Long-term evolution of white and gray matter structural properties in migraine

Area of Science:

• Neuroimaging
• Neurology
• Migraine Research

Background:

• Previous studies identified gray matter (GM) and white matter (WM) differences between chronic migraine (CM) and episodic migraine (EM).
• Specific GM changes in CM include increased cortical thickness and reduced surface area in various brain regions.
• WM alterations in CM involve widespread reduced diffusivity in key white matter tracts.

Purpose of the Study:

• To investigate longitudinal brain structural changes in migraine patients.
• To correlate these changes with distinct clinical diagnoses and temporal disease progression.
• To understand the evolution of GM and WM differences over an extended period.

Main Methods:

• Longitudinal cohort study using brain MRI (T1- and diffusion-weighted) at two timepoints.
• Analysis of three WM descriptors and four GM morphometry parameters.
• Generalized linear mixed models used to analyze longitudinal changes in stable EM (31), stable CM (24), and improved CM to EM (24) groups.

Main Results:

• Stable EM patients showed longitudinal cortical thickness increases in parietal and temporal regions.
• Stable CM and EM patients exhibited longitudinal cortical thickness decreases in the posterior cingulate gyrus.
• Stable EM patients demonstrated a longitudinal increase in fractional anisotropy in the cerebral peduncle.

Conclusions:

• Clinical evolution in migraine is associated with distinct patterns of structural brain changes.
• Migraine patients who improved from CM to EM showed no significant GM changes.
• Longitudinally stable migraine patients displayed maladaptation in pain processing regions and adaptation in other areas.