女性偏头痛患者下丘脑亚区体积与VSS-C总症状负担的关系：一项探索性横断面MRI研究
Hypothalamic subregional volume in relation to VSS-C total symptom burden in women with migraine: an exploratory cross-sectional MRI study.
文献信息
| PMID | 42834909 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Linyi Che |
| 作者单位 | Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. |
| 期刊 | Frontiers in neurology |
| SCI 分区 | Q2 |
| IF | 3.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 头晕、眩晕及相关自主神经症状在偏头痛中常见，但其合并症状频率负担是否与下丘脑亚区结构相关尚不清楚。
方法： 这项探索性横断面二次分析纳入39名符合ICHD-3定义的偏头痛女性。所有源T1加权图像均使用FreeSurfer 7.4.1和自动下丘脑亚单位分割进行统一处理。在无临床数据的情况下进行盲法质量控制，并由一名神经放射科医生独立确认。暴露因素为VSS-C总分，即眩晕-平衡和自主神经-焦虑症状频率的复合评分。针对五个双侧亚单位和全下丘脑体积的模型调整了年龄、估计总颅内体积和基线每月偏头痛天数；对六个结局应用Benjamini-Hochberg错误发现率校正。结局特异性质量控制分母为37或39。
结果： 前上丘脑体积与VSS-C总分相关（n=39；β=0.165 mm3/分，95%置信区间0.064至0.266，p=0.0021；BH-FDR校正后p=0.0127）。将所有六个结局限制于相同的37名参与者后，该关联仍然存在（BH-FDR校正后p=0.0334）。在观察到的20分VSS-C四分位距范围内，该系数对应3.31 mm3，即前上体积均值的8.54%。DHI在单独校正的支持性分析中识别出相同亚区，但相互调整后两个系数均减弱。
结论： 在女性偏头痛患者中，较高的VSS-C总症状负担与较大的前上丘脑体积相关。这一结果确定了一个亚区靶点，可用于前瞻性重复验证，并结合成分级症状评估和正式的前庭表型分析。
英文摘要
BACKGROUND: Dizziness, vertigo, and related autonomic symptoms are common in migraine, but whether their combined symptom-frequency burden is associated with hypothalamic subregional structure remains unclear.
METHODS: This exploratory cross-sectional secondary analysis included 39 women with ICHD-3-defined migraine. All source T1-weighted images were processed uniformly with FreeSurfer 7.4.1 and automated hypothalamic subunit segmentation. Blinded quality control was performed without clinical data and independently confirmed by a neuroradiologist. The exposure was VSS-C total score, a composite of vertigo-balance and autonomic-anxiety symptom frequency. Models for five bilateral subunits and whole-hypothalamus volume adjusted for age, estimated total intracranial volume, and baseline monthly migraine days; Benjamini-Hochberg false-discovery-rate correction was applied across the six outcomes. Outcome-specific quality-control denominators were 37 or 39.
RESULTS: Anterior-superior hypothalamic volume was associated with VSS-C total score (n = 39; β = 0.165 mm3 per point, 95% confidence interval 0.064 to 0.266, p = 0.0021; BH-FDR-adjusted p = 0.0127). The association remained after restricting all six outcomes to the same 37 participants (BH-FDR-adjusted p = 0.0334). Across the observed 20-point VSS-C interquartile range, the coefficient corresponded to 3.31 mm3, or 8.54% of mean anterior-superior volume. DHI identified the same subregion in a separately corrected supporting analysis, but mutual adjustment attenuated both coefficients.
CONCLUSION: Higher VSS-C total symptom burden was associated with larger anterior-superior hypothalamic volume in women with migraine. This result identifies a subregional target for prospective replication with component-level symptom assessment and formal vestibular phenotyping.