Structural brain abnormalities in patients with vestibular migraine

Area of Science:

• Neuroscience
• Neurology
• Radiology

Background:

• Vestibular migraine (VM) pathophysiology involves significant overlap with migraine pathways.
• Understanding regional brain abnormalities in VM is crucial for differentiating it from other migraine subtypes.

Purpose of the Study:

• To investigate gray matter (GM) and white matter (WM) volumetric differences in VM patients compared to migraine with aura (MWA), migraine without aura (MWoA), and controls.
• To correlate these brain abnormalities with clinical manifestations in VM patients.

Main Methods:

• Voxel-based morphometry (SPM12) was used to analyze 3.0 Tesla MRI scans (T2-weighted and 3D T1-weighted) from 19 VM, 19 MWA, 19 MWoA, and 20 control participants.
• GM and WM volumes were assessed for regional abnormalities.

Main Results:

• Migraine patients showed decreased left cerebellar GM and increased left temporal lobe GM compared to controls.
• VM patients exhibited increased GM volume in frontal and occipital regions compared to controls and other migraine groups.
• VM patients had increased left thalamus GM volume compared to MWoA and MWA patients.
• No significant WM volumetric differences were found between groups.
• Regional GM abnormalities did not correlate with disease duration or attack frequency.

Conclusions:

• Vestibular migraine is associated with specific GM volume abnormalities in nociceptive and multisensory vestibular brain areas.
• Findings suggest abnormal brain sensitization and dismodulation of multimodal sensory integration in VM.
• These distinct neuroanatomical findings aid in understanding VM pathophysiology and differentiating it from other migraine types.