics of patients,P<0.05 was considered to have significant correlation.SPSS 22.0 was used for statistical analysis.ResultsThere was no significant difference in gender,age,years of education,course of disease,frequency of attack and scores of MoCA,HAMA and HAMD between the two groups(P>0.05).Headache VAS,HIT-6 and MIDAS scores in VM patients were significantly lower than those in MwoA patients(P<0.05).Compared with MwoA patients,the

关 键 词：前庭性偏头痛 无先兆偏头痛 磁共振成像 功能连接 

分 类 号：R747.2[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]