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Updated: May 30, 2025
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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
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Trigeminal nerve microstructure is linked with neuroinflammation and brainstem activity in migraine
Sarasa Tohyama1,2, Michael Datko1,2,3, Ludovica Brusaferri1,4
1Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA.
Brain : a Journal of Neurology
|January 28, 2025
Summary
Migraine patients show altered trigeminal nerve roots with neuroinflammation and reduced brainstem activation. These findings highlight trigeminal system changes in migraine pathophysiology and potential therapeutic targets.
Area of Science:
- Neuroscience
- Medical Imaging
- Neurology
Background:
- The trigeminovascular system's role in migraine pathophysiology is recognized but incompletely understood.
- Limited in vivo neuroimaging studies exist for trigeminal system abnormalities in migraine patients.
Purpose of the Study:
- To investigate neural mechanisms of trigeminal system abnormalities in migraine using multimodal neuroimaging.
- To evaluate white matter microstructure, neuroinflammation, and brainstem functional MRI response in migraineurs.
Main Methods:
- Utilized ultra-high field 7 Tesla diffusion tensor imaging (DTI), functional MRI (fMRI), and Positron Emission Tomography (PET) with [11C]-PBR28.
- Studied 60 migraine patients and 20 healthy controls, assessing the trigeminal nerve root and brainstem response to stimulation.
Main Results:
- Migraine patients exhibited altered white matter microstructure (reduced fractional anisotropy) at the trigeminal nerve root compared to controls.
- Lower fractional anisotropy correlated with higher neuroinflammation (elevated [11C]-PBR28 PET signal) and reduced spinal trigeminal nucleus activation on fMRI.
- Findings were more pronounced on the right side, correlating with higher migraine severity in right-dominant headache patients.
Conclusions:
- Multimodal imaging reveals trigeminal system remodeling, including neuroinflammation and altered neural activation, in migraine pathophysiology.
- These findings underscore the trigeminal system's significance in migraine dynamics and suggest it as a therapeutic target.
