Volume alterations of brainstem subregions in migraine with aura

The brainstem plays a significant role in migraine pathogenesis, but a relationship between volume alterations of brainstem subregions and migraine aura characteristics has not been sufficiently investigated. The aim of this study is to compare the volume of the brainstem, and its subregions, between patients with a migraine with aura (MwA) and healthy controls (HC), and also to correlate characteristics of MwA and the volume of the brainstem subregions.

Forty-two MwA and 42 HCs, balanced by sex and age, were selected for this study. Total brainstem volume changes as well as volume changes in the pons, medulla, midbrain and the superior cerebellar peduncles were investigated in MwA relative to HCs. In addition, the relationships between brainstem subregions and aura characteristics (aura duration, the frequency of the aura, occurrence of somatosensory and dysphasic aura, duration of a headache, intensity of headache pain and disease duration) were explored in MwA.

MwA patients had a larger brainstem volume relative to HCs (25,941.35 ± 2559.2 mm³ vs. 25,179.32 ± 2019.1 mm³; p = .008), as well as the midbrain and pons (6155.98 ± 565.7 mm³ vs. 5964.22 ± 457.0 mm³, p = .002; 15,105.13 ± 1765.5 mm³ vs. 14,539.89 ± 1408.4 mm³, p = .007, respectively). Total brainstem volume, as well as volumes of brainstem subregions, were not significantly correlated to the MwA characteristics.

The results of this study reveal that a migraine with aura is associated with a larger volume of the brainstem with a particular involvement of the midbrain and pons.