Phasic perfusion dynamics among migraine subtypes: a multimodel arterial spin labeling investigation

Area of Science:

• Neuroimaging
• Neurology
• Medical Research

Background:

• Migraine-associated perfusion changes are inconsistently documented.
• Phasic and spatial dynamics of perfusion across migraine subtypes are poorly understood.

Purpose of the Study:

• To investigate the spatiotemporal dynamics of gray matter (GM) perfusion in migraine patients.
• To compare perfusion changes between episodic migraine (EM), chronic migraine (CM), and healthy controls (HCs).

Main Methods:

• Prospective recruitment of 344 participants (172 EM, 120 CM, 52 HCs).
• 3-tesla arterial spin labeling (ASL) MRI to measure whole-brain cerebral blood flow (CBF).
• Voxel-wise and whole-brain GM CBF analysis, spatial pattern analysis, and correlation with headache frequency.

Main Results:

• Higher CBF in various anatomical locations was observed during ictal phases in both EM and CM patients.
• Spatial distribution of CBF alterations differed between ictal and interictal phases and was not correlated between EM and CM.
• Positive correlations between headache frequency and CBF were found in ictal EM and CM.

Conclusions:

• Migraine patients exhibit unique spatiotemporal CBF dynamics that differ across migraine phases and subtypes.
• Findings offer neurobiological insights into the engagement of anatomical structures during migraine attacks and adaptation with chronicity.