Diffusion Tensor Imaging in Episodic Cluster Headache
Diffusion Tensor Imaging in Episodic Cluster Headache
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DOI：
10.1111/j.1526-4610.2011.02000.x
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发表时间：
2012-02-01
期刊：
影响因子：
5
通讯作者：
Knake, Susanne
中科院分区：
文献类型：
--
作者：
Teepker, Michael;Menzler, Katja;Knake, Susanne
背景。丛集性头痛 (CH) 是一种罕见的头痛疾病，伴有严重的单侧头痛发作和自主神经症状。 CH 的病理生理学尚不完全清楚。使用基于体素的形态测量范式或功能成像，可以在 CH 发作期间证明下丘脑和疼痛矩阵的关键作用。然而，尚无弥散张量成像 (DTI) 数据调查 CH 患者大脑白质微观结构。因此，我们使用 DTI 来描绘无头痛状态下 CH 患者的微观结构变化。方法 - 纳入 7 名阵发性 CH 男性患者和 7 名健康受试者，并使用常规 1.5 T 磁共振成像扫描仪进行检查。使用基于轨迹的空间统计数据，在没有先验假设的情况下，对测量分数各向异性的全头 DTI 扫描进行了分析。结果。-我们发现脑干白质、额叶、颞叶、枕叶、内囊以及丘脑和小脑的右侧显着的微结构脑组织变化。作为嗅觉系统一部分的基底额叶也出现了进一步的损伤。脑干分数各向异性的改变可能表明内侧丘系和中枢交感神经通路的变化。结论：阵发性 CH 患者的疼痛基质区域的脑微观结构发生变化。此外，我们能够检测到表明嗅觉系统受累的结构变化以及表明三叉神经和交感系统受累的脑干病变。
Background. Cluster headache (CH) is a rare headache disorder with severe unilateral headache bouts and autonomic symptoms. The pathophysiology of CH is not completely understood. Using a voxel-based morphometric paradigm or functional imaging, a key role of the hypothalamus and the pain matrix could be demonstrated during CH episodes. However, there are no diffusion tensor imaging (DTI) data investigating the white matter microstructure of the brain in patients with CH. Therefore, we used DTI to delineate microstructural changes in patients with CH in a headache-free state.Methods.-Seven male patients with episodic CH and 7 healthy subjects were included and examined with a routine 1.5 T magnetic resonance imaging scanner. Whole-head DTI scans measuring fractional anisotropy were analyzed without a priori hypotheses using track-based spatial statistics.Results.-We found significant microstructural brain tissue changes bilaterally in the white matter of the brainstem, the frontal lobe, the temporal lobe, the occipital lobe, the internal capsule, and on the right side of thalamus and cerebellum. There were further lesions in the basal frontal lobe that were part of the olfactory system. Alterations of fractional anisotropy in the brainstem might indicate changes of the medial lemniscus and central sympathetic pathways.Conclusions.-Patients with episodic CH have microstructural brain changes in regions that belong to the pain matrix. Furthermore, we were able to detect structural changes suggesting an involvement of the olfactory system as well as lesions in the brainstem indicating an involvement of trigeminal and sympathetic systems.