Volume Gain of Brainstem on Medication-Overuse Headache Using Voxel-Based Morphometry

作     者：Zhioye Chen Xiao-Yan Chen Meng-Qi Liu Lin Ma Sheng-Yuan Yu Chen Zhi-Ye;Chen Xiao-Yan;Liu Meng-Qi;Ma Lin;Yu Sheng-Yuan

作者机构：Department of Radiology Chinese People's Liberation Army General Hospital Beijing 100853 China Department of Radiology Hainan Branch of Chinese People's Liberation Army General Hospital Sanya Hainan 572013 China Department of Neurology Chinese People's Liberation Army General Hospital Beijing 100853 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2018年第131卷第18期

页      面：2158-2163页

核心收录：

学科分类：1006[医学-中西医结合] 1002[医学-临床医学] 10[医学] 100602[医学-中西医结合临床] 

基　　金：This work was supported by grants from Hainan Provincial Natural Science Foundation of China （No. 818MS153）  Special Financial Grant from the China Postdoctoral Science Foundation （No. 2014T70960）  and Foundation for Medical and Health Science and Technology Innovation Project of Sanya （No. 2016YW37）. 

主　　题：Medication-Overuse Headache Substantia Nigra Trigeminal Root Entry Zone Ventral Tegmental Area Voxel-Based Morphometry 

摘      要：Background： Histopathology identified the anatomical and molecular abnormalities ofbrainstem nuclei in migraine patients. However, the exact whole brainstem structural changes in vivo have not yet been identified in medication-overuse headache （MOH） transformed from migraine. The aim of this study was to investigate the regional volume changes over the whole brainstem in the MOH patients using voxel-based morphometry （VBM） in vivo.Methods： High-resolution three-dimensional structural images were obtained using a 3.0-Tesla magnetic resonance system from 36 MOH patients and 32 normal controls （NCs） who were consecutively recruited from the International Headache Center, Chinese People＇s Liberation Army General Hospital, from March 2013 to June 2016. VBM was used to assess the brainstem structural alteration in the MOH patients, and voxel-wise correlation was performed to evaluate the relationship with the clinical characteristics.Results： The brainstem region with increased volume located in the left ventrolateral periaqueductal gray （MNI coordinate： -1, -33, -8）, ventral tegmental area （MNI coordinate： 0, -22, - 12）, bilateral substantia nigra （MNI coordinate： -8, - 16, - 12, 9, - 16, - 12）, and trigeminal root entry zone （MNI coordinate： -19, -29, -31; 19, -32, -29） in MOH patients compared with NCs. The headache visual analog scale score was positively related with the left rostral ventromedial medulla （RVM） （MNI coordinate： -1, -37, -56; cluster size： 20; r = 0.602） in the MOH patients.Conclusions： The regional volume gain ofbrainstem could underlie the neuromechanism of impaired ascending and descending pathway in the MOH patients, and the left RVM volume alteration could imply the impaired tolerance ofnociceptive pain input and could be used to assess the headache disability in the MOH patients.