Structural gray matter abnormalities in migraine relate to headache lateralization, but not aura
Structural gray matter abnormalities in migraine relate to headache lateralization, but not aura
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DOI：
10.1177/0333102414532378
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发表时间：
2015-01-01
期刊：
影响因子：
4.9
通讯作者：
Ashina, Messoud
中科院分区：
文献类型：
--
作者：
Hougaard, Anders;Amin, Faisal M.;Ashina, Messoud
背景资料：偏头痛先兆（MA）的标志是短暂的皮质功能障碍，但目前尚不清楚MA是否与结构性皮质或皮质下变化有关。为了确定MA和结构性灰质异常之间的关系，我们研究了一个独特的样本，20例患者频繁侧锁MA，即视觉光环始终发生在同一hemifield.Methods：我们采用了高度敏感的患者内设计，以评估解剖差异与基于体素的形态测量和基于表面的形态测量在整个半球的水平和特定的解剖区域的利益。受试者内的比较进行了先兆症状（N = 20比20）和头痛（N = 13比13）。结果：我们发现，在灰质结构方面的先兆症状MA患者没有差异。比较典型的偏头痛侧的患者对侧显示差异额下回皮质厚度（平均差异0.12毫米，P = 0.036）。结论：MA本身是与功能异常，但不与偏侧异常的灰质结构。下额叶皮质的改变表明，疼痛抑制回路的结构重组，以响应由于头痛发作而引起的重复强烈的伤害性输入。
Background: The hallmark of migraine aura (MA) is transient cortical dysfunction but it is not known if MA is associated with structural cortical or subcortical changes. To determine the relation between MA and structural gray matter abnormalities, we studied a unique sample of 20 patients with frequent side-locked MA, i.e. visual aura consistently occurring in the same hemifield.Methods: We applied a highly sensitive within-patient design to assess anatomical differences with both voxel-based morphometry and surface-based morphometry on a whole-hemisphere level and for specific anatomical regions of interest. Within-subject comparisons were made with regard to aura symptoms (N = 20 vs 20) and with regard to headache (N = 13 vs 13).Results: We found no differences in gray matter structure with regard to aura symptoms in MA patients. Comparing the typical migraine headache side of the patients to the contralateral side revealed a difference in cortical thickness in the inferior frontal gyrus (mean difference 0.12 mm, p = 0.036).Conclusion: MA per se is associated with abnormal function but not with lateralized abnormalities of gray matter structure. Alteration of the inferior frontal cortex suggests structural reorganization of pain inhibitory circuits in response to the repeated intense nociceptive input due to the headache attacks.