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Published on: June 2, 2014
Quantitative MRI studies of chronic brain white matter hyperintensities in migraine patients
Mihály Aradi1, Attila Schwarcz, Gábor Perlaki
1Diagnostic Center of Pécs, Pécs, Hungary.
Objective:
The aim of this study was to examine chronic brain white matter hyperintensities in migraine and to gain data on the characteristics of the lesions.
Background:
Migraine associates with a higher incidence of magnetic resonance imaging (MRI)-visible white matter signal abnormalities. Several attack-related pathomechanisms have been proposed in the lesion development, including the effect of repeated intracerebral hemodynamic changes.
Methods:
Supratentorial white matter hyperintensities of 17 migraine patients were investigated interictally with quantitative MRI, including quantitative single voxel spectroscopy, diffusion, and perfusion MRI at 3.0-Tesla. The findings were compared with data measured in the contralateral, normal-appearing white matter of migraineurs and in the white matter of 17 healthy subjects.
Results:
Significantly higher apparent diffusion coefficient values, prolonged T2 relaxation times, and decreased N-acetyl-aspartate and creatine/phosphocreatine concentrations were found in the white matter hyperintensities. The cerebral blood flow and blood volume values were mildly decreased inside the hyperintensities. Differences were not present between the migraine patients' normal-appearing white matter and the white matter of healthy subjects.
Conclusions:
The MRI measurements denote tissue damage with axonal loss, low glial cell density, and an enlarged extracellular space with an increased extracellular water fraction. These radiological features might be the consequences of microvascular ischemic changes during migraine attacks.
Insights
Migraine patients show chronic brain white matter hyperintensities indicating tissue damage. These lesions, characterized by microvascular ischemic changes, suggest axonal loss and increased extracellular water.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Migraine is linked to white matter signal abnormalities on MRI.
- Intracerebral hemodynamic changes are proposed mechanisms for lesion development.
Purpose of the Study:
- To investigate chronic brain white matter hyperintensities in migraine.
- To characterize the lesions using quantitative MRI techniques.
Main Methods:
- Quantitative MRI, including spectroscopy, diffusion, and perfusion, was used.
- 17 migraine patients were studied interictally.
- Findings were compared to normal-appearing white matter and healthy controls.
Main Results:
- White matter hyperintensities showed increased diffusion, prolonged T2 times, and reduced N-acetyl-aspartate and creatine/phosphocreatine.
- Cerebral blood flow and volume were mildly decreased in hyperintensities.
- No significant differences were found between migraineurs' normal-appearing white matter and controls' white matter.
Conclusions:
- MRI findings suggest tissue damage with axonal loss, reduced glial density, and increased extracellular water.
- These features may result from microvascular ischemic changes during migraine attacks.
