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White matter changes in chronic and episodic migraine: a diffusion tensor imaging study.

Álvaro Planchuelo-Gómez1, David García-Azorín2, Ángel L Guerrero3,4,5

  • 1Imaging Processing Laboratory, Universidad de Valladolid, Valladolid, Spain.

The Journal of Headache and Pain
|January 4, 2020
PubMed
Summary

Chronic migraine patients show distinct white matter microstructural differences compared to episodic migraine patients, particularly in axonal integrity. These changes may indicate early maladaptive plasticity following chronic migraine onset.

Keywords:
Chronic migraineDiffusion tensor imagingMagnetic resonance imaging (MRI)MigraineTract-based spatial statistics

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Area of Science:

  • Neuroimaging
  • Neurology
  • White Matter Integrity

Background:

  • Migraine is associated with white matter alterations.
  • Previous research has not identified specific microstructural white matter differences between episodic and chronic migraine.
  • Limited comparative studies exist between these migraine subtypes.

Purpose of the Study:

  • To investigate microstructural white matter differences between episodic and chronic migraine patients.
  • To compare white matter integrity in migraine patients versus healthy controls.
  • To explore correlations between clinical features and white matter measures.

Main Methods:

  • Recruited 51 healthy controls, 55 episodic migraine, and 57 chronic migraine patients.
  • Utilized T1-weighted and diffusion-weighted MRI with Tract-Based Spatial Statistics (TBSS).
  • Compared fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity between groups and correlated with clinical data.

Main Results:

  • Chronic migraine patients exhibited significantly decreased axial diffusivity in 38 white matter regions compared to episodic migraine patients.
  • A positive correlation was observed between time from chronic migraine onset and mean fractional anisotropy in the bilateral external capsule.
  • A negative correlation was found between time from chronic migraine onset and mean radial diffusivity in the bilateral external capsule.

Conclusions:

  • Global white matter structural differences exist between episodic and chronic migraine.
  • Chronic migraine patients may experience axonal integrity impairment in the initial months post-onset.
  • Observed white matter changes could represent maladaptive plasticity after chronic migraine onset.