| Tension-type headache(TTH),also known as psychogenic headache or stress headache,is a nervous system disease caused by common psychological and physical tension.And TTH is also one of the most common psychosomatic diseases in clinics.In the past decade,with the development of society,the pressure of study,work,and life has increased.The clinical incidence rate of TTH has increased significantly.In the evaluation in 2016,the global prevalence of TTH ranked third and was ranked as the third most prevalent disease in the world.However,most of the current research on the pathological mechanism of TTH focuses on the changes in neural activity in single brain regions,ignoring the abnormal connection between brain regions.The completion of any task requires the cooperation of several brain regions.However,whether the rate of information transmission and processing of the whole brain network is abnormal,and whether the connection strength between the brains of TTH is abnormal,are still unexplored areas.Therefore,exploring the pathogenesis of TTH patients from the perspective of a network is a crucial task in this field.In addition,negative emotions such as anxiety,depression,and stress are risk factors for maintaining headache attacks.However,it is unclear whether these risk factors are related to abnormal brain connectivity and information transmission rate in TTH patients,and whether they are one of the reasons for or maintaining brain abnormalities in TTH patients.This study recruited 32 TTH patients(42.66 ± 12.26 years old)and 28 healthy controls(HCs,37.04 ± 10.35 years old)from the Affiliated Hospital of Weifang Medical University,and collected resting-state functional magnetic resonance imaging(rs-f MRI)data.Firstly,the method of graph theory was used to analyze the whole brain network,and then the ability of the entire brain to transmit information(small world attributes,global efficiency)for two groups of participants is calculated separately.The abnormality of the brain information transmission ability of the two groups of subjects was analyzed using a two-sample T-test.Subsequently,the correlation analysis was used to assess the correlation between abnormal transmission ability and the Depression-Anxiety-Stress Scale(DASS)score.If there is an abnormality in the information transmission ability of the entire brain of TTH patients,the network-based statistics(NBS)method was used in Study 2 to further analyze which specific brain regions have undergone changes in information communication.The Power264 atlas was used to divide the brain into 264 brain regions,extracted the average time series of each brain region,and calculated the Pearson correlation between brain regions.Next,a two-sample T-test was used to analyze the differences in brain connectivity strength between the two groups.Similarly,correlation analysis was used to evaluate the relationship between abnormal network connectivity and psychological factors.In study 1,it was found that the brain information transmission rate of TTH patients increased.However,the information transmission rate in local brain areas was reduced,and the ability to function separation was weakened.And the results of study 2 further found that,compared with the HCs,the connection between the occipital lobe and brainstem,supplementary motor area,precental gyrus,and cingulate gyrus of TTH patients were enhanced;The connections between the brain areas inside the occipital lobe,the connections between the cerebellum and the precental gyrus,temporal lobe,occipital lobe(middle occipital gyrus,lingual gyrus),the connections between the bilateral cerebellum,and the connections between the occipital lobe(middle occipital gyrus,lingual gyrus)and temporal lobe(inferior temporal gyrus)were weakened.This is consistent with the increased brain information transmission rate,decreased information transmission rate in local regions,and weakened ability to separate functions found in Study 1.In addition,the Correlation analysis showed that the abnormal connection strength between the right superior occipital gyrus and the left anterior cingulate and paracingulate gyri was significantly positively correlated with anxiety;The abnormal connection between the right lingual gyrus and the left inferior temporal gyrus was significantly negatively correlated with anxiety,indicating that there is a certain correlation between patient’s anxiety and abnormal brain connectivity in TTH patients.These results indicate that the brain transmission information rate of TTH patients is accelerated.The specific brain regions involved mainly include: the occipital lobe,cingulate gyrus,supplementary motor area,temporal lobe,brainstem,cerebellum,and other brain regions.The abnormal connection between the occipital lobe and anterior cingulate gyrus,and brainstem may be the brain nerve mechanism for TTH patients to rapidly transmit harmful information.Abnormal connections in the internal area of the occipital lobe may be the neural basis of photophobia in TTH patients.And these abnormal connections were significantly correlated with anxiety.Specifically,The weaker the functional connection between the lingual gyrus and the inferior temporal gyrus,the higher the TTH patient’s anxiety level;The stronger the functional connection between the right superior occipital gyrus and the left anterior cingulate and paracingulate gyri,the higher the level of anxiety in TTH patients;These findings enrich the relevant research on brain imaging of TTH,make people deeper understand the pathological mechanism of TTH,and provide a brain physiological basis and new ideas for the treatment of TTH. |
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