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Updated: Nov 29, 2025
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
[Response prediction for chronic migraine preventive treatment by gray matter morphometry in magnetic resonance
A Planchuelo-Gómez1, D García-Azorín2,3, A L Guerrero-Peral2,1,3
1Universidad de Valladolid, Valladolid, España.
Introduction:
Topiramate is the only oral preventative with level of evidence I for the treatment of chronic migraine.
Aim:
To evaluate gray matter parameters, obtained with magnetic resonance imaging (MRI), as biomarkers of the response to topiramate in chronic migraine patients.
Patients And Methods:
The sample was composed by 57 chronic migraine patients, screened for first time in a Headache Unit due to chronic migraine. MRI acquisitions were performed at a 3 T unit. Afterwards, topiramate preventive treatment began. Response and tolerability were evaluated after three months, defining response as at least 50% reduction in headache days per month. We included patients that tolerated topiramate. T1- and diffusion-weighted MRI were processed to obtain gray matter (68 cortical and 16 subcortical regions) descriptive parameters. A logistic regression model was employed for the predictive assessment.
Results:
Forty-two patients tolerated the treatment and were analyzed, responding 23 of them (54.7%). The final prediction model was built with gray matter parameters with significant results. In this model, higher left cuneus curvature and right insula area values were associated with a higher probability of response, while higher right inferior parietal cortex volume and left superior temporal gyrus area values were associated with a lower probability. The accuracy of the predictive model was 95%.
Conclusion:
The gray matter parameters may be useful biomarkers of preventive treatment response with topiramate in chronic migraine.
