A Preliminary Study Of Odor-induced Task Functional Magnetic Resonance Imaging In Migraine Patient With Osmophobia

Objective:To observe the changes of brain functional magnetic resonance imaging(fMRI)in migraine patients with osmophobia under olfactory stimulation,analyze the characteristics of olfactory related brain network,and preliminarily explore the neuroimaging mechanism of migraine with osmophobia,so as to provide reference and basis for the early diagnosis,treatment and prognosis of migraine.Methods:39 migraine patients diagnosed in the Department of Neurology of the Affiliated Hospital of North Sichuan Medical College from January 2021 to January 2022 were enrolled,including 27 migraine without osmophobia(MwoO)and 12 migraine with osmophobia(MwO).20 healthy adults were recruited as the control group at the same time.The demographic and clinical characteristics of all subjects were collected.All subjects were evaluated by using visual analogue scale(VAS)and underwent synchronous fMRI scanning under the stimulation of olfactory task.SPM12 and MATLAB 2019b were used to analyze MRI data.The activation of brain regions in MwoO group,MwO group and control group were statistically analyzed by single sample t-test.The activation differences of brain regions in MwoO group,MwO group and control group were compared by one-way ANOVA and then multiple analysis was carried out to compare the differences between each two groups.Result:1.VAS scoreThe mean VAS score was 6.18± 1.30 in the MwoO group,5.16± 1.11 in the MwO group and 8.59±1.14 in the control group respectively.There were significant differences in VAS score between MwoO group,MwO group and control group(P<0.05).2.Olfactory fMRI results(1)In the control group,these activated brain areas included left cerebellum,left inferior temporal gyrus,superior temporal gyrus,left fusiform gyrus,right middle frontal gyrus,right anterior central gyrus,right posterior central gyrus,insula,right central sulcus cover,superior marginal gyrus,right lenticular putamen,wedge lobe,superior occipital gyrus,middle cingulate gyrus,supplementary motor area,paracentral lobule and superior parietal gyrus(P<0.05).(2)In MwoO group,these activated brain areas were right cerebellar area 8,right fusiform gyrus,right inferior temporal gyrus,right anterior central gyrus and right posterior central gyrus.These deactivated brain areas included right cerebellar area 9,middle temporal gyrus,left temporal pole superior temporal gyrus,left inferior frontal gyrus orbit,orbital interior of superior frontal gyrus,right dorsolateral superior frontal gyrus,right middle frontal gyrus,left middle frontal gyrus orbit,right superior temporal gyrus,right superior marginal gyrus,right angular gyrus,anterior cingulate and paracingulate gyrus,medial superior frontal gyrus,right medial and paracingulate gyrus(P<0.05).(3)These activated brain areas in MwO group included cerebellum,inferior frontal gyrus of insula,insular lobe,anterior central gyrus,superior temporal gyrus of right temporal pole,inferior frontal gyrus of triangle,middle frontal gyrus,hippocampus,central sulcus cover,lenticular putamen,right parahippocampal gyrus,left central posterior gyrus,amygdala,supplementary motor area,medial superior frontal gyrus,medial and paracingulate gyrus of right side,right superior temporal gyrus,superior marginal gyrus Left anterior cingulate gyrus and paracingulate gyrus,left inferior parietal marginal angular gyrus.These deactivated brain areas were right fusiform gyrus,right lingual gyrus,right angular gyrus,right occipital lobe,right dorsolateral superior frontal gyrus,left inferior parietal marginal angular gyrus and superior parietal gyrus(P<0.05).(4)These brain areas in MwoO group which were weaker than the control group included left cerebellar 9 area,right insula,right middle frontal gyrus orbit,left inferior frontal gyrus orbit,right dorsolateral superior frontal gyrus,right superior temporal gyrus,right superior occipital gyrus,medial and paracingulate gyrus,and right superior parietal gyrus(P<0.05)(5)These brain areas in MwO group which were weaker than the control group included the right superior occipital gyrus and the right superior parietal gyrus;these brain areas in MwO group which were stronger than the control group included middle frontal gyrus and right supplementary motor area(P<0.05).(6)These brain areas in MwO group which were weaker than the MwoO group included the right superior parietal gyrus;these brain areas in MwO group which were stronger than the MwoO group included left cerebellar 9 area,right insular lobe,left orbital inferior frontal gyrus,right superior temporal gyrus,middle frontal gyrus,right insular inferior frontal gyrus,right medial and paracingulate gyrus,and right supplementary motor area(P<0.05).Conclusion:1.The olfactory function has decreased in interictal migraine patients and significantly reduced in those with osmophobia,and olfactory-related brain networks has changed.2.Migraine patients with osmophobia may probably have specific brain networks,the cerebellum,the superior temporal gyrus and the middle frontal gyrus may be involved in the pathogenesis of osmophobia.