The predicting effect of disrupted functional connectivity of anterior cingulate cortex on the efficacy of nonsteroidal anti-inflammatory drugs in migraineurs without aura / 中华行为医学与脑科学杂志

ABSTRACT

Objective:To investigate the predicting effect of the disrupted functional connectivity of the anterior cingulate cortex (ACC) on the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with migraineurs without aura (MwoA).Methods:From January 2019 to January 2021, seventy patients with migraine and thirty-three healthy people in the same period were selected.The functional connectivity analysis based on the ACC was used in MwoA patients with NSAIDS-effective ( n=35), MwoA patients with NSAIDS-ineffective ( n=35), and healthy controls (HCs) ( n=33). The abnormal resting-state functional connectivity patterns among the three groups were analyzed to reveal potential correlations with clinical characteristics in migraine. Then the receiver operating characteristic (ROC) curve was used to analyze the predictive ability of the abnormal ACC functional connectivity on the efficacy of NSAIDs in patients with MwoA. Results:(1)Compared with the MwoA patients with NSAIDs-ineffective, the MwoA patients with NSAIDs-effective showed higher functional connectivity between bilateral ACC and left middle cingulate cortex (MCC) (MNI x, y, z=0, -24, 48, cluster=14, t=3.380) and postcentral gyrus (PoCG)( MNI x, y, z=-21, -45, 69, cluster=12, t=3.016) (all P<0.005, Bonferroni correction). Compared with the HCs, patients with MwoA showed increased functional connectivity between left ACC and ipsilateral inferior parietal lobule, middle frontal gyrus (MFG) and angular gyrus (AG), and between right ACC and right precuneus, bilateral MFG and left AG (all P<0.005, Bonferroni correction). (2)There was a positive correlation between the functional connectivity of right ACC to right precuneus and MIDAS scores ( r=0.375, P=0.035) in MwoA patients with NSAIDs-effective. In MwoA patients with NSAIDs-ineffective, there were also significant correlations between the functional connectivity of left ACC to ipsilateral AG and MFG and headache onset duration ( r=0.357, P=0.045) and disease duration ( r=-0.367, P=0.039). (3)ROC curve analysis showed that the area under the curve (AUC) for the functional connectivity between the right ACC and left MCC and between the left ACC and left PoCG to predict the efficacy of NSAIDs were 0.728 and 0.736, respectively. Conclusions:Resting-state functional connectivity of the ACC is involved in the evaluation and prediction for analgesic efficacy of NSAIDs in migraine patients, which provides neuroimaging evidence for further investigations on the neurophysiological mechanism of migraine and assistance in clinical individualized precise treatment.