Brain imaging in migraine with and without aura: Similarities and differences

Area of Science:

• Neurology
• Neuroimaging
• Pathophysiology

Background:

• The biological independence of migraine with aura (MA) from migraine without aura (MO) remains debated.
• Neuroimaging studies offer insights into the pathophysiology of both migraine types.
• Understanding functional and structural differences is crucial.

Purpose of the Study:

• To review neuroimaging studies comparing migraine with aura and migraine without aura.
• To elucidate functional and structural differences between MA and MO.

Main Methods:

• A comprehensive PubMed search of neuroimaging studies comparing MA and MO was conducted.
• Included studies utilized diffusion tensor imaging, voxel-based morphometry, surface-based morphometry, functional MRI, and arterial spin labeling.
• No publication date restrictions were applied.

Main Results:

• MA patients showed heightened engagement in visual regions, cerebellum, and thalamus.
• Both MA and MO involved parts of the salience network and similar visual areas.
• Inconsistencies were noted due to study design, patient inclusion, and analysis methods.

Conclusions:

• MA patients exhibited greater visual region involvement, reduced cerebellar antinociceptive activity, and impaired thalamic filtering.
• Biases in current studies limit the reliability of findings.
• Further standardized research is required to definitively differentiate MA and MO.