BackgroundIncreasing evidence has suggested that the cerebellum is associated with pain and migraine. In addition, the descending pain system of the brainstem is the major site of trigeminal pain processing and modulation and has been discussed as a main player in the pathophysiology of migraine. Cerebellar and brainstem structural changes associated with migraineurs remain to be further investigated.MethodsVoxel-based morphometry (VBM) (50 controls, 50 migraineurs without aura (MWoAs)) and diffusion tensor imaging (DTI) (46 controls, 46 MWoAs) were used to assess cerebellum and brainstem anatomical alterations associated with MWoAs. We utilized a spatially unbiased infratentorial template toolbox (SUIT) to perform cerebellum and brainstem optimized VBM and DTI analysis. We extracted the average diffusion values from a probabilistic cerebellar white matter atlas to investigate whether MWoAs exhibited microstructure alterations in the cerebellar peduncle tracts.ResultsMWoAs showed decreased fractional anisotropy (FA) in the vermis VI extending to the bilateral lobules V and VI of the cerebellum. We also found higher axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) in the right inferior cerebellum peduncle tract in MWoAs. MWoAs exhibited both reduced gray matter volume and increased AD, MD and RD in the spinal trigeminal nucleus (SpV).ConclusionMWoAs exhibited microstructural changes in the cerebellum and the local brainstem. These structural differences might contribute to dysfunction of the transmission and modulation of noxious information, trigeminal nociception, and conduction and integration of multimodal information in MWoAs. These findings further suggest involvement of the cerebellum and the brainstem in the pathology of migraine without aura.

中文翻译：

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无先兆偏头痛的小脑和脑干结构变化

背景越来越多的证据表明小脑与疼痛和偏头痛有关。此外，脑干下行疼痛系统是三叉神经疼痛处理和调节的主要部位，并且已被认为是偏头痛病理生理学的主要参与者。与偏头痛相关的小脑和脑干结构变化仍有待进一步研究。 方法使用基于体素的形态测量（VBM）（50名对照，50名无先兆偏头痛（MWoAs））和弥散张量成像（DTI）（46名对照，46名MWoA）评估与 MWoAs 相关的小脑和脑干解剖学改变。我们利用空间无偏幕下模板工具箱 (SUIT) 来执行小脑和脑干优化的 VBM 和 DTI 分析。我们从小脑白质概率图谱中提取平均弥散值，以研究 MWoAs 是否在小脑脚束中表现出微观结构改变。结果MWoAs 显示，小脑蚓部 VI 的分数各向异性 (FA) 降低，延伸至小脑双侧小叶 V 和 VI。我们还发现 MWoAs 的右小脑下脚束具有较高的轴向扩散率 (AD)、平均扩散率 (MD) 和径向扩散率 (RD)。MWoAs 表现出灰质体积减少和三叉神经脊髓核 (SpV) 中 AD、MD 和 RD 增加。结论 MWoAs 表现出小脑和局部脑干的微观结构变化。这些结构差异可能导致 MWoAs 中有害信息的传输和调节、三叉神经伤害感受以及多模态信息的传导和整合功能障碍。这些发现进一步表明小脑和脑干参与无先兆偏头痛的病理学。