Changes of Basilar Artery in Patients With Migraine: A Case-Control Study Based on 3T MRI

As a neurovascular disorder, migraine currently lacks well-established macroscopic biomarkers detectable by magnetic resonance angiography (MRA). While the basilar artery (BA) has been implicated in migraine pathophysiology, this relationship remains poorly characterized. This study investigates whether BA morphological parameters could serve as diagnostic biomarkers for migraine and predictive markers for disease progression.

This study included 41 healthy controls (HCs), 41 episodic migraine (EM) patients, and 95 chronic migraine (CM) patients who completed both MRI examinations and standardized questionnaires. Using established diagnostic criteria for vertebrobasilar dolichoectasia (VBD), we quantified the diameter, length, and height of the BA bifurcation. Furthermore, we measured the superior cerebellar artery (SUCA) outlet angle and basilar artery lateral displacement (BALD). These BA-derived metrics were subsequently incorporated into multivariable logistic regression models to assess their predictive value for migraine chronification.

No significant differences were found in BA diameter, BA length, BADE, or VBD when comparing either EM or CM groups with HCs. However, both BALD and SUCA outlet angles showed significant intergroup differences. There was a statistically significant difference in BADE between EM and CM. In the logistic regression, migraine was significantly associated with both BALD and SUCA outlet angles. In the multinomial logistic regression analysis, EM was significantly associated with SUCA outlet angle, while CM was significantly associated with both BALD and SUCA outlet angle.

Our data suggest that the reduced SUCA outlet angle may represent a risk factor for migraine and could potentially serve as an imaging biomarker. Additionally, BALD may constitute an independent risk factor for CM and could function as an MRA biomarker for migraine chronicity. Potential indicators related to the basilar artery may influence migraine attacks by affecting hemodynamic changes in migraine pathophysiology.