Interictal Hyperperfusion in the Higher Visual Cortex in Patients With Episodic Migraine

Area of Science:

• Neuroscience
• Radiology
• Medical Imaging

Background:

• Migraine pathophysiology involves complex cortical and subcortical alterations.
• Brain imaging studies reveal alterations in higher-order visual cortex in migraine patients.
• Arterial spin labeling MRI (ASL-MRI) is a non-invasive technique for assessing cerebral blood flow (CBF).

Purpose of the Study:

• To investigate interictal CBF differences between episodic migraine (EM) patients (with or without aura) and healthy controls (HC).

Main Methods:

• ASL-MRI was used to assess interictal CBF in 17 EM patients and 19 HC.
• Data was acquired using 2D pseudo-continuous ASL-MRI on a 3 Tesla scanner.

Main Results:

• EM patients showed significantly higher CBF in the right MT+ region compared to HC (Cohen's d = 0.99).
• EM with aura subgroup exhibited hyperperfusion in the right MT+ and superior temporal gyrus compared to HC.
• Anxiety levels correlated positively with CBF in the parietal operculum and angular gyrus in EM patients.

Conclusions:

• Interictal CBF changes in extrastriate brain regions, potentially linked to cortical spreading depression, are observed in EM.
• ASL-MRI is a sensitive tool for identifying localized neuro-functional CBF abnormalities in interictal EM patients.