Structural Gray Matter Alterations in Chronic Migraine: Implications for a Progressive Disease?

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.