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Updated: Jun 25, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Differentiation of hemispheric white matter lesions in migraine and multiple sclerosis with similar radiological
Flóra John1, Gréta Kis-Jakab1,2,3, Hedvig Komáromy1
1Department of Neurology, Medical School, University of Pécs, Pécs, Hungary.
Background And Aim:
White matter hyperintensities (WMHs), presented on T2-weighted or fluid-attenuated inversion recovery magnetic resonance imaging (MRI) sequences, are lesions in the human brain that can be observed in both migraine and multiple sclerosis (MS).
Methods:
Seventeen migraine patients and 15 patients with relapsing-remitting multiple sclerosis with WMHs, and 17 healthy subjects age-and sex-matched to the migraine group were prospectively enrolled and underwent conventional and advanced MRI studies with diffusion-and perfusion-weighted imaging and single voxel proton magnetic resonance spectroscopy.
Results:
In both disease groups, elevated T2 relaxation time, apparent diffusion coefficient (ADC) values, and decreased N-acetyl-aspartate levels were found in the intralesional white matter compared to the contralateral normal-appearing white matter (NAWM), while there was no difference between the hemispheres of the control subjects. Migraine patients had the lowest intralesional creatine + phosphocreatine and myo-inositol (mI) values among the three groups, while patients with MS showed the highest intralesional T1 and T2 relaxation times, ADC, and mI values. In the contralateral NAWM, the same trend with mI changes was observed in migraineurs and MS patients. No differences in perfusion variables were observed in any groups.
Conclusion:
Our multimodal study showed that tissue damage is detectable in both diseases. Despite the differences in various advanced MRI measures, with more severe injury detected in MS lesions, we could not clearly differentiate the two white matter lesion types.
Insights
White matter hyperintensities (WMHs) in migraine and multiple sclerosis (MS) show detectable tissue damage using advanced MRI. While MS lesions exhibit more severe injury, differentiating these WMH types remains challenging.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- White matter hyperintensities (WMHs) are brain lesions observed in both migraine and multiple sclerosis (MS).
- These lesions are visualized using T2-weighted or fluid-attenuated inversion recovery magnetic resonance imaging (MRI) sequences.
Purpose of the Study:
- To investigate and compare tissue damage in white matter hyperintensities (WMHs) between migraine and multiple sclerosis (MS) patients using multimodal MRI.
- To assess differences in advanced MRI measures between the two disease groups and healthy controls.
Main Methods:
- Prospective enrollment of 17 migraine patients, 15 MS patients with WMHs, and 17 age- and sex-matched healthy controls.
- Conventional and advanced MRI studies including diffusion-weighted imaging, perfusion-weighted imaging, and single voxel proton magnetic resonance spectroscopy were performed.
Main Results:
- Both migraine and MS groups showed elevated T2 relaxation time, apparent diffusion coefficient (ADC) values, and decreased N-acetyl-aspartate in intralesional white matter compared to normal-appearing white matter (NAWM).
- Migraine patients had lower intralesional creatine+phosphocreatine and myo-inositol (mI) values. MS patients exhibited higher intralesional T1/T2 relaxation times, ADC, and mI values.
- Similar mI changes were noted in contralateral NAWM for both migraineurs and MS patients; no perfusion differences were observed.
Conclusions:
- Multimodal MRI confirms detectable tissue damage in WMHs for both migraine and MS.
- Despite distinct advanced MRI findings with more severe injury in MS lesions, clear differentiation between migraine-associated and MS-associated WMHs was not achieved.
