Cerebral perfusion variance in new daily persistent headache and chronic migraine: an arterial spin-labeled MR imaging study

Abstract

Background and purpose New daily persistent headache (NDPH) and chronic migraine (CM) are two different types of headaches that might involve vascular dysregulation. There is still a lack of clarity about altered brain perfusion in NDPH and CM. This study aimed to investigate the cerebral perfusion variances of NDPH and CM using multi-delay pseudo-continuous arterial spin-labeled magnetic resonance imaging (pCASL-MRI). Methods Fifteen patients with NDPH, 18 patients with CM, and 15 age- and sex-matched healthy controls (HCs) were included. All participants underwent 3D multi-delay pCASL-MRI to obtain cerebral perfusion data, including arrival-time-corrected cerebral blood flow (CBF) and arterial cerebral blood volume (aCBV). The automated anatomical labeling atlas 3 (AAL3) was used to parcellate 170 brain regions. The CBF and aCBV values in each brain region were compared among the three groups. Correlation analyses between cerebral perfusion parameters and clinical variables were performed. Results Compared with HC participants, patients with NDPH were found to have decreased CBF and aCBV values in multiple regions in the right hemisphere, including the right posterior orbital gyrus (OFCpost.R), right middle occipital gyrus (MOG.R), and ventral anterior nucleus of right thalamus (tVA.R), while patients with CM showed increased CBF and aCBV values presenting in the ventral lateral nucleus of left thalamus (tVL.L) and right thalamus (tVL.R) compared with HCs (all p < 0.05). In patients with NDPH, after age and sex adjustment, the increased aCBV values of IFGorb. R were positively correlated with GAD-7 scores; and the increased CBF and aCBV values of tVA.R were positively correlated with disease duration. Conclusion The multi-delay pCASL technique can detect cerebral perfusion variation in patients with NDPH and CM. The cerebral perfusion changes may suggest different variations between NDPH and CM, which might provide hemodynamic evidence of these two types of primary headaches.

Mapping the aberrant brain functional connectivity in new daily persistent headache: a resting-state functional magnetic resonance imaging study

“…Some studies suggested that migraine with visual aura exist in altered neurochemical coupling in the occipital cortex [ 19 ]. Our recent study also reported decreased cerebral perfusion, increased regional homogeneity and multiple frequency amplitudes of low-frequency fluctuation in the middle occipital gyrus in patients with NDPH [ 8 , 27 ]. The above evidence suggests that the abnormal functional network and imbalance of neurotransmitters of the occipital lobe might be involved in headache and pain.…”

“…4B; p < 0.001) were significantly decreased in the NDPH group compared to the HC group. (8) The FC between the right thalamus and bilateral cuneus (Fig. 5A-C; L: p = 0.015; R: p = 0.025), left calcarine (Fig.…”

“…Some evidence reported alterations in the structure and function of the brain in adolescents with NDPH [ 7 ]. Our previous study reported that adult patients of NDPH have decreased cerebral blood flow and arterial cerebral blood volume of multiple regions in the right hemisphere, and it provided hemodynamic evidence of NDPH [ 8 ]. However, recent evidence had demonstrated that no structural brain alterations in adult patients of NDPH, suggests that adults and adolescents with NDPH might have different brain mechanisms [ 9 ].…”

Brain structure and cortical activity changes of new daily persistent headache: multimodal evidence from MEG/sMRI

“…We found that 39.28% of NDPH group had photophobia symptoms and their GM volume of calcarine increased. The brain perfusion of occipital in patients with NDPH was altered in our previous study, and we suggested that patients with NDPH may have abnormal activation of the visual system [ 39 , 40 ]. This is not surprising given the visual pathway's established role in nociceptive pathways.…”

Alterations in regional homogeneity and multiple frequency amplitudes of low-frequency fluctuation in patients with new daily persistent headache: a resting-state functional magnetic resonance imaging study

“…A retrospective study on whether patients with NDPH develop white matter abnormalities or infarct-like lesions on neuroimaging involved 97 patients with NDPH found that only 13 patients with NDPH demonstrated white matter abnormalities, and none had infarct-like lesions [ 30 ]. Our previous arterial spin-labelled magnetic resonance imaging (MRI) study found decreased cerebral blood flow (CBF) and arterial cerebral blood volume (aCBV) values in the right posterior orbital gyrus, right middle occipital gyrus, and ventral anterior nucleus of the right thalamus in patients with NDPH ( n = 15) compared to HCs ( n = 15) [ 31 ]. A cross-sectional voxel-based morphometry (VBM) and surface-based morphometry (SBM) study investigated 23 patients with NDPH and 23 age- and gender-matched healthy controls (HCs) and found no grey matter changes in patients with NDPH [ 32 ].…”