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Imaging of neuroinflammation in migraine with aura: A [11C]PBR28 PET/MRI study

Daniel S Albrecht1, Caterina Mainero1, Eri Ichijo1

  • 1From the A.A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown.

Neurology
|March 29, 2019
PubMed
Abstract

Insights

Migraine with aura is linked to neuroinflammation, indicated by elevated glial activation markers in brain regions involved in pain processing and cortical spreading depression (CSD). This suggests a potential connection between CSD and glial activity in migraineurs.

Area of Science:

  • Neuroscience
  • Immunology
  • Radiology

Background:

  • Migraine with aura is a debilitating neurological condition.
  • Preclinical models suggest a link between cortical spreading depression (CSD) and neuroinflammation.
  • Glial activation is a potential marker for neuroinflammation in human pain conditions.

Purpose of the Study:

  • To investigate the association between migraine with aura and neuroinflammation.
  • To explore the role of glial activation in migraine pathophysiology.
  • To determine if CSD is linked to glial activation in migraineurs.

Main Methods:

  • Integrated Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) brain scans were performed on 13 migraineurs with aura and 16 healthy controls.
  • The radioligand [11C]PBR28, a marker for glial activation, was used to measure standardized uptake value ratio (SUVR).
  • Region of interest and whole-brain voxelwise analyses were conducted to compare SUVR between groups and correlate with clinical variables.

Main Results:

  • Migraineurs showed elevated SUVR in pain processing areas (thalamus, somatosensory cortices, insular cortex) and the visual cortex compared to controls.
  • Elevated SUVR was observed in areas implicated in CSD generation.
  • SUVR levels in specific brain regions correlated with migraine attack frequency.

Conclusions:

  • Migraine with aura is associated with neuroimmune activation and neuroinflammation.
  • Findings support a potential link between CSD and glial activation in migraine.
  • Neuroinflammation may play a significant role in the pathophysiology of migraine with aura.

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