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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Cerebral perfusion changes in migraineurs: a voxelwise comparison of interictal dynamic susceptibility contrast MRI
Enrico B Arkink1, Egbert J W Bleeker, Nicole Schmitz
1Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands. e.b.arkink@lumc.nl
Introduction:
The increased risk of cerebro- and cardiovascular disease in migraineurs may be the consequence of a systemic condition affecting whole body vasculature. At cerebrovascular level, this may be reflected by interictal global or regional cerebral perfusion abnormalities. Whether focal perfusion changes occur during interictal migraine has not been convincingly demonstrated.
Methods:
We measured brain perfusion with dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) in 29 interictal female migraineurs (12 migraine with aura (MA), 17 migraine without aura (MO)), and 16 female controls. Perfusion maps were compared between these groups with a voxelwise (p < 0.001, uncorrected, minimum cluster size 20 voxels) and a region-of-interest approach.
Results:
In whole brain voxelwise analyses interictal hyperperfusion was observed in the left medial frontal gyrus in migraineurs and in the inferior and middle temporal gyrus in MO patients, in comparison with controls. Hypoperfusion was seen in the postcentral gyrus and in the inferior temporal gyrus in MA patients and in the inferior frontal gyrus in MO patients. Additional focal sites of hyperperfusion were noted in subgroups based on attack frequency and disease history. Region-of-interest analyses of the pons, hypothalamus, occipital lobe, and cerebellum did not show interictal perfusion differences between migraineurs and controls.
Conclusions:
We conclude that interictal migraine is characterized by discrete areas of hyper- and hypoperfusion unspecific for migraine pathophysiology and not explaining the increased vulnerability of particular brain regions for cerebrovascular damage.
Insights
Migraineurs show distinct interictal brain perfusion changes, including both increased and decreased blood flow in specific regions. These focal perfusion abnormalities are not specific to migraine and do not explain the heightened risk of cerebrovascular damage.
Area of Science:
- Neuroimaging
- Cerebrovascular Health
- Migraine Research
Background:
- Migraineurs exhibit an elevated risk of cerebro- and cardiovascular diseases, potentially linked to systemic vascular conditions.
- Interictal cerebral perfusion abnormalities may reflect this systemic vascular involvement, but focal changes during migraine-free periods remain unclear.
Purpose of the Study:
- To investigate whether focal cerebral perfusion changes occur in female migraineurs during interictal periods.
- To compare brain perfusion patterns between migraineurs and healthy controls using advanced MRI techniques.
Main Methods:
- Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) was employed to measure brain perfusion.
- 29 female migraineurs (12 migraine with aura, 17 migraine without aura) and 16 female controls were analyzed.
- Voxelwise and region-of-interest analyses were conducted on perfusion maps.
Main Results:
- Voxelwise analysis revealed interictal hyperperfusion in the left medial frontal gyrus (migraineurs) and temporal gyri (migraine without aura).
- Hypoperfusion was observed in the postcentral gyrus and temporal gyrus (migraine with aura) and frontal gyrus (migraine without aura).
- Region-of-interest analyses of the pons, hypothalamus, occipital lobe, and cerebellum showed no significant interictal perfusion differences.
Conclusions:
- Interictal migraine is associated with focal hyper- and hypoperfusion areas.
- These perfusion changes are non-specific to migraine pathophysiology.
- The observed abnormalities do not account for the increased vulnerability of specific brain regions to cerebrovascular damage in migraineurs.
