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Alternative Microstructural Measures to Complement Diffusion Tensor Imaging in Migraine Studies with Standard MRI

Álvaro Planchuelo-Gómez1, David García-Azorín2,3, Ángel L Guerrero2,3,4

  • 1Imaging Processing Laboratory, Universidad de Valladolid, 47011 Valladolid, Spain.

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Summary

New diffusion imaging techniques reveal white matter alterations in migraine patients. Apparent measures using reduced acquisitions (AMURA) identified differences in episodic and chronic migraine not seen with traditional diffusion tensor imaging (DTI).

Keywords:
chronic migrainediffusion magnetic resonance imagingdiffusion tensor imagingmagnetic resonance imaging (MRI)migrainetract-based spatial statistics

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Area of Science:

  • Neuroimaging
  • White Matter Microstructure
  • Migraine Pathophysiology

Background:

  • Diffusion tensor imaging (DTI) studies on white matter in migraine have yielded conflicting results.
  • Investigating white matter integrity is crucial for understanding migraine mechanisms.

Purpose of the Study:

  • To compare white matter microstructure in healthy controls, episodic migraine (EM), and chronic migraine (CM) patients.
  • To evaluate the utility of ensemble average diffusion propagator (EADP) measures, specifically apparent measures using reduced acquisitions (AMURA), in detecting migraine-related white matter changes.
  • To assess if AMURA provides additional insights beyond DTI.

Main Methods:

  • Employed apparent measures using reduced acquisitions (AMURA): return-to-axis (RTAP), return-to-origin (RTOP), and return-to-plane probabilities (RTPP).
  • Utilized tract-based spatial statistics (TBSS) to compare DTI measures (FA, MD, AD, RD) and AMURA measures between 50 healthy controls, 54 EM patients, and 56 CM patients.
  • Applied family-wise error correction for statistical significance (p < 0.05).

Main Results:

  • Chronic migraine patients showed significantly lower axial diffusivity in 38 white matter regions and higher RTOP values in the middle cerebellar peduncle compared to controls.
  • Episodic migraine patients exhibited significantly lower RTPP values in 24 white matter regions compared to healthy controls.
  • No significant differences were detected using conventional DTI measures between groups.

Conclusions:

  • White matter microstructure is demonstrably altered in migraine, with distinct patterns differentiating episodic and chronic forms.
  • Apparent measures using reduced acquisitions (AMURA) offer superior sensitivity in detecting white matter alterations in migraine compared to DTI.
  • AMURA holds promise for advancing the understanding and diagnosis of white matter changes in migraine.