Abstract
BackgroundThe periaqueductal gray (PAG) dysfunction was recognized in migraine, and the nonspecific PAG lesions were also observed in episodic migraine (EM) recently. However, the PAG volume change was not totally detected in EM up to now. Herein, the aim of this study was to investigate altered PAG volume in EM patients based on high resolution brain structural image.MethodsThe brain structural images were obtained from 18 normal controls (NC), 18 EM patients and 16 chronic migraine (CM) on 3.0 T MR system. PAG template was created based on the ICBM152 gray matter template using MRIcron, and the individual PAG was created by applying the deformation field to the PAG template after structural image segment. One-way analysis of covariance, partial correlation analysis and Receiver operating characteristics (ROC) curve were applied.ResultsEM had a larger PAG volume (0.35 ± 0.02 ml) than that (0.32 ± 0.02 ml) of NC (P = 0.017). The PAG volume of CM (0.33 ± 0.02 ml) was negatively related to the VAS score (P = 0.03). ROC analysis demonstrated that PAG volume has higher diagnostic efficacy (AUC, 0.731; Sensitivity, 0.556; Specificity, 0.889) for NC vs. EM compared with that NC vs. CM (AUC, 0.634; Sensitivity, 0.438; Specificity, 0.833) and EM vs. CM (AUC, 0.618; Sensitivity, 0.813; Specificity, 0.556).ConclusionPAG volume expansion may be the direct impairment evidence on the brain in EM, and could be considered as a diagnostic and evaluated imaging biomarker in migraine.
Highlights
The periaqueductal gray (PAG) dysfunction was recognized in migraine, and the nonspecific PAG lesions were observed in episodic migraine (EM) recently
There was a significant difference for age between EM (33.39 ± 10.69 years old) and chronic migraine (CM) (42.44 ± 8.65 years old)
There was a significant difference for Hamilton Anxiety Scale (HAMA) between normal controls (NC) (9.67 ± 3.16) and EM (15.67 ± 9.85), Hamilton Depression Scale (HAMD) between EM (15.67 ± 9.85) and CM (16.31 ± 10.52), Montreal Cognitive Assessment (MoCA) among NC (26.89 ± 2.47), EM (29.16 ± 1.47), and CM (22.94 ± 5.37)
Summary
The periaqueductal gray (PAG) dysfunction was recognized in migraine, and the nonspecific PAG lesions were observed in episodic migraine (EM) recently. The aim of this study was to investigate altered PAG volume in EM patients based on high resolution brain structural image. Of all the target “generator” of migraine attacks, the PAG region has been the key observed brain structure. PAG abnormalities can be detected in migraine patients with brain T2-visible lesion using voxel-based morphometry (VBM), which mainly identified increased. Chen et al The Journal of Headache and Pain (2017) 18:83. The altered PAG density indicated the volume change without modulation in VBM, which did not represent the true volume change [14]. The true PAG volume abnormalities were not investigated in episodic migraine
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