Hypoechogenicity of brainstem raphe correlates with depression in migraine patients
Hypoechogenicity of brainstem raphe correlates with depression in migraine patients
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脑干中缝的低回声与偏头痛患者的抑郁症相关
DOI：
10.1186/s10194-019-1011-2
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发表时间：
2019-05-15
影响因子：
7.4
通讯作者：
Wang, Yu
中科院分区：
文献类型：
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作者：
Tao, Wei-Wei;Cai, Xin-Ting;Wang, Yu
背景 经颅超声检查 (TCS) 中的脑干中缝 (BR) 低回声已在重度抑郁症 (MD) 患者和患有不同神经退行性疾病的抑郁症患者中得到描述。但迄今为止，TCS 中 BR 改变与偏头痛患者抑郁症之间的关联尚未有报道。本研究旨在探讨经TCS进行BR检查对患有抑郁症的偏头痛患者的可能作用。方法招募42名无先兆偏头痛（MwoA）患者和40名健康对照者。用 TCS 评估豆状核（LN）、尾状核（CN）、黑质（SN）和脑干中缝（BR）的回声以及侧脑室和第三脑室额角的宽度。抑郁症诊断依据《精神障碍诊断与统计手册IV》（DSM-IV）标准，采用汉密尔顿抑郁量表（HAM-D）和医院焦虑抑郁量表抑郁子量表（HADS-D）测量抑郁严重程度。结果偏头痛患者侧脑室额角宽度（p= 0.955）、脑室宽度与对照组比较，差异无统计学意义。第三脑室 (p= 0.129) 以及 SN (p= 0.942)、CN (p= 0.053)、LN (p= 0.052) 和 BR (p= 0.677) 的回声性。在这里，与对照组相比，似乎更多的偏头痛患者被检测到 CN 和 LN 的回声增强（CN 为 33.3% 对比 15.0%，LN 为 19.0% 对比 5.0%），尽管它们没有统计学意义。低回声 BR 患者的 HAM-D 和 HADS-D 评分显着高于 BR 信号正常的患者（HAM-D 和 HADS-D 的 p= 0.000），大多数（83.33%）患有抑郁症的偏头痛患者表现出低回声中缝，但没有（0.00%）患有抑郁症的偏头痛患者没有（0.00%）表现出低回声中缝。 (p= 0.000)。结论 BR 的 TCS 信号改变可以作为偏头痛抑郁症的生物标志物，但它与偏头痛本身无关。 TCS中LN和CN的改变可能反映了它们在偏头痛发病机制中的潜在作用，这一点需要进一步阐明。
BackgroundBrainstem raphe (BR) hypoechogenicity in transcranial sonography (TCS) has been depicted in patients with major depression (MD) and in depressed patients with different neurodegenerative diseases. But, up to date, the association of BR alterations in TCS with depression in migraineurs has never been reported. This study was to investigate the possible role of BR examination via TCS in migraineurs with depression.MethodsForty two migraine without aura (MwoA) patients and 40 healthy controls were recruited. Echogenicity of lentiform nuclei (LN), caudate nuclei (CN), substantia nigra (SN) and brainstem raphe (BR) and width of the frontal horns of the lateral ventricles and the third ventricle were assessed with TCS. The diagnosis of depression was based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV (DSM –IV), and the severity of depression was measured by Hamilton Rating Scale for Depression (HAM-D) and Hospital Anxiety and Depression Scale depression subscale (HADS-D).ResultsThere were no significant differences between migraineurs and controls in the width of frontal horn of the lateral ventricle (p= 0.955), width of third ventricle (p= 0.129) as well as in the echogenicity of SN (p= 0.942), CN (p= 0.053), LN (p= 0.052) and BR (p= 0.677). Here, it seems that more migraineurs were detected with increased echogenecity of CN and LN compared with controls (33.3% versus 15.0% for CN, 19.0% versus 5.0% for LN) though they had no statistical significance. Patients with hypoechogenic BR had significantly higher HAM-D and HADS-D scores than those with normal BR signal (p= 0.000 for both HAM-D and HADS-D), and most (83.33%) migraineurs with depression exhibited hypoechogenic raphe but none (0.00%) of the migraineurs without depression exhibited hypoechogenic raphe (p= 0.000).ConlusionsTCS signal alteration of BR can be a biomarker for depression in migraine but it is not associated with migraine headache itself. LN and CN alterations in TCS may reflect a potential role of them in the pathogenesis of migraine, which needs to be further elucidated.