PDF(Pubmed)
Abstract：
OBJECTIVE: Numerous studies demonstrate a link between cerebrovascular alterations and migraine pathogenesis. We investigated the association between migraine and vertebral artery dominance (VAD), basilar artery (BA) curvature, and elongation.
METHODS: This cross-sectional MRI study included 74 migraine patients and 74 control subjects aged between 18 and 55 years. Diameters of the intracranial part of the vertebral artery (VA) and BA, height of the BA bifurcation, and total lateral displacement of the BA were measured. In addition, we investigated the directional relationship between VAD and BA curvature.
RESULTS: There were no statistically significant differences between the groups regarding VA and BA diameters and total lateral displacement of the BA. The height of the BA bifurcation was found to be significantly higher in migraine patients compared to controls (p = 0.002). The left-side VAD was more frequent in migraine patients compared to control subjects (60.8% (45/74) vs 41.9% (31/74), p = 0.001). In migraine patients, particularly those with aura (MwA) patients, with left-side VAD, the rate of BA displacement to the right side is significantly higher than those with right-side VAD or non-VAD (p = 0.022). Also, we found that total lateral displacement of the BA is correlated with VA asymmetry in patients with MwA (r = 0.538, p = 0.007).
CONCLUSIONS: VAD and its opposite-directional relationship with the lateral displacement of the BA may be associated with migraine pathophysiology. Together with aging, this association may contribute to changes in the vertebrobasilar system (VBS) geometry which may result in increased risk for posterior circulation infarction (PCI) in migraineurs.
METHODS: This cross-sectional MRI study included 74 migraine patients and 74 control subjects aged between 18 and 55 years. Diameters of the intracranial part of the vertebral artery (VA) and BA, height of the BA bifurcation, and total lateral displacement of the BA were measured. In addition, we investigated the directional relationship between VAD and BA curvature.
RESULTS: There were no statistically significant differences between the groups regarding VA and BA diameters and total lateral displacement of the BA. The height of the BA bifurcation was found to be significantly higher in migraine patients compared to controls (p = 0.002). The left-side VAD was more frequent in migraine patients compared to control subjects (60.8% (45/74) vs 41.9% (31/74), p = 0.001). In migraine patients, particularly those with aura (MwA) patients, with left-side VAD, the rate of BA displacement to the right side is significantly higher than those with right-side VAD or non-VAD (p = 0.022). Also, we found that total lateral displacement of the BA is correlated with VA asymmetry in patients with MwA (r = 0.538, p = 0.007).
CONCLUSIONS: VAD and its opposite-directional relationship with the lateral displacement of the BA may be associated with migraine pathophysiology. Together with aging, this association may contribute to changes in the vertebrobasilar system (VBS) geometry which may result in increased risk for posterior circulation infarction (PCI) in migraineurs.
摘要：
目的：大量研究表明脑血管改变与偏头痛发病机制之间存在联系。我们调查了偏头痛和椎动脉优势（VAD）之间的关系，基底动脉（BA）曲率，和伸长率。
方法：这项横断面MRI研究包括74名年龄在18至55岁之间的偏头痛患者和74名对照受试者。椎动脉（VA）和BA的颅内部分的直径，BA分叉的高度，并测量了BA的总侧向位移。此外,我们研究了VAD和BA曲率之间的方向关系。
结果：两组之间的VA和BA直径以及BA的总侧向位移没有统计学上的显着差异。与对照组相比，偏头痛患者的BA分叉高度明显更高（p=0.002）。与对照组相比，偏头痛患者的左侧VAD频率更高（60.8％（45/74）对41.9％（31/74），p=0.001)。在偏头痛患者中，特别是那些有先兆（MwA）的患者，左边的VAD,BA向右侧位移的速率明显高于右侧VAD或非VAD的速率（p=0.022）。此外，我们发现，在MwA患者中，BA的总侧向位移与VA不对称性相关（r=0.538，p=0.007）。
结论：VAD及其与BA侧向位移的反方向关系可能与偏头痛的病理生理有关。随着衰老，这种关联可能导致椎基底动脉系统(VBS)几何结构的改变,这可能导致偏头痛患者后循环梗死(PCI)的风险增加.
方法：这项横断面MRI研究包括74名年龄在18至55岁之间的偏头痛患者和74名对照受试者。椎动脉（VA）和BA的颅内部分的直径，BA分叉的高度，并测量了BA的总侧向位移。此外,我们研究了VAD和BA曲率之间的方向关系。
结果：两组之间的VA和BA直径以及BA的总侧向位移没有统计学上的显着差异。与对照组相比，偏头痛患者的BA分叉高度明显更高（p=0.002）。与对照组相比，偏头痛患者的左侧VAD频率更高（60.8％（45/74）对41.9％（31/74），p=0.001)。在偏头痛患者中，特别是那些有先兆（MwA）的患者，左边的VAD,BA向右侧位移的速率明显高于右侧VAD或非VAD的速率（p=0.022）。此外，我们发现，在MwA患者中，BA的总侧向位移与VA不对称性相关（r=0.538，p=0.007）。
结论：VAD及其与BA侧向位移的反方向关系可能与偏头痛的病理生理有关。随着衰老，这种关联可能导致椎基底动脉系统(VBS)几何结构的改变,这可能导致偏头痛患者后循环梗死(PCI)的风险增加.
