成年无先兆偏头痛患者治疗前后脑白质DT-MRI分析

目的研究成年无先兆偏头痛患者脑白质可能存在的微细结构异常,探讨其药物治疗前后的变化特点.方法选择成年无先兆偏头痛患者(病例组)及年龄与性别相匹配的同期健康体检者(对照组)各32例进行磁共振弥散张量成像(DT-MRI)检查;分别于胼胝体膝部、体部、压部及双侧额叶白质最厚的部位设置感兴趣区,测取部分各向异性值(FA值)和表观弥散系数值(ADC值).结果病例组患者治疗前胼胝体膝部、体部及压部FA值均较对照组明显降低(P<0.01);治疗后,胼胝体各部位FA值较治疗前均明显升高(P<0.01);各时间点双侧额叶白质FA值与对照组比较均无明显差异(P>0.05).胼胝体各部位及双侧额叶白质ADC值治疗前后各时间点与对照组比较均无明显差异(P>0.05).病程与胼胝体膝部、体部及压部FA值均呈明显负相关(r值分别为-0.743、-0.742及-0.363,P值分别为0.000、0.000及0.009),而与双侧额叶白质FA值无明显相关性(P>0.05);月均头痛次数与胼胝体膝部及体部FA值均呈明显负相关(r值分别为-0.824、-0.792,P值均为0.000),而与胼胝体压部与双侧额叶白质FA值无明显相关性(P>0.05).结论成年无先兆偏头痛患者存在胼胝体神经纤维微细结构完整性的损害;经有效治疗这种损害是可逆的.

Investigations on the white matter abnormalities in adult patients with migraine without aura before and after treatment with diffusion tensor magnetic resonance imaging

Objective To investigate the possible microstructural abnormalities of the cerebral white matter and its changes in adult patients with migraine without aura before and after treatment. Methods Diffusion tensor magnetic resonance imaging（DT-MRI） was carried out in 32 adult patients with migraine without aura and 32 age- and sex- matched healthy controls. Fractional anisotropy（FA） and apparent diffusion coefficient（ADC） were measured at genu, body, and splenium of the corpus callosum（CC） and bilateral frontal white matter, respectively. Results The FA values at the genu, body, and splenium of the CC from patients with migraine without aura before treatment were significantly lower than the control（P〈0.01）. The FA values at the genu, body, and splenium of the CC after treatment all increased significantly compared with before treatment（P〈0.01）. However, the FA values at the bilateral frontal white matter were not significant different between the two groups（P〉0.05）. The ADC values of the above regions were not significantly different between the two groups（P〉0.05）. There were negative correlations between disease course and the FA values at the genu, body, and splenium of the CC（r=-0.743, -0.742, and -0.363, P=0.000, 0.000, and 0.009, respectively）. Negative correlations were also found between headache frequency and FA values at the genu and body of the CC（r=-0.824, and -0.792, P=0.000, and 0.000, respectively）. Conchlsion There might be an integrity change of neurofibrotic microstructures in the C C in adult patients with migraine without aura, which may be reversible through effective treatment.