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Clinical Features Contributing to Cortical Thickness Changes in Chronic Migraine - A Pilot Study
Yohannes W Woldeamanuel1, Danielle D DeSouza1, Bharati M Sanjanwala1
1Stanford Headache and Facial Pain Program, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Headache
|November 24, 2018
Summary
Chronic migraine (CM) patients show increased cortical covariance, with brain structure linked to CM duration, PTSD, and sleep quality. Pain self-efficacy may buffer these changes, suggesting targeted management strategies for chronic migraine.
Area of Science:
- Neuroimaging
- Neurology
- Psychiatry
Background:
- Cortical thickness and its relationship with clinical features in chronic migraine (CM) remain underexplored.
- Understanding these associations can elucidate cortical substrates of migraine progression and identify key clinical variables for management.
Purpose of the Study:
- To identify cortical thickness regions differentiating chronic migraine from controls.
- To assess group differences in interregional cortical thickness covariance.
- To determine how clinical variables associate with cortical thickness in chronic migraine.
Main Methods:
- 30 chronic migraine patients and 30 controls underwent T1-weighted MRI.
- Whole-brain cortical thickness and interregional cortical thickness covariance were analyzed.
- Associations between clinical features (headache history, PTSD, sleep, pain self-efficacy, somatic symptoms) and cortical thickness were examined.
Main Results:
- No significant differences in overall cortical thickness between groups.
- Significant associations found between clinical features and cortical thickness in CM patients, notably in the right superior temporal sulcus and right insula.
- Chronic migraine patients exhibited higher interregional cortical covariance (OR=3.1), particularly in temporal and frontal lobes.
Conclusions:
- Chronic migraine is characterized by increased interregional cortical covariance compared to controls.
- Cortical thickness in CM is influenced by migraine duration, PTSD, and sleep quality, with pain self-efficacy showing a buffering effect.
- Management strategies should prioritize addressing PTSD, optimizing sleep, early intervention for CM duration, and enhancing pain self-efficacy to mitigate cortical abnormalities.
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