Preliminary Study Of Multimodal MRI In The Structure And Function Of The Brain In Migraine With Foramen Ovale Opacification

Objective:This study combined the application of structural,perfusion,and functional three modalities of magnetic resonance imaging with a standardized image analysis method in an attempt to systematically investigate the structural and functional brain alterations and their neural mechanisms in the migraine with patent foramen ovale patients,in terms of gray matter morphology,cortical surface area,cerebral blood perfusion,and functional brain activity.Materials and Methods:1.Study population:20 patients with migraine with patent foramen ovale and 28 sex-and age-matched healthy controls.2.General information and clinical data collection:Demographic data such as age,gender,height,weight,and education level of the patients were collected in the study.The frequency of headache attacks and the presence or absence of aura were recorded.A standardized Migraine Incapacity Assessment Questionnaire(MIDAS)was used.A series of neuropsychological assessments were also performed,including the Hamilton Anxiety Inventory(HAMA)with the Hamilton Depression Inventory(HAMD)were collected.3.MRI data acquisition:MRI data acquisition for all subjects was performed on a GE Discovery MR750W3.0T MRI scanner(GE Healthcare,Milwaukee,WI,USA).The MRI data were scanned during the interictal period of headache attacks in patients with migraine with oval foramen.The scanned sequences included 3D-T1 Bravo,rs-f MRI,and 3D-ASL sequences.4.Preprocessing and statistical analysis of MR images:The preprocessing and statistical analysis of MR images were performed on SPM8,SPM12,CAT12,Dpabi in MATLAB 2018b(www.mathworks.com).5.Statistical analysis:Baseline demographic information was analyzed using SPSS25.0(IBM SPSS Statistics for Windows)software.6.Results presentation:The results of the images were presented using Dpabi,Xjview,and Brain Net Viewer software.Results:1.General data comparison results:Gender was compared between the two groups using the chi-square test,and age was compared between the two groups using the Mann-Whitney U test,and no statistical differences were found between the two groups of subjects in terms of gender and age composition(P > 0.05).2.Voxel-based morphometrics(VBM)results:A total of 20 patient groups as well as 28 healthy controls were finally included in the VBM analysis.Total intracranial volume(TIV),gender,and age were used as covariates.Compared to healthy controls,gray matter density was found to be lower in the left inferior temporal gyrus,left precuneus,right precuneus,left middle temporal gyrus,left middle occipital gyrus,left perirhinal cortex,right perirhinal cortex,left syrinx,left lingual gyrus,left medial and paracentral cingulate gyrus,left inferior occipital gyrus,left hippocampus,midbrain,and left cerebellum and right brainstem in the patient group.3.Surface area-based morphometry(SBM)results:A total of 20 patient groups as well as 28 healthy controls were eventually included in the SBM analysis.Age and sex were used as covariates.The depth of the sulcus was found to be reduced in the insula,superior temporal gyrus,inferior frontal gyrus triangle,temporal pole,lateral prefrontal cortex,internal olfactory cortex,lingual gyrus,hippocampal gyrus,and talar parietal gyrus in the left brain of the patient group compared to the healthy controls.In the right brain,the gyral index was reduced in the lateral occipital lobe,superior parietal lobule,cuneus,and precuneus.4.CBF results:A total of 20 patients and 28 healthy controls with CBF maps generated from ASL sequences were finally included in the analysis.Age and gender were used as covariates.Compared to healthy controls,CBF values were higher in the cerebellum and in the left perirhinal cortex,left lingual gyrus,and right lingual gyrus in the patient group.CBF values were lower in the right middle frontal gyrus,right superior temporal gyrus,right insula,right insula inferior frontal gyrus,right delta inferior frontal gyrus,right precentral gyrus,right supramarginal gyrus,and right postcentral gyrus.5.Reho results:A total of 19 patients and 19 healthy controls were finally included in the analysis for the Reho maps generated from the BOLD sequence.Compared to healthy controls,Reho was higher in the left hippocampus,left thalamus,and lower in the left precuneus in the patient group,after correcting for the effects of gender and age.6.Al FF results:A total of 19 patients and 19 healthy controls with BOLD sequences generating ALFF maps were finally included in the analysis.Compared to the healthy controls,the Alff values of the right middle frontal gyrus,the left inferior deltoid frontal gyrus,the right rectus,the left superior temporal gyrus,the left dorsolateral superior frontal gyrus,and the right caudate nucleus were reduced in the patient group after correcting for the effects of gender and age.Conclusion:The study used multimodal magnetic resonance imaging to identify multiple eigenvalue changes in brain structure and function in the migraine with patent foramen ovale patients,and brain regions with two or more eigenvalue changes were mainly located in the temporal lobe,frontal lobe,occipital lobe,insula,cuneus,precuneus,and cerebellum.It lays a foundation for studying the pathological mechanism of the disease and providing disease-related imaging markers.To provide a basis for further study on the relatively special brain mechanism and treatment of migraine patients with patent foramen ovale.