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Evaluating migraine with typical aura with neuroimaging
Nazia Karsan1,2, Elisa Silva1, Peter J Goadsby1,2,3
1Headache Group, School of Neuroscience, Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Frontiers in Human Neuroscience
|April 7, 2023
Summary
Neuroimaging reveals distinct brain dysfunction in migraine with aura, particularly in visual and sensory areas. These findings suggest unique biological differences and guide future personalized migraine treatments.
Area of Science:
- Neuroscience
- Radiology
- Neurology
Background:
- Migraine with aura exhibits complex neurobiology, necessitating advanced neuroimaging for subtype characterization.
- Understanding biological differences between migraine with and without aura is crucial for developing personalized therapeutics.
- Neuroimaging biomarkers are increasingly utilized to explore the mechanisms underlying migraine aura.
Purpose of the Study:
- To conduct a narrative literature review of neuroimaging studies in migraine with typical aura.
- To enhance understanding of migraine subtypes and the biological basis of aura phenomena.
- To explore the role of advanced neuroimaging techniques in migraine research.
Main Methods:
- A comprehensive PubMed literature search was performed using relevant keywords for imaging in migraine with aura.
- Findings from significant neuroimaging studies (n >= 6) were collated and analyzed.
- The review focused on summarizing key studies and their implications for understanding aura mechanisms.
Main Results:
- Aura is associated with widespread brain dysfunction, affecting visual, somatosensory, insular cortex, and thalamus.
- Migraine with aura may involve heightened brain excitability and altered resting-state functional connectivity, potentially with a genetic basis.
- Pure visual aura might indicate different network reorganization and mitochondrial dysfunction compared to aura with additional sensory or speech symptoms.
Conclusions:
- Distinct neurobiological differences likely exist between migraine with and without aura, despite shared symptoms.
- The occipital cortex shows a predisposition to aura mechanisms, predominantly manifesting as visual aura.
- Future research should investigate the precise mechanisms of cortical spreading depression, headache linkage, and the reasons for inconsistent aura presentation.
