Brain morphology, functional performance, and clinical features of migraine patients - a cross-sectional study

• Autor(a) principal: Maciel, Nicoly Machado
• Data de Publicação: 2022
• Tipo de documento: Tese
• Idioma: eng
• Título da fonte: Biblioteca Digital de Teses e Dissertações da USP
• Texto Completo: https://www.teses.usp.br/teses/disponiveis/17/17152/tde-20062022-153053/
• topic: Equilíbrio postural; Fotofobia; Hiperacusia; Hyperacusis; Magnetic resonance; Migraine disorders; Photophobia; Postural balance; Ressonância magnética; Transtornos migranosos

Objective: To investigate locomotion in patients with migraine and healthy controls during tasks that involve anticipatory control (obstacle crossing, stepping up and down a curb) with increasing levels of sensory disturbance (visual and auditory). And to verify if the clinical signs related to functional performance can be related to morphological brain changes Methods: Initially, for the first study 51 women with migraine and 22 healthy women performed three walking tasks: crossing an obstacle, stepping-up and stepping-down a curb, in a control situation with ambient lighting (≅350 lux), bright light (≅1200 lux), and loud sound (≅90 dBa). For the kinematic evaluation, the VICON motion capture system was used. The second study we considered of 45 women with migraine, and we only consider stepping-up and stepping-down tasks in a control situation with ambient lighting. Afterwards, these 45 volunteers underwent to analysis of the brain volumes and withe matter lesions which were calculated from 3 Tesla magnetic resonance imaging. For statistical analysis, in the first study a t-test, a Spearman correlation test, and a repeated measures mixed ANOVA were applied. And in the second study a multiple backward linear regression was used. Results: The first study showed that migraineurs presented higher discomfort induced by light (p ≤ 0.0001) and sound (p = 0.001). In the obstacle task, migraineurs had greater step width than controls in the ambient light condition (p = 0.038) and participants of both groups placed their leading foot farther away from the obstacle in the light (p = 0.033) than in the ambient light condition. For the step-up task, this distance increased for both groups and limbs in the light (leading limb: p = 0.015; trailing limb: p = 0.002) and sound (leading limb: p = 0.010; trailing limb: p ≤ 0.0001) conditions compared to the ambient light condition. Step speed increased for light and sound conditions compared to ambient light condition, except for the sound condition in the step-down task. In the second study in the step-up task, 31.4% of the step width variation was explained by subcortical gray volume, cingulate gyrus, and average withe matter lesions volume (p=0.001). And 31.2% of the step speed variation was explained by cerebellum, parietal lobe, and temporal lobe (p=0.001). In the step-down task, 37.3% of the step width variation was explained by the basal ganglia, brainstem, nucleus accumbens, cingulate gyrus and average withe matter lesions volume (p=0.002). And 25.1% of the step speed variation was explained by the volume of the cerebellum, parietal lobe, and temporal lobe (p=0.007). Conclusions: Although the discomfort induced by light and sound was higher in the migraine group, bright light and loud sound had an impact on functional activities, regardless of migraine status, except for step width in one task. Furthermore, the variability of functional performance during dynamic tasks possibly can be explained in parts by changes in the volume of brain regions, some specifically related to functional performance in migraine patients. Future studies are still needed to identify longitudinal changes in neuroimaging markers as possible predictors of poor functional performance in patients with migraine.