Migraine with aura and white matter tract changes.

Area of Science:

• Neuroimaging
• Neurology
• White Matter Research

Background:

• Migraine with aura (MA) is a common neurological disorder.
• Understanding the underlying white matter structural changes in MA is crucial for diagnosis and treatment.
• Previous studies have yielded inconsistent findings regarding white matter integrity in MA.

Purpose of the Study:

• To investigate potential structural white matter differences in MA patients compared to healthy subjects (HS).
• To compare diffusion tensor imaging (DTI) parameters between MA subgroups based on aura characteristics.
• To explore correlations between DTI parameters, aura frequency, and aura complexity.

Main Methods:

• Diffusion tensor probabilistic tractography was employed in 43 MA patients and 20 HS.
• Analysis focused on identifying differences in diffusivity indices (e.g., axial, mean diffusivity) in specific white matter tracts.
• Statistical thresholds were applied to compare MA patients with HS and within MA subgroups.

Main Results:

• No significant differences in white matter tracts were found between MA patients and HS.
• A trend towards lower diffusivity indices was observed in MA patients in tracts including the forceps minor and right anterior thalamic radiation (ATR).
• Migraineurs with complex auras (somatosensory, dysphasic) showed a tendency for lower diffusivity indices in certain tracts compared to those with visual aura only. Aura frequency negatively correlated with ATR diffusivity.

Conclusions:

• While no definitive structural differences were identified, trends suggest subtle white matter alterations in MA.
• Complex aura symptoms may be associated with differences in white matter myelination.
• Reduced diffusivity in the right ATR is linked to a higher frequency of MA attacks, indicating potential clinical relevance.