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Updated: Feb 24, 2026
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Volume expansion of periaqueductal gray in episodic migraine: a pilot MRI structural imaging study
Zhiye Chen1,2,3, Xiaoyan Chen2, Mengqi Liu1,3
1Department of Radiology, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, China.
Background:
The periaqueductal gray (PAG) dysfunction was recognized in migraine, and the nonspecific PAG lesions were also observed in episodic migraine (EM) recently. However, the PAG volume change was not totally detected in EM up to now. Herein, the aim of this study was to investigate altered PAG volume in EM patients based on high resolution brain structural image.
Methods:
The brain structural images were obtained from 18 normal controls (NC), 18 EM patients and 16 chronic migraine (CM) on 3.0 T MR system. PAG template was created based on the ICBM152 gray matter template using MRIcron, and the individual PAG was created by applying the deformation field to the PAG template after structural image segment. One-way analysis of covariance, partial correlation analysis and Receiver operating characteristics (ROC) curve were applied.
Results:
EM had a larger PAG volume (0.35 ± 0.02 ml) than that (0.32 ± 0.02 ml) of NC (P = 0.017). The PAG volume of CM (0.33 ± 0.02 ml) was negatively related to the VAS score (P = 0.03). ROC analysis demonstrated that PAG volume has higher diagnostic efficacy (AUC, 0.731; Sensitivity, 0.556; Specificity, 0.889) for NC vs. EM compared with that NC vs. CM (AUC, 0.634; Sensitivity, 0.438; Specificity, 0.833) and EM vs. CM (AUC, 0.618; Sensitivity, 0.813; Specificity, 0.556).
Conclusion:
PAG volume expansion may be the direct impairment evidence on the brain in EM, and could be considered as a diagnostic and evaluated imaging biomarker in migraine.
Insights
Episodic migraine (EM) patients show larger periaqueductal gray (PAG) volumes compared to healthy individuals. This PAG volume expansion may serve as a key imaging biomarker for diagnosing migraine.
Area of Science:
- Neuroimaging
- Neurology
- Medical Science
Background:
- Periaqueductal gray (PAG) dysfunction is implicated in migraine pathophysiology.
- Previous studies noted nonspecific PAG lesions in episodic migraine (EM).
- PAG volume changes in EM were not fully characterized.
Purpose of the Study:
- Investigate altered PAG volume in EM patients.
- Utilize high-resolution brain structural imaging for analysis.
- Determine the diagnostic potential of PAG volume in migraine.
Main Methods:
- Acquired 3.0T MRI scans from 18 normal controls (NC), 18 EM patients, and 16 chronic migraine (CM) patients.
- Created a PAG template and segmented individual PAG volumes.
- Applied statistical analyses including ANCOVA, partial correlation, and ROC curve analysis.
Main Results:
- EM patients exhibited significantly larger PAG volumes (0.35 ± 0.02 ml) than NC (0.32 ± 0.02 ml).
- PAG volume in CM patients negatively correlated with Visual Analog Scale (VAS) scores.
- PAG volume demonstrated higher diagnostic efficacy for NC vs. EM (AUC=0.731) than for other comparisons.
Conclusions:
- PAG volume expansion represents direct brain impairment evidence in EM.
- PAG volume can be considered a diagnostic imaging biomarker for migraine.
- Further research can validate PAG volume as a reliable biomarker.
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