Structural and functional brain changes in perimenopausal women who are susceptible to migraine: a study protocol of multi-modal MRI trial

Abstract

BackgroundAs a common clinical symptom that often bothers midlife females, migraine is closely associated with perimenopause. Previous studies suggest that one of the most prominent triggers is the sudden decline of estrogen during perimenopausal period. Hormone replacement therapy (HRT) is widely used to prevent this suffering in perimenopausal women, but effective diagnostic system is lacked for quantifying the severity of the diseaase. To avoid the abuse and overuse of HRT, we propose to conduct a diagnostic trial using multimodal MRI techniques to quantify the severity of these perimenopausal migraineurs who are susceptible to the decline of estrogen.MethodsPerimenopausal women suffering from migraine will be recruited from the pain clinic of our hospital. Perimenopausal women not suffering from any kind of headache will be recruited from the local community. Clinical assessment and multi-modal MR imaging examination will be conducted. A follow up will be conducted once half year within 3 years. Pain behavior, neuropsychology scores, fMRI analysis combined with suitable statistical software will be used to reveal the potential association between these above traits and the susceptibility of migraine.DiscussionMulti-modal imaging features of both healthy controls and perimenopausal women who are susceptible to estrogen decline will be acquired. Imaging features will include volumetric characteristics, white matter integrity, functional characteristics, topological properties, and perfusion properties. Clinical information, such as basic information, blood estrogen level, information of migraine, and a bunch of neurological scale will also be used for statistic assessment. This clinical trial would help to build an effective screen system for quantifying the severity of illness of those susceptible women during the perimenopausal period.Trial registrationThis study has already been registered at Clinical Trials. gov (ID: NCT02820974). Registration date: September 28th, 2014.

Impaired Inter-Hemispheric Functional Connectivity during Resting State in Female Patients with Migraine

“…Furthermore, migraines related to menstrual episodes are considered more disabling and less responsive to treatment than non-menstrual episodes [ 28 ]. Recent brain fMRI studies supported the existence of functional differences between women and men, between migraine patients and HCs, and between female migraine patients with different hormone levels [ 6 , 29 ]. One study suggested that the FC impairments of the ACC were significantly correlated with pain severity, and pain-associated emotional disorders in menstrual migraine patients and, therefore, the ACC might be an important biomarker to differentiate migraines from HCs [ 30 ].…”

Brain structural and functional changes in asymptomatic chronic internal carotid artery occlusion: protocol for a multi-modal MRI trial

“…According to our previous studies [17,23], PASS software was used to calculate the sample size. A sample size of 40 patients in each group will be suitable for a power of 0.8 and an alpha signi cance at the level of 0.05 (two-sided).…”