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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Intact blood-brain barrier during spontaneous attacks of migraine without aura: a 3T DCE-MRI study
F M Amin1, A Hougaard1, S P Cramer2
1Department of Neurology, Faculty of Health and Medical Sciences, Danish Headache Center, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark.
Background And Purpose:
The integrity of the blood-brain barrier (BBB) has been questioned in migraine, but BBB permeability has never been investigated during spontaneous migraine attacks. In the present study, BBB permeability during spontaneous attacks of migraine without aura was investigated compared to an interictal state.
Methods:
Seventy-four patients suffering from migraine without aura were recruited to participate in this cross-sectional dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) study. The patients were instructed to report at the hospital for DCE-MRI scan during and outside of a spontaneous migraine attack. The primary end-point was a difference in the BBB permeability (ml/100 g/min) between the attack and the headache-free days. The permeability was assessed in five different regions of interest (ROIs) located in the anterior, middle and posterior cerebral area, brain stem, posterior pons and whole brain. The paired samples t test was used to compare Ki (permeability) values between the attack and headache-free days.
Results:
Nineteen patients completed the study. Median time from onset of migraine attack to scan was 6.5 h (range 4.0-15.5 h). No change in the mean BBB permeability (ml/100 g/min) was found between the attack and the headache-free days in any of the measured ROIs. No relationship between the pain side or intensity and BBB permeability was found in 15 patients with unilateral pain during the examined attack.
Conclusions:
It was demonstrated that the BBB permeability during spontaneous migraine attacks without aura was unchanged.
Insights
Blood-brain barrier (BBB) permeability was unchanged during spontaneous migraine attacks without aura. This study compared BBB integrity during migraine attacks versus headache-free periods using dynamic contrast-enhanced MRI.
Area of Science:
- Neurology
- Neuroimaging
- Migraine Pathophysiology
Background:
- The blood-brain barrier (BBB) integrity is often questioned in migraine pathophysiology.
- Previous research has not investigated BBB permeability during active, spontaneous migraine attacks.
Purpose of the Study:
- To investigate blood-brain barrier (BBB) permeability during spontaneous migraine attacks without aura.
- To compare BBB permeability during migraine attacks versus interictal (headache-free) states.
Main Methods:
- A cross-sectional study involving 74 patients with migraine without aura.
- Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was used to assess BBB permeability (Ki) in five brain regions.
- Paired samples t-test compared permeability during attacks and headache-free days.
Main Results:
- Nineteen patients completed the study; scans occurred a median of 6.5 hours after migraine onset.
- No significant difference in mean BBB permeability was found between migraine attacks and headache-free states across all measured regions.
- No correlation was observed between pain side/intensity and BBB permeability in patients with unilateral pain.
Conclusions:
- Blood-brain barrier permeability remains unchanged during spontaneous migraine attacks without aura.
- Findings suggest that BBB integrity is maintained during the acute phase of migraine without aura.
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