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Enlarged perivascular spaces in patients with migraine: a case-control study based on 3T MRI

Ziyu Yuan1, Wei Li2, Hefei Tang1

  • 1Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Annals of Clinical and Translational Neurology
|June 6, 2023
PubMed
Abstract

Insights

Enlarged perivascular spaces (EPVS) in the centrum semiovale and midbrain are significantly more common in migraine patients, suggesting they may predict migraine development. However, EPVS were not linked to migraine chronification.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Enlarged perivascular spaces (EPVS) are fluid-filled spaces surrounding blood vessels in the brain.
  • Their association with neurological conditions like migraine is an area of ongoing research.
  • Understanding EPVS may offer insights into migraine pathophysiology.

Purpose of the Study:

  • To investigate the association between MRI-visible enlarged perivascular spaces (EPVS) and migraine.
  • To determine if EPVS can predict migraine onset.
  • To explore the correlation between EPVS and migraine chronification.

Main Methods:

  • A case-control study included 231 participants: 57 healthy controls (HC), 59 episodic migraine (EM) patients, and 115 chronic migraine (CM) patients.
  • High-grade EPVS in the centrum semiovale (CSO), midbrain (MB), and basal ganglia (BG) were assessed using 3T MRI and a visual rating scale.
  • Chi-square or Fisher's exact tests and multivariate logistic regression were used for statistical analysis.

Main Results:

  • High-grade EPVS prevalence was significantly higher in migraineurs compared to HCs in the CSO (64.94% vs. 42.11%) and MB (55.75% vs. 29.82%).
  • Individuals with high-grade EPVS in CSO (OR: 2.324) and MB (OR: 3.261) were more likely to have migraine.
  • No significant difference in high-grade EPVS was found between EM and CM groups.

Conclusions:

  • High-grade EPVS in the centrum semiovale and midbrain are associated with migraine and may serve as a predictor.
  • The findings suggest a potential role for glymphatic system dysfunction in migraine.
  • No significant correlation was found between EPVS and migraine chronification.

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