月经性偏头痛患者静息态功能磁共振研究

目的采用静息态功能磁共振成像(rf MRI)技术描述月经性偏头痛患者发作间期的脑功能改变,探索其可能的病理生理学机制。方法对10例发作间期的月经性偏头痛患者和10例受教育程度、年龄相匹配的健康对照行rf MRI扫描,计算低频振幅(ALFF),采用双样本t检验得到差异的脑区。结果偏头痛组左侧额叶ALFF值较对照组显著增强(P<0.05);偏头痛组双侧枕叶、双侧丘脑ALFF值较对照组明显减弱(P<0.05)。结论月经性偏头痛患者在头痛发作间期仍然存在皮质及皮质下脑区功能异常。     

有先兆偏头痛发作间期的静息态功能磁共振研究

目的本研究采用静息态功能磁共振(rfMRI)技术描述有先兆偏头痛(MA)患者大脑自发脑活动的局部一致性(ReHo)的改变,为MA的发病机制提供新的见解。方法收集12例发作间期的MA患者和15例性别、年龄、受教育程度相匹配的健康被试,并进行临床资料的采集及rfMRI检查。计算每个被试大脑相邻体素的ReHo值,并对两组被试的ReHo值脑图行统计学分析。结果与对照组ReHo脑图相比,偏头痛组右侧丘脑、右侧壳核、右侧小脑、脑干的ReHo值显著降低,而右侧枕叶的ReHo值显著增高(P0.05)。结论MA患者发作间期疼痛处理及调节相关的脑区功能异常,中枢敏化作用及皮质高反应性在MA发病机制中可能占有重要作用。     

精神分裂症患者发病年龄与静息态脑功能局部一致性的关系

目的探讨精神分裂症患者发病年龄与静息态脑功能局部一致性(Re Ho)之间的关系。方法选取19名45~59岁符合《精神障碍诊断与统计手册(第4版)》(DSM-Ⅳ)精神分裂症诊断标准的精神分裂症患者为被试。以发病年龄25岁为分界线,将患者分为25岁之前发病的早期发病患者组9名和25岁之后发病的晚期发病患者组10名,采集静息态功能磁共振数据,对比两组Re Ho值。结果相对于早期发病的精神分裂症患者,晚期发病组大脑右侧额上回处的Re Ho值显著降低(P0.01,簇大小486mm3)。同时,右侧额上回处的Re Ho均值与精神分裂症病程呈正相关,即个体病程越短,该脑区的Re Ho值越低。结论患者发病年龄越早、病程越长,对右侧额上回功能同步性越明显。     

不同症状为主的精神分裂症患者静息态功能磁共振成像研究

目的:探讨不同症状为主的精神分裂症患者在静息状态下功能磁共振成像(f MRI)是否存在脑功能异常及异常其区域。方法:采用病例-对照研究方法,将病例组分为妄想组(20例)和幻觉组(20例),分别对妄想组、幻觉组和20名正常对照进行f MRI扫描,利用局部一致性(Re Ho)方法处理每个被试的f MRI数据。结果:与正常对照组比较,病例组Re Ho值普遍降低,妄想组在右颞上回和左颞下回Re Ho值增高;幻觉组在左额下回、左梭状回、右颞上回和右尾状核Re Ho值增高。结论:以妄想症状为主的患者和以幻觉症状为主的患者在静息状态下可能存在广泛分布的脑区功能异常,二者异常有共同点,也有各自的特征。     

首发精神分裂症患者静息态脑局部一致性功能性磁共振研究

目的:应用功能性磁共振(f MRI)技术,探讨首发精神分裂症患者静息状态下脑局部一致性(Re Ho)功能变化的特征。方法:对首发未用药精神分裂患者(急性期组)及性别、年龄、受教育年限匹配的经抗精神病药治疗后症状缓解的首发精神分裂症患者(缓解组)各17例,分别进行f MRI扫描,利用Re Ho的方法分析数据,比较两组间Re Ho变化。结果:与急性期组相比,缓解期组表现出右侧颞上回、舌回/梭状回、左侧和右侧额下回、左侧和右侧中央后回、小脑等脑区局部一致性异常,均有统计学意义(P均0.05)。结论:缓解期组较急性期组相比,多个脑区有相应的局部一致性异常,这种脑功能特征的变化,可能与抗精神病药改善症状有关,且可能反映精神分裂症生物内表型的变化。     

有先兆偏头痛患者发作间期的静息态功能磁共振变化

目的采用静息态功能磁共振成像技术探讨有先兆偏头痛患者的自发神经元活动,分析其脑功能网络的变化,以便更好地认识有先兆偏头痛的发病机制。方法对7例发作间期有先兆偏头痛患者和7例年龄、性别及受教育程度相匹配的健康对照行静息态功能磁共振成像扫描,分析原始数据,得出全脑低频振幅(ALFF),进行双样本t检验,并以ALFF差异脑区为感兴趣区(ROI)校正后行功能连接(FC)分析,比较两组之间影像学表现的差异。结果病例组双侧额上回、左侧眶额皮质低频振幅值显著高于对照组(t=2.18~5.12,P0.05)。病例组左侧颞中回、左侧颞下回、左侧尾状核、双侧丘脑、右侧运动前区低频振幅ALFF值显著低于对照组(t=-5.12~-2.18,P0.05);与对照组相比,病例组右侧眶额皮质、左侧额中回、双侧前扣带皮质、右侧缘上回与左侧额上回功能连接增强,病例组左侧小脑、右侧脑岛、脑干与左侧额上回之间的功能连接减弱。结论有先兆偏头痛患者头痛发作间期疼痛处理相关脑区功能异常,支持偏头痛并非单纯的发作性疾病。     

难治性精神分裂症患者脑局部一致性的功能磁共振研究

目的:探讨难治性精神分裂症患者在静息状态下的脑功能活动情况。方法:采用局部一致性(Re Ho)方法,对24例难治性精神分裂症患者(患者组)和21名与之相匹配的正常人(正常对照组)在静息状态下脑功能活动情况进行比较分析。结果:与正常对照组相比,患者组在静息状态下Re Ho增强的脑区为双侧楔前叶、右内侧前额叶和右侧颞上回;Re Ho降低的脑区为左侧脑干(未校正,P0.001,cluster10)。结论:难治性精神分裂症患者在静息状态下发生功能活动改变的脑区主要集中于默认网络内。     

偏头痛发作间期疼痛刺激的脑磁图研究

目的探讨偏头痛患者在发作间期大脑对疼痛电刺激的反应特点。方法收集30例发作间期的无先兆偏头痛患者(偏头痛组)和30名年龄、性别相匹配的健康对照者(对照组),利用脑磁图描记术记录正中神经疼痛电刺激下诱导的脑电磁信号。比较偏头痛组与对照组之间在痛觉处理上的差异。结果与对照组相比,偏头痛组疼痛电刺激疼痛阈值显著降低(P0.05),疼痛电刺激产生的体感诱发磁场M20潜伏期明显延长(P0.01)。偏头痛组疼痛诱发Gamma振荡平均能量较对照组显著增强(P0.01),且Gamma震荡能量值与视觉模拟评分法(VAS)、偏头痛残疾程度评估量表(MIDAS)评分均呈正相关(VAS左手:r=0.45,P0.05;VAS右手:r=0.46,P0.05;MIDAS左手:r=0.47,P0.01;MIDAS右手:r=0.59,P0.01)。结论偏头痛患者发作间期存在疼痛感觉异常,且痛觉刺激相关的皮质兴奋性增高。     

无先兆偏头痛患者大脑结构和功能异常的MRI研究

目的研究无先兆偏头痛患者大脑结构和功能异常的MRI表现。方法选取30例无先兆偏头痛患者作为观察组,同期25例健康志愿者作为对照组。Signa Excite 3.0 T磁共振扫描仪,采用平面回波成像序列采集对象静息态功能MRI图像,采用单次激发回波平面成像序列采集脑白质DTI图像。采用肯德尔系数评估静息态局部一致性,采用基于纤维束追踪空间统计分析技术(TBSS)分析脑白质纤维的分数各项异性(FA)、平行弥散系数(RD)、轴向弥散系数(AD)、以及平均弥散系数(MD)。结果与对照组比较,观察组患者多个脑区存在局部一致性降低,包括左侧前后扣带回、左侧颞下回、左侧梭状回、右侧中央前后回、右侧额中回、右侧舌回局部一致性减弱(FEW校正,P0.05)。观察组患者双侧大脑脚、双侧内囊后肢、右侧内囊前肢、右侧上纵束、右侧胼胝体体部和压部、右侧上放射冠和后放射冠、左侧扣带的FA值显著降低(FEW校正,P0.05);双侧上放射冠和后放射冠、双侧扣带、双侧丘脑后辐射、双侧上纵束、右侧大脑脚、右侧内囊前后肢以及右侧胼胝体体部和压部的RD值显著升高(FEW校正,P0.05);胼胝体体部和压部,右侧上放射冠和后放射冠,以及右侧上纵束的MD值显著升高(FEW校正,P0.05);两组各脑区的AD值无显著性差异(FEW校正,P0.05)。结论无先兆偏头痛患者大脑静息态局部一致性和脑白质纤维束存在改变,且明显区别于健康志愿者。     

无先兆偏头痛患者的经颅多普勒和皮肤交感反应的对比分析

目的探讨无先兆偏头痛(MWA)患者发作间期的脑血管血液动力学异常和自主神经功能失常。方法对48例MWA患者和36例健康人群(HC)的经颅多普勒(TCD)和皮肤交感反应(SSR)进行对比分析。结果 MWA组的TCD大脑中动脉最高平均流速(MFV-MCA)异常率和SSR异常率分别为64.6%和58.3%,与HC组相比,均具有非常显著性差异(P<0.01);MWA组的SSR主要异常表现为潜伏期延长,与HC组相比,差异具有显著性(P<0.05)。MWA组TCD的异常改变和SSR的异常具有较好的一致性(总符合率=68.7%,Kappa值=0.343,P=0.017)。结论在发作间期无先兆偏头痛患者确实存在脑血液动力学的改变和自主神经功能的异常;TCD与SSR存在一致性异常有助于鉴别无先兆偏头痛患者的发病机制和原因。     

Contrasts in cortical magnesium, phospholipid and energy metabolism between migraine syndromes

BACKGROUND: Previous single voxel (31)P MRS pilot studies of migraine patients have suggested that disordered energy metabolism or Mg(2+) deficiencies may be responsible for hyperexcitability of neuronal tissue in migraine patients. These studies were extended to include multiple brain regions and larger numbers of patients by multislice (31)P MR spectroscopic imaging. METHODS: Migraine with aura (MWA), migraine without aura (MwoA), and hemiplegic migraine patients were studied between attacks by (31)P MRS imaging using a 3-T scanner. RESULTS: Results were compared with those in healthy control subjects without headache. In MwoA, consistent increases in phosphodiester concentration [PDE] were measured in most brain regions, with a trend toward increase in [Mg(2+)] in posterior brain. In MWA, phosphocreatine concentration ([PCr]) was decreased to a minor degree in anterior brain regions and a trend toward decreased [Mg(2+)] was observed in posterior slice 1, but no consistent changes were found in phosphomonoester concentration [PME], [PDE], inorganic phosphate concentration ([Pi]), or pH. In hemiplegic migraine patients, [PCr] had a tendency to be lower, and [Mg(2+)] was significantly lower than in the posterior brain regions of control subjects. Trend analysis showed a significant decrease of brain [Mg(2+)] and [PDE] in posterior brain regions with increasing severity of neurologic symptoms. CONCLUSIONS: Overall, the results support no substantial or consistent abnormalities of energy metabolism, but it is hypothesized that disturbances in magnesium ion homeostasis may contribute to brain cortex hyperexcitability and the pathogenesis of migraine syndromes associated with neurologic symptoms. In contrast, migraine patients without a neurologic aura may exhibit compensatory changes in [Mg(2+)] and membrane phospholipids that counteract cortical excitability.     

Abnormal Brain Activity Changes in Patients with Migraine: A Short-Term Longitudinal Study

Background and Purpose

Whether or not migraine can cause cumulative brain alterations due to frequent migraine-related nociceptive input in patients is largely unclear. The aim of this study was to characterize longitudinal changes in brain activity between repeated observations within a short time interval in a group of female migraine patients, using resting-state functional magnetic resonance imaging.

Methods

Nineteen patients and 20 healthy controls (HC) participated in the study. Regional homogeneity (ReHo) and functional interregional connectivity were assessed to determine the focal and global features of brain dysfunction in migraine. The relationship between changes in headache parameters and longitudinal brain alterations were also investigated.

Results

All patients reported that their headache activity increased over time. Abnormal ReHo changes in the patient group relative to the HC were found in the putamen, orbitofrontal cortex, secondary somatosensory cortex, brainstem, and thalamus. Moreover, these brain regions exhibited longitudinal ReHo changes at the 6-week follow-up examination. These headache activity changes were accompanied by disproportionately dysfunctional connectivity in the putamen in the migraine patients, as revealed by functional connectivity analysis, suggesting that the putamen plays an important role in integrating diverse information among other migraine-related brain regions.

Conclusions

The results obtained in this study suggest that progressive brain aberrations in migraine progress as a result of increased headache attacks.     

Familial migraine with and without aura: clinical characteristics and co-occurrence

Migraine with aura (MwA) and migraine without aura (MwoA) are the two common forms of migraine. Many migraine patients suffer from both kinds of attacks. In a questionnaire-based study using the current International Headache Society (IHS) criteria we determined the clinical characteristics and occurrence of MwA + MwoA in 1000 migraine patients belonging to 210 Finnish migraine families. Nine hundred and six patients were able to indicate whether they suffered from MwA (but not MwoA), migraine aura without headache (migraine equivalent) (but not MwA) or MwA and MwoA. Of these patients, 3.2% had experienced MwoA, 11.1% MwA, 40.6% MwA + MwoA, 23.5% MwoA and 20.3% MwA-like symptoms not meeting the IHS criteria. The high prevalence of MwA attacks in the families studied supports the belief that aura has a strong hereditary component. The MwA + MwoA patients had significantly more severe attacks, more typical headache and more prodromal symptoms than the MwA and MwoA subjects. Therefore, it is possible that there is a continuum with pure MwA at the neural and pure MwoA at the headache end of the spectrum, and MwA + MwoA lying in between the two. The MwA + MwoA patients would thus be liable to both types of migraine, making their attacks more characteristic and more severe. This would also explain why the co-occurrence of MwA and MwoA is more common in the clinic compared with population based epidemiological studies. These findings have consequences for future research on liability genes for migraine.     

Cognitive performance in young and middle-aged adults with migraine: Investigating the correlation with white matter hyperintensities and psychological symptoms

Introduction

This study aimed to evaluate the cognitive performance of migraine patients with (MwA) and without aura (MwoA) and investigate the correlation of white matter hyperintensities (WMHs) and psychological symptoms with their cognitive test scores.

基于局域一致性分析的BOLD-fMRI探讨无灶性癫痫的发作机制

目的利用基于局域一致性（regional homogeneity,ReHo）分析方法的血氧水平依赖功能磁共振成像技术,探讨无灶性癫痫的发作机制。方法运用功能性磁共振成像技术,采集无灶性癫痫患者17例和健康对照组16例的静息态数据,然后运用局域一致性分析方法对数据进行分析,观察无灶性癫痫患者脑局域一致性与正常对照组的变化。结果无灶性癫痫组和健康对照组相比ReHo值增强的脑区主要分布在双侧海马;ReHo值降低的脑区主要分布在右顶叶、右中央前回、右额叶、右侧小脑半球及左楔前叶、左前额。结论无灶性癫痫患者静息状态下脑功能活动较对照组有所改变,ReHo值升高的脑区反映了该脑区参与了癫痫的高活动,而降低的脑区可能反应了由于长期癫痫发作导致这些区域的神经元受损。     

以妄想为主的男性精神分裂症患者脑局部一致性的功能磁共振研究

目的：探讨男性偏执型精神分裂症患者在静息状态下是否存在脑功能活动异常及其区域。方法：采用病例一对照研究方法,对20例以妄想为主的男性精神分裂症患者（患者组）和20名性别、年龄、受教育程度相匹配的正常对照者（正常对照组）进行功能磁共振成像（fMRI）扫描,分析静息状态下各脑区的局部一致性（regionalhomogeneity,ReHo）的差异。结果：设P〈0．05、体素范围（k值）≥85,与正常对照组比较,患者组双侧额上回、双侧颞中回、左额中回、左中央前回、左小脑脚和右扣带回局部一致性（ReHo值）减低,右颞上回和左颞下回ReHo值增高,而左梭状回ReHo值既有增高也有减低。结论：以妄想为主的男性精神分裂症患者在静息状态下可能存在广泛分布的脑区功能异常。     

Cerebrovascular reactivity to l-arginine in the anterior and posterior cerebral circulation in migraine patients

Perko D, Pretnar‐Oblak J, Šabovič M, Žvan B, Zaletel M. Cerebrovascular reactivity to l‐arginine in the anterior and posterior cerebral circulation in migraine patients.
Acta Neurol Scand: 2011: 124: 269–274.
© 2011 John Wiley & Sons A/S. Objective – Cerebral infarction preferentially affects the posterior cerebral artery distribution in migraine patients. The results obtained from the few known studies that have compared the anterior and posterior cerebral endothelial function are contradictory. To the best of our knowledge, cerebrovascular reactivity to L‐arginine (CVR), measured by transcranial Doppler sonography (TCD), has not been previously used to determine the posterior cerebral endothelial function in migraine patients with (MwA) and without aura (MwoA). Materials and methods – Forty migraine patients without comorbidities (20 MwA, 20 MwoA) and 20 healthy subjects were included. By employing strict inclusion criteria, we avoided the possible vascular risk factors. Mean arterial velocity in the middle cerebral artery (MCA) and the posterior cerebral artery (PCA) was measured by TCD before and after infusion of L‐arginine, and CVR to L‐arginine was then calculated. Results – All migraine patients had lower CVR to L‐arginine in PCA (P = 0.002) and similar in MCA (P = 0.29) compared to healthy subjects. This difference was also present in MwA and MwoA compared to healthy subjects (P = 0.003). Conclusions – Lower CVR to L‐arginine in PCA in migraine patients could associate migraine and cerebral infarcts that are more common in the posterior cerebral artery distribution.     

A resting-state functional magnetic resonance imaging study on the first-degree relatives of persons with schizophrenia

In this study, resting state fMRI images and BOLD signals were recorded from 13 first-degree relatives of schizophrenic patients and 13 healthy controls. The data were analyzed with the ReHo approach after realignment, registration, and normalization in statistical parametric mapping 2 (SPM2). A two-sample t-test was used to analyze the ReHo differences between first-degree relatives and healthy controls in a voxel by voxel manner. A combined threshold of p < 0.005 and number of voxels >5 was designated as statistically significant. To evaluate cognitive deficits in first-degree relatives, attention/vigilance and verbal/visual memory were measured. Significant impairments in attention were observed in first-degree relatives compared to healthy controls. Significant abnormalities in ReHo were observed in resting brain in first-degree relatives. Decreased ReHo was found to be distributed over the bilateral middle frontal, middle temporal, cingulate gyrus and cerebellar tonsil; the left inferior frontal gyrus, inferior parietal lobule and dorsolateral prefrontal cortex; the right superior frontal gyrus and dorsolateral prefrontal cortex. Increased ReHo was found to be distributed in the right precuneus and superior temporal gyrus. These changes in ReHo suggest abnormality in the resting state brain function of first-degree relatives of schizophrenic patients and may be early signs for the development of schizophrenia.     

青少年广泛性焦虑障碍患者静息态功能磁共振成像研究

目的:运用局部一致性(ReHo)方法研究首发青少年广泛性焦虑障碍患者的局部自发性脑活动. 方法:对19例首发青少年广泛性焦虑障碍患者及14名年龄、性别与其相匹配的正常对照进行静息态脑功能磁共振成像扫描,通过计算每个给定体素与其最邻近的26个体素之间的肯德尔和谐系数(KCC)来获得全脑的局部一致性(ReHo)图,利用双样本t检验分析两组受试者静息态下局部一致性的差异. 结果:与正常对照相比,青少年广泛性焦虑障碍患者局部一致性降低的脑区包括双侧额中回、枕中回,左侧额上回、颞下回、前扣带回及右侧顶下回、枕下回(P ＜0.005,未校正);局部一致性增高的脑区包括:右侧楔前叶、角回及左侧枕上回(P ＜0.005,未校正). 结论:青少年广泛性焦虑障碍患者静息态脑功能局部一致性存在异常.     

Decreased regional homogeneity in lingual gyrus,increased regional homogeneity in cuneus and correlations with panic symptom severity of first-episode,medication-naïve and late-onset panic disorder patients

This study was designed to explore regional homogeneity (ReHo), an indicator of the synchronization of brain function, in first-episode, medication-naïve and late-onset patients with panic disorder (PD). Participants comprised 30 patients and 21 healthy controls who underwent with 3-Tesla magnetic resonance imaging (MRI) scanning and ReHo functional MRI analysis. All participants were studied with clinical rating scales to assess the severity of PD symptoms. ReHo values were obtained using the REST toolbox (resting-state functional MRI data analysis toolbox). Differences in demographic data and ReHo values between the two groups were evaluated with the independent two-sample t-test function of the Statistical Package for the Social Sciences and REST. There were significant differences in clinical ratings between the two groups. No demographic differences were noted. We found decreased ReHo in the left lingual gyrus and increased ReHo in the right cuneus cortex of patients compared with controls. ReHo values of patients were negatively correlated with PD ratings in the right cuneus. ReHo differences found in the left lingual gyrus and the right cuneus might suggest sensory and inhibitory dysfunction in first-episode, medication-naïve, late-onset patients with PD.