Morphological Abnormalities of Thalamic Subnuclei in Migraine: A Multicenter MRI Study at 3 Tesla
Morphological Abnormalities of Thalamic Subnuclei in Migraine: A Multicenter MRI Study at 3 Tesla
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DOI：
10.1523/jneurosci.2154-15.2015
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发表时间：
2015-10-07
影响因子：
5.3
通讯作者：
Sprenger, Till
中科院分区：
文献类型：
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作者：
Magon, Stefano;May, Arne;Sprenger, Till
丘脑包含三叉神经系统的第三级中继神经元，动物模型以及偏头痛患者小队列的初步成像研究表明丘脑在头痛病理生理学中的作用。然而，缺乏在大量患者人群中使用先进成像技术的大型研究。在本研究中，我们调查了一个大型多中心队列偏头痛患者丘脑体积和形状的变化。131例偏头痛患者在3特斯拉下获得的高分辨率T1加权MRI数据（38例有先兆; 30.8 ± 9岁; 109例女性;每月发作频率：3.2 ± 2.5;病程：14 ± 8.4年）和115例匹配的健康受试者（29 +/- 7岁; 81名女性）来自四个国际三级头痛中心进行了分析。丘脑和丘脑亚核，纹状体，苍白球分割使用全自动多图谱的方法。进行基于变形的形状分析以定位表面异常。偏头痛患者和健康受试者之间的差异使用ANCOVA模型进行评估。多重比较校正后，使用错误发现率方法进行（p < 0.05校正），在偏头痛患者中观察到以下丘脑核团的显著体积减小：中央核复合体（F-（1，F-233）= 6.79）、前核（F-（1，F-237）= 7.38）和外侧背核（F-（1，F-238）= 6.79）。此外，在患者中观察到纹状体体积减少（F-（1，F-238）= 6.9）。这项大规模的研究表明偏头痛患者的丘脑结构异常。体积异常的丘脑核团与边缘系统紧密相连。因此，这些数据支持偏头痛中高阶积分系统发生改变的观点。
The thalamus contains third-order relay neurons of the trigeminal system, and animal models as well as preliminary imaging studies in small cohorts of migraine patients have suggested a role of the thalamus in headache pathophysiology. However, larger studies using advanced imaging techniques in substantial patient populations are lacking. In the present study, we investigated changes of thalamic volume and shape in a large multicenter cohort of patients with migraine. High-resolution T1-weighted MRI data acquired at 3 tesla in 131 patients with migraine (38 with aura; 30.8 +/- 9 years old; 109 women; monthly attack frequency: 3.2 +/- 2.5; disease duration: 14 +/- 8.4 years) and 115 matched healthy subjects (29 +/- 7 years old; 81 women) from four international tertiary headache centers were analyzed. The thalamus and thalamic subnuclei, striatum, and globus pallidus were segmented using a fully automated multiatlas approach. Deformation-based shape analysis was performed to localize surface abnormalities. Differences between patients with migraine and healthy subjects were assessed using an ANCOVA model. After correction for multiple comparisons, performed using the false discovery rate approach (p < 0.05 corrected), significant volume reductions of the following thalamic nuclei were observed in migraineurs: central nuclear complex (F-(1,F-233) = 6.79), anterior nucleus (F-(1,F-237) = 7.38), and lateral dorsal nucleus (F-(1,F-238) = 6.79). Moreover, reduced striatal volume (F-(1,F-238) = 6.9) was observed in patients. This large-scale study indicates structural thalamic abnormalities in patients with migraine. The thalamic nuclei with abnormal volumes are densely connected to the limbic system. The data hence lend support to the view that higher-order integration systems are altered in migraine.