Investigation Of Imaging Features In Migraine Without Aura Using Multi-modal Magnetic Resonance Imaging

Migraine is a recurrent and disabling neurological disease,which is characterized by moderate to severe headaches,with a combination of nausea,vomitting,phonophobia,and hypersensitivities to external stimuli?such as visual,auditory,olfactory,and somatosensory stimuli?.Migraine can lead to serious economic burden and has a high prevalence around the world.It has become an important public health concern.Unfortunately,migraine pathological mechanism is poorly understood until now.The previous neuroimaging research have contributed to a better understanding of the mechanisms of migraine.However,the most previous studies have a limited sample size,a single analysis method and a lack of comparison and verification by multiple methods.Multi-modal magnetic resonance imaging?MRI?can explore the pathology of migraine from different aspects and provide useful information for clinical diagnosis and treatment.In current study,we recruited 50 patients with migriane without aura?MWoA?and50 healthy controls?HC?to investigate the imaging features associated with pathology of MWoA using multi-modal MRI,including high resolution T₁ weighted imaging,diffusion tensor imaging?DTI?and resting-state functinol MRI?rs-fMRI?.Firstly,the structural analysis were performed in current study.Morphological MRI and DTI analysis were used to evaluate the changes of brain morphological structure and tissue microstructure in patients with MWoA.And it was found that the abnormal brain regions in MWoA were mainly in the gray matter areas,including cerebellar cortex,occipital cortex,insular cortex,prefrontal cortex,posterior parietal lobe,and primary somatosensory cortex?S1?,but DTI analysis shows no positive results for MWoA.Then,resting-state fMRI was used to validate the findings of structural analysis and to explore the abnormal brain function activity and connectivity patterns of functional network.The main research were as follows:1)Using the rs-fMRI measures,including regional homogeneity?ReHo?,degree centrality?DC?,amplitude of low-frequency fluctuation?ALFF?and fractional ALFF?fALFF?,we investigate abnormalities of fucntional activity in patients with MWoA,and we found that there were multiple measures changes in S1 and prmotor cortex?PMC?within sensorimotor cortex,and the patterns of functional connectivity were altered between S1 and posterior parietal lobe,insula,primary mortor cortex?M1?,and precuneus.In addition,patients with MWoA aslo exist functional abnormalities in the default mode network,cerebellum,and temporal lobe;2)Brain functional networks of MWoA and HC were constructed based on Brainnetome atlas and AAL atlas separately,and were used to evluate the changes of topological properties and FC patterns in MWoA.The results found that patients with MWoA not only exhibited abnormalities in small world property measures,but also showed abnormalities in nodal centrality and disrupted functional network.Furthermore,we preliminarily explored the feasibility of automating the classification of patients with MWoA and HC,and the important brain regions for classification process using multi-voxel pattern analysis?MVPA?based on fMRI measures——ReHo and DC.Although MVPA classification results did not achieve high accuracy,the accuracy rate was significantly higher than random level?p<0.05?.The altered brain regions are mainly located in the sensorimotor cortex,cerebellum,and temporal cortex,which are consistent with the preious results.This study suggest that MVPA can be used to locate the abnormal brain regions of migraine and explore the ability of individualized diagnosis.It is necessary to further improve the accuracy by combining with more features of other modal MRI data to achieve the individual prediction.The multi-modal MRI research found structrual and functional abnormalities of MWoA patients in insular cortex and sensorimotor cortex,suggesting that there may disrupt trigeminal neurovascular pathway and cannot effectively process nociceptive information in patients with MWoA.Furthermore,the current study also found functional changes in default mode network,cerebellum,prefrontal cortex,and parietal lobe associated with pain and cogintive processing.It is suggest that migraine is an extremely complex neurological disease involving structural and functional brain regions on multiple cortices.It is worth noting that sensorimotor cortex and insula are important brain areas in the pain processing pathways and their abnormalities have been identified by multiple MRI parameters,which suggests that they can be as the target regions for clinical interventions for migraine patients.