Cortical thickness studies in migraine: Current evidence and future directions

Area of Science:

• Neuroimaging
• Migraine Pathophysiology
• Structural Brain Analysis

Background:

• Structural neuroimaging, particularly Magnetic Resonance Imaging (MRI) morphometry, is vital for understanding migraine.
• Cortical thickness analysis offers a direct measure of cytoarchitectural and neuroplastic changes in migraine, surpassing gray matter volume and cortical curvature.
• Advanced MRI techniques like surface-based morphometry (SBM) and voxel-based morphometry (VBM) provide high-resolution insights into brain morphometry and dynamic changes in migraine.

Purpose of the Study:

• To review and synthesize findings from cortical thickness studies in migraine.
• To examine methodological variations in imaging sequences and study designs (cross-sectional and longitudinal).
• To explore the clinical significance and potential as a biomarker for migraine progression and treatment response.

Main Methods:

• Narrative review of published studies on cortical thickness in migraine.
• Focus on methodologies including SBM and VBM.
• Analysis of cross-sectional and longitudinal study designs and imaging protocols.

Main Results:

• Inconsistent findings reported across SBM and VBM studies.
• Increased cortical thickness observed in pain-processing regions (e.g., somatosensory cortex, insula) suggests hyperexcitability or maladaptive neuroplasticity.
• Cortical thinning noted in regions like the orbitofrontal cortex, potentially indicating neuronal loss or impaired integrity; differences observed between episodic and chronic migraine.

Conclusions:

• Cortical thickness analysis is a valuable tool for understanding migraine pathophysiology.
• It shows potential as a biomarker for disease progression and treatment response.
• Standardized MRI protocols and larger longitudinal studies are needed to resolve inconsistencies and confirm clinical relevance.