Perivascular spaces and headache: A population-based imaging study (HUNT-MRI)

Area of Science:

• Neurology
• Neuroimaging
• Epidemiology

Background:

• Previous clinic-based MRI studies suggested a link between headache disorders and increased perivascular spaces (PVS).
• Specifically, migraine sufferers were reported to have more PVS than headache-free individuals.

Purpose of the Study:

• To investigate the association between headache prevalence and the number of visible PVS in a large, population-based cohort.
• To compare PVS counts in headache sufferers (migraine with/without aura, non-migrainous headache) versus headache-free individuals.

Main Methods:

• Utilized data from the Nord-Trøndelag Health Survey (HUNT), including HUNT-MRI (2007-2009).
• Analyzed MRI scans of 1006 participants (age 50-65) to quantify PVS in the basal ganglia (BG) and hemispheric white matter (HWM).
• Compared PVS counts between headache sufferers and headache-free groups.

Main Results:

• Overall, small differences in PVS counts were observed between headache sufferers and headache-free participants.
• Migraineurs without aura showed fewer PVS in the basal ganglia (OR=0.84) and combined basal ganglia/white matter (OR=0.97) compared to headache-free individuals.
• No significant difference in PVS counts was found between long-term headache sufferers and long-term headache-free individuals.

Conclusions:

• This large, population-based study contradicts previous findings, showing no increased number of dilated PVS in headache sufferers.
• The observed reduction in PVS among migraineurs without aura is likely a spurious finding and warrants further investigation.