No microstructural white matter alterations in chronic and episodic migraineurs: a case-control diffusion tensor magnetic resonance imaging study
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Lars Neeb1, Kaili Bastian, Kersten Villringer
1Klinik und Hochschulambulanz für Neurologie, Charité Universitätsmedizin Berlin, Berlin, Germany; Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany.
Background:
In patients with episodic migraine (EM), diffusion tensor imaging (DTI) revealed microstructural white matter alterations in various brain regions related to pain processing. Some of these changes were correlated with migraine duration and attack frequency, suggesting that migraine is a progressive disease with proceeding structural alterations of the brain. This study aimed to identify possible microstructural white matter alterations in patients with chronic migraine (CM) using DTI. We hypothesized that alterations in DTI are more pronounced in patients with CM compared with EM.
Methods:
Individually, age- and sex-matched subjects with CM without aura, EM without aura, and healthy controls (n = 21 per group) underwent conventional head magnetic resonance imaging and DTI imaging in a 3T MRI scanner and were included in analysis. DTI data were analyzed using a tract-based spatial statistics approach. Fractional anisotropy (FA), mean diffusivity, radial diffusivity, and axial diffusivity were compared between subjects with CM and EM, CM and controls, EM and controls, as well as between all subjects with migraine (EM + CM) and controls.
Results:
In chronic migraineurs (mean age 49 ± 7.5 years), we did not find any statistically significant difference (P < .05, threshold-free cluster enhancement corrected for multiple comparison) in DTI-derived parameters in comparison with episodic migraineurs (FA: P > .245) and healthy controls (FA: P > .099). In contrast to previous DTI studies, we did not find alterations in DTI-derived indices in subjects with EM compared with healthy controls (FA: P > .486).
Conclusions:
No microstructural white matter changes could be observed in middle-aged chronic and episodic migraineurs using DTI. CM does not seem to be a risk factor for progressive microstructural changes in DTI.
Insights
This study found no evidence of white matter changes in chronic or episodic migraine patients using diffusion tensor imaging. Chronic migraine does not appear to increase the risk of progressive microstructural brain alterations.
Area of Science:
- Neuroimaging
- Neurology
- Medical Research
Background:
- Episodic migraine (EM) patients show white matter alterations via diffusion tensor imaging (DTI), suggesting migraine may be progressive.
- Previous research indicates potential structural brain changes correlating with migraine duration and frequency.
Purpose of the Study:
- To investigate microstructural white matter alterations in chronic migraine (CM) patients using DTI.
- To determine if DTI alterations are more pronounced in CM compared to EM patients.
Main Methods:
- Compared DTI parameters (FA, mean diffusivity, radial diffusivity, axial diffusivity) in age- and sex-matched groups of CM, EM, and healthy controls (n=21 per group).
- Utilized tract-based spatial statistics for DTI data analysis on a 3T MRI scanner.
- Performed conventional head MRI alongside DTI imaging for all participants.
Main Results:
- No statistically significant differences in DTI parameters were found between CM patients and EM patients (FA: P>.245).
- No significant DTI differences were observed between CM patients and healthy controls (FA: P>.099).
- Contrary to prior studies, no DTI alterations were detected in EM patients compared to healthy controls (FA: P>.486).
Conclusions:
- Diffusion tensor imaging revealed no microstructural white matter changes in middle-aged individuals with chronic or episodic migraine.
- Chronic migraine is not identified as a risk factor for progressive microstructural changes detectable by DTI.
