CAJ | 학술논문

目的研究成年无先兆偏头痛患者脑白质可能存在的微细结构异常,探讨其药物治疗前后的变化特点.方法选择成年无先兆偏头痛患者(病例组)及年龄与性别相匹配的同期健康体检者(对照组)各32例进行磁共振弥散张量成像(DT-MRI)检查;分别于胼胝体膝部、体部、压部及双侧额叶白质最厚的部位设置感兴趣区,测取部分各向异性值(FA值)和表观弥散系数值(ADC值).结果病例组患者治疗前胼胝体膝部、体部及压部FA值均较对照组明显降低(P<0.01);治疗后,胼胝体各部位FA值较治疗前均明显升高(P<0.01);各时间点双侧额叶白质FA值与对照组比较均无明显差异(P>0.05).胼胝体各部位及双侧额叶白质ADC值治疗前后各时间点与对照组比较均无明显差异(P>0.05).病程与胼胝体膝部、体部及压部FA值均呈明显负相关(r值分别为-0.743、-0.742及-0.363,P值分别为0.000、0.000及0.009),而与双侧额叶白质FA值无明显相关性(P>0.05);月均头痛次数与胼胝体膝部及体部FA值均呈明显负相关(r值分别为-0.824、-0.792,P值均为0.000),而与胼胝体压部与双侧额叶白质FA值无明显相关性(P>0.05).结论成年无先兆偏头痛患者存在胼胝体神经纤维微细结构完整性的损害;经有效治疗这种损害是可逆的.
목적연구성년무선조편두통환자뇌백질가능존재적미세결구이상,탐토기약물치료전후적변화특점.방법선택성년무선조편두통환자(병례조)급년령여성별상필배적동기건강체검자(대조조)각32례진행자공진미산장량성상(DT-MRI)검사;분별우변지체슬부、체부、압부급쌍측액협백질최후적부위설치감흥취구,측취부분각향이성치(FA치)화표관미산계수치(ADC치).결과병례조환자치료전변지체슬부、체부급압부FA치균교대조조명현강저(P<0.01);치료후,변지체각부위FA치교치료전균명현승고(P<0.01);각시간점쌍측액협백질FA치여대조조비교균무명현차이(P>0.05).변지체각부위급쌍측액협백질ADC치치료전후각시간점여대조조비교균무명현차이(P>0.05).병정여변지체슬부、체부급압부FA치균정명현부상관(r치분별위-0.743、-0.742급-0.363,P치분별위0.000、0.000급0.009),이여쌍측액협백질FA치무명현상관성(P>0.05);월균두통차수여변지체슬부급체부FA치균정명현부상관(r치분별위-0.824、-0.792,P치균위0.000),이여변지체압부여쌍측액협백질FA치무명현상관성(P>0.05).결론성년무선조편두통환자존재변지체신경섬유미세결구완정성적손해;경유효치료저충손해시가역적.
@@@@Objective To investigate the possible microstructural abnormalities of the cerebral white matter and its changes in adult patients with migraine without aura before and after treatment. Methods Diffusion tensor magnetic resonance imaging(DT-MRI) was carried out in 32 adult patients with migraine without aura and 32 age- and sex- matched healthy controls. Fractional anisotropy(FA) and apparent diffusion coefficient(ADC) were measured at genu, body, and splenium of the corpus callosum(CC) and bilateral frontal white matter, respectively. Results The FA values at the genu, body, and splenium of the CC from patients with migraine without aura before treatment were significantly lower than the control(P<0.01). The FA values at the genu, body, and splenium of the CC after treatment all increased significantly compared with before treatment(P<0.01). However, the FA values at the bilateral frontal white matter were not significant different between the two groups(P>0.05). The ADC values of the above regions were not significantly different between the two groups(P>0.05). There were negative correlations between disease course and the FA values at the genu, body, and splenium of the CC(r=-0.743, -0.742, and -0.363, P=0.000, 0.000, and 0.009, respectively). Negative correlations were also found between headache frequency and FA values at the genu and body of the CC(r=-0.824, and -0.792, P=0.000, and 0.000, respectively). Conclusion There might be an integrity change of neurofibrotic microstructures in the CC in adult patients with migraine without aura, which may be reversible through effective treatment.