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Grey and white matter alteration in patients with patent foramen ovale: A cross-sectional observational study using
Ying Yang1,2,3,4, Yong Ye5, Qi Li1,2,3,4
1Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, Hubei, China.
Abstract:
Patent foramen ovale (PFO) is closely associated with migraine. However, the mechanism remains unclear. Surface-based morphometry (SBM) and voxel-based morphometry (VBM) were widely used to study microstructural changes in the brain. We aimed to use SBM and VBM to investigate microstructural changes in the brain in migraineurs with PFO. A total of 20 migraineurs were enrolled in the PFO group, and 20 TCD-negative migraineurs, matched by gender and similar age, were included in the control group. All patients underwent brain MRI. 3D-T1-WI imaging was used to reconstruct and post-process for VBM and SBM analysis. There were no significant differences in their baseline clinical characteristics. VBM results showed that white matter (WM) volumes decreased in six relevant brain regions in the PFO group: cerebellar vermis VIII, right caudate, left superior temporal gyrus, left fusiform, left posterior cingulate gyrus, and left postcentral gyrus (P < .05 or P < .01). Also, the gray matter (GM) volumes of the bilateral hippocampus were significantly decreased in the PFO group (P < .01). Furthermore, SBM results showed that the cortex of the right superior frontal gyrus was thicker, the sulcus of the right rostral middle frontal gyrus was deeper, and the fractal dimension of the left superior parietal gyrus was more complex in the PFO group, but these results couldn't pass FDR correction (P > .05). This cross-sectional study demonstrates that migraine patients with PFO exhibit focal gray and white matter volume reductions in multiple pain, cognition, and emotion-related brain regions. These structural alterations may represent important neural substrates underlying PFO-related migraine.
Insights
Patent foramen ovale (PFO) is linked to migraine. Brain imaging reveals reduced gray and white matter volumes in migraine patients with PFO, suggesting structural changes may underlie this association.
Area of Science:
- Neurology
- Neuroimaging
- Cardiology
Background:
- Patent foramen ovale (PFO) is a common cardiac anomaly associated with migraine.
- The underlying mechanisms linking PFO and migraine remain incompletely understood.
- Advanced neuroimaging techniques like VBM and SBM are crucial for investigating brain alterations.
Purpose of the Study:
- To investigate microstructural brain changes in migraineurs with PFO using VBM and SBM.
- To identify specific brain regions affected by PFO in migraine patients.
- To explore potential neural substrates for PFO-related migraine.
Main Methods:
- Cross-sectional study comparing 20 migraineurs with PFO to 20 age- and gender-matched migraineurs without PFO.
- Brain MRI with 3D-T1-WI imaging was performed on all participants.
- Voxel-based morphometry (VBM) and surface-based morphometry (SBM) were employed for data analysis.
Main Results:
- VBM revealed significant white matter (WM) volume reductions in the PFO group across regions including cerebellar vermis VIII, right caudate, and left temporal/fusiform/cingulate/postcentral gyri.
- Gray matter (GM) volumes of the bilateral hippocampus were significantly decreased in migraineurs with PFO.
- SBM indicated some cortical thickness and sulcal depth differences, but these did not reach statistical significance after FDR correction.
Conclusions:
- Migraine patients with PFO exhibit distinct focal reductions in gray and white matter volumes.
- These structural brain alterations are observed in regions associated with pain, cognition, and emotion processing.
- The identified neuroanatomical changes may contribute to the pathophysiology of migraine in individuals with PFO.
