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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(03): 150-157
DOI: 10.1590/0004-282X20180004
Article

Migraine improvement correlates with posterior cingulate cortical thickness reduction

Variação da espessura cortical no cíngulo posterior em pacientes com enxaqueca. Correlação com a melhora pós-tratamento profilático
Vanise C. G. Amaral
1   Universidade Estadual do Amazonas, Departamento de Neurologia e Neurocirurgia, Manaus AM, Brasil
,
Gustavo Tukamoto
2   Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro RJ, Brasil
,
Tadeu Kubo
2   Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro RJ, Brasil
,
Ronir Raggio Luiz
3   Universidade Federal do Rio de Janeiro, Departamento de Saúde Pública, Rio de Janeiro RJ, Brasil
,
Emerson Gasparetto
4   Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Departamento de Radiologia, Rio de Janeiro RJ, Brasil
,
Maurice B. Vincent
5   Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Departamento de Radiologia, Rio de Janeiro RJ, Brasil
6   Neuroscience. Eli Lilly and Company, Indianapolis, USA
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ABSTRACT

Objective The main goal of this study was to correlate migraine improvement, after prophylactic therapy, with cortical thickness changes.

Methods Cortical thickness maps were obtained with magnetic resonance imaging (MRI) from 19 patients with migraine before (first scan) and after (second scan) prophylactic treatment, and these were compared with controls using the FreeSurfer MRI tool. Cortical changes were correlated with the headache index (HI).

Results Anincrease incortical thickness was found in the right cuneus and precuneus, somatosensory and superior parietal cortices in both patient scans, compared with the controls. No changes were observed in the left hemisphere. Following correction for multiple comparisons, no areas changed from the first to the second scan. Regression analysis showed a significant negative correlation between the HI improvement and cortical thickness changes in the left posterior cingulate, a region involved with nociception and, possibly, the development of chronic pain.

Conclusion There were changes in cortical thickness in patients with migraine relative to controls in areas involved with vision and pain processing. Left posterior cingulate cortical changes correlated with headache frequency and intensity.

RESUMO

Objetivos Correlacionar a melhora de pacientes enxaquecosos após tratamento preventivo com alterações na espessura do córtex cerebral.

Métodos Espessura cortical foi determinada a partir de imagens de ressonância magnética (RM)em 19 pacientes com enxaqueca, antes (1ª RM) e após (2ª RM) o tratamento profilático, e comparada com controles, usando o programa FreeSurfer. Mudanças corticais foram correlacionadas com o índice de cefaleia (HI).

Resultados O hemisfério direito apresentou aumento da espessura no córtex do cúneus e pré-cúneus, parietal superior e somatossensitivo na primeira RM e na segunda RM, em comparação aos controles. Após correção para comparações múltiplas, nenhuma região cortical se mostrou estatisticamente diferente entre a primeira e a segunda RM. A regressão mostrou correlação (negativa) significativa entre melhora do HI e mudanças na espessura cortical do cíngulo posterior esquerdo.

Conclusão Existem alterações de espessura cortical em pacientes com enxaqueca em relação a controles em áreas envolvidas com processamento visual e com a dor. As alterações corticais no cíngulo posterior esquerdo variaram de acordo com a frequência e intensidade das crises.

Keywords

migraine disorders - magnetic resonance imaging - FreeSurfer - prophylactic treatment

Palavras-chave

enxaqueca - ressonância magnética - Free Surfer - tratamento profilático


Publication History

Received: 21 September 2017

Accepted: 09 December 2017

Article published online:
28 August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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