目的:通过静息血氧水平依赖性功能磁共振成像(BOLDfMRI)研究年轻女性非经期无先兆偏头痛(MWoA)针刺前后低频波动幅度(ALFF)和度中心性(DC)值的变化。
方法:招募非月经MWoA患者(第1组,n=50)和健康对照组(第2组,n=50)。第1组在2个时间点进行功能磁共振成像:针刺前(时间点1,TP1);和所有针刺结束后(时间点2,TP2),并在第2组中作为一次性扫描进行。在进行fMRI后,在TP1和TP2使用偏头痛残疾评估问卷(MIDAS)和简短的McGill疼痛问卷(SF-MPQ)对第1组患者进行评估。在两个时间点在组1内以及在组1和组2之间比较ALFF和DC值。分析ALFF和DC值与临床量表评分的相关性。
结果:大脑活动在左梭状回和右角回增加,左枕中回,第1组的双侧前额叶皮质和左侧顶叶下小叶降低,与第2组相比,在TP1时ALFF值不同。双侧梭状回,双侧颞下回和右颞中回增加,右角回,右上边缘回,右下顶叶小叶,右枕中回,右额上回,右额中回,右前中央回,在TP1时,与第2组相比,第1组活动中右侧补充运动面积减少的DC值不同。右颞下回ALFF和DC值,与TP2相比,TP1组1的右梭形回和右颞中回减少。组1中左枕中区ALFF值与TP1处疼痛程度呈正相关(相关系数r,r=0.827,r=0.343;P<0.01,P=0.015)。第1组TP1时右颞下区DC值与疼痛程度呈正相关(r=0.371;P=0.008)。
结论:针刺改变了非月经MwoA的年轻女性的自发性脑活动和网络变化。右颞区可能是针刺调节非月经MwoA年轻女性脑功能的重要目标。
OBJECTIVE: To investigate the changes in amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) values before and after acupuncture in young women with non-menstrual migraine without aura (MWoA) through rest blood-oxygen-level-dependent functional magnetic resonance imaging (BOLD fMRI).
METHODS: Patients with non-menstrual MWoA (Group 1, n = 50) and healthy controls (Group 2, n = 50) were recruited. fMRI was performed in Group 1 at 2 time points: before acupuncture (time point 1, TP1); and after the end of all acupuncture sessions (time point 2, TP2), and performed in Group 2 as a one-time scan. Patients in Group 1 were assessed with the Migraine Disability Assessment Questionnaire (MIDAS) and the Short-Form McGill Pain Questionnaire (SF-MPQ) at TP1 and TP2 after fMRI was performed. The ALFF and DC values were compared within Group 1 at two time points and between Group 1 and Group2. The correlation between ALFF and DC values with the statistical differences and the clinical scales scores were analyzed.
RESULTS: Brain activities increased in the left fusiform gyrus and right angular gyrus, left middle occipital gyrus, and bilateral prefrontal cortex and decreased in left inferior parietal lobule in Group 1, which had different ALFF values compared with Group 2 at TP1. The bilateral fusiform gyrus, bilateral inferior temporal gyrus and right middle temporal gyrus increased and right angular gyrus, right superior marginal gyrus, right inferior parietal lobule, right middle occipital gyrus, right superior frontal gyrus, right middle frontal gyrus, right anterior central gyrus, and right supplementary motor area decreased in activity in Group 1 had different DC values compared with Group 2 at TP1. ALFF and DC values of right inferior temporal gyrus, right fusiform gyrus and right middle temporal gyrus were decreased in Group1 at TP1 compared with TP2. ALFF values in the left middle occipital area were positively correlated with the pain degree at TP1 in Group1 (correlation coefficient r, r = 0.827, r = 0.343; P < 0.01, P = 0.015). The DC values of the right inferior temporal area were positively correlated with the pain degree at TP1 in Group 1 (r = 0.371; P = 0.008).
CONCLUSIONS: Spontaneous brain activity and network changes in young women with non-menstrual MwoA were altered by acupuncture. The right temporal area may be an important target for acupuncture modulated brain function in young women with non-menstrual MwoA.