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White matter alterations in cluster headache identified using PSMD analysis.

Jinseung Kim1, Dong Ah Lee2, Ho-Joon Lee3

  • 1Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.

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|July 7, 2025
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Summary

Patients with cluster headaches show altered white matter microstructure, indicated by higher peak width of skeletonized mean diffusivity (PSMD) values. These changes correlate with age but are not localized to one brain hemisphere.

Keywords:
Cluster headacheDiffusion tensor imagingWhite matter

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Area of Science:

  • Neuroimaging
  • Neurology
  • Biomedical Engineering

Background:

  • Cluster headaches are a debilitating neurological disorder.
  • White matter microstructural integrity is crucial for brain function.
  • Diffusion Tensor Imaging (DTI) offers insights into white matter changes.

Purpose of the Study:

  • To investigate white matter microstructural changes in cluster headache patients.
  • To utilize peak width of skeletonized mean diffusivity (PSMD) from DTI for assessing these changes.
  • To explore correlations between PSMD and clinical factors in cluster headaches.

Main Methods:

  • Recruited 20 cluster headache patients and 20 healthy controls.
  • Acquired DTI data using a 3 Tesla MRI scanner.
  • Quantified PSMD via preprocessing, skeletonization, masking, and FSL histogram analysis.

Main Results:

  • Cluster headache patients exhibited significantly higher PSMD values than controls (p=0.009).
  • PSMD positively correlated with age in the cluster headache group (r=0.575, p=0.008).
  • No significant PSMD difference was found between affected and unaffected hemispheres (p=0.909).

Conclusions:

  • Cluster headache patients display compromised white matter microstructure, evidenced by elevated PSMD.
  • Aging contributes to white matter microstructure changes, as indicated by age-related PSMD increase.
  • White matter alterations in cluster headaches appear diffuse, not localized to the symptomatic hemisphere.