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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Structural Gray Matter Alterations in Chronic Migraine: Implications for a Progressive Disease?
Lars Neeb1,2, Kaili Bastian1,2, Kersten Villringer2
1Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.
Objective:
To identify possible gray matter alterations in patients with chronic migraine using voxel-based morphometry (VBM).
Background:
VBM studies demonstrate structural alterations of gray matter (GM) in episodic migraine (EM) patients. Some of these alterations correlate with disease duration and headache frequency. We assessed GM alterations in chronic migraine (CM) and EM to evaluate the concept of migraine as a progressive disorder of the brain.
Methods:
Individually age and sex-matched subjects with CM or EM (both without aura) and healthy controls (n = 21 per group) underwent magnetic resonance imaging-based VBM.
Results:
We found an increase of GM volume (GMV) in amygdala and putamen, in CM compared to controls. GMV of EM compared to controls did not differ statistically significantly. Headache frequency in all migraineurs (EM and CM) correlated positively with GMV in putamen, frontal and temporal gyrus and negatively in left cuneus.
Conclusion:
CM is associated with structural changes in brain regions involved in pain processing but also in affective and cognitive aspects of pain. Some GM alterations are correlated with headache frequency assessed in EM and CM. The findings support the assumption that chronic pain alters brain plasticity. GMV increase may reflect a remodeling of the central nervous system due to repetitive headache attacks leading to chronic sensitization and a continuous ictal-like state of the brain in chronic migraineurs.
Insights
Chronic migraine (CM) is linked to increased gray matter volume in brain regions for pain processing. These changes, particularly in the amygdala and putamen, may reflect brain plasticity due to frequent headaches.
Area of Science:
- Neuroimaging
- Neurology
- Brain Anatomy
Background:
- Episodic migraine (EM) shows gray matter (GM) alterations, potentially linked to disease duration and headache frequency.
- Investigating GM changes in chronic migraine (CM) and EM helps understand migraine as a progressive brain disorder.
Purpose of the Study:
- To identify gray matter (GM) alterations in chronic migraine (CM) patients using voxel-based morphometry (VBM).
- To compare GM alterations between CM, episodic migraine (EM), and healthy controls.
Main Methods:
- Voxel-based morphometry (VBM) analysis of magnetic resonance imaging (MRI) data.
- Inclusion of individually age and sex-matched subjects: CM (n=21), EM (n=21), and healthy controls (n=21).
- All participants were assessed without aura.
Main Results:
- Chronic migraine (CM) patients showed increased gray matter volume (GMV) in the amygdala and putamen compared to controls.
- No significant GMV differences were found between episodic migraine (EM) patients and controls.
- Headache frequency correlated positively with GMV in the putamen, frontal, and temporal gyrus, and negatively in the left cuneus across all migraineurs.
Conclusions:
- Chronic migraine (CM) is associated with structural brain changes in regions involved in pain, emotion, and cognition.
- Gray matter alterations correlate with headache frequency in both EM and CM.
- Increased GMV in CM may indicate central nervous system remodeling due to chronic pain and sensitization.
