Altered periaqueductal gray resting state functional connectivity in migraine and the modulation effect of treatment.
Altered periaqueductal gray resting state functional connectivity in migraine and the modulation effect of treatment.
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DOI：
10.1038/srep20298
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发表时间：
2016-02-03
影响因子：
4.6
通讯作者：
Kong J
中科院分区：
文献类型：
--
作者：
Li Z;Liu M;Lan L;Zeng F;Makris N;Liang Y;Guo T;Wu F;Gao Y;Dong M;Yang J;Li Y;Gong Q;Liang F;Kong J
本研究的目的是1)比较无先兆偏头痛（MwoA）患者和健康对照组（HC）的静息状态功能连接（rs-fc），以及2)研究有效治疗如何影响MwoA患者PAG rs-fc。招募100例MwoA患者和46例匹配的HC。患者被随机分为椎体针刺组、假针刺组和等候组。采集静息状态fMRI数据，应用基于种子的功能连接分析。与HC相比，MwoA患者PAG与前扣带皮层吻侧/内侧前额叶皮层（rACC/mPFC）、DPMS关键区域及其他疼痛相关脑区之间的rs-fc减少。PAG和rACC/mPFC之间rs-fc的降低与基线时偏头痛强度的增加有关。治疗后，MwoA患者PAG与rACC之间的rs-fc显著升高。PAG、rACC和腹侧纹状体中rs-fc的变化与头痛强度的改善有显著相关。DPMS损伤与偏头痛的神经病理生理有关。偏头痛患者DPMS受损，经有效治疗后可恢复正常。
The aims of this study were to 1) compare resting state functional connectivity (rs-fc) of the periaqueductal gray (PAG), a key region in the descending pain modulatory system (DPMS) between migraine without aura (MwoA) patients and healthy controls (HC), and 2) investigate how an effective treatment can influence the PAG rs-fc in MwoA patients. One hundred MwoA patients and forty-six matched HC were recruited. Patients were randomized to verum acupuncture, sham acupuncture, and waiting list groups. Resting state fMRI data were collected and seed based functional connectivity analysis was applied. Compared with HC, MwoA patients showed reduced rs-fc between the PAG and rostral anterior cingulate cortex/medial prefrontal cortex (rACC/mPFC), key regions in the DPMS and other pain related brain regions. The reduced rs-fc between the PAG and rACC/mPFC was associated with increased migraine headache intensity at the baseline. After treatments, rs-fc between the PAG and the rACC in MwoA patients significantly increased. The changes of rs-fc among the PAG, rACC and ventral striatum were significantly associated with headache intensity improvement. Impairment of the DPMS is involved in the neural pathophysiology of migraines. Impaired DPMS in migraine patients can be normalized after effective treatment.