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Updated: Jan 13, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

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Chronic Migraine Is Associated With Region-Specific High-Grade Enlarged Perivascular Spaces: Retrospective Matched

Jae Wook Cho^1,2, Gha-Hyun Lee^2,3, Jiyoung Kim^2,4

¹Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Journal of Clinical Neurology (Seoul, Korea)

|January 10, 2026

Summary

Chronic migraine patients show more enlarged perivascular spaces (EPVS) in specific brain areas, indicating impaired glymphatic system function. These findings suggest EPVS may serve as an imaging biomarker for chronic migraine.

Keywords:

chronic migraine glymphatic system perivascular space

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Area of Science:

Neuroimaging
Neurology
Vascular Biology

Background:

Enlarged perivascular spaces (EPVS) on MRI suggest impaired glymphatic system (GS) function.
The link between EPVS and chronic migraine is not well understood.

Purpose of the Study:

To investigate the association between chronic migraine and a high burden of region-specific high-grade EPVS.

Main Methods:

A retrospective case-control study compared 44 chronic migraine patients, 44 episodic migraine patients, and 39 healthy controls.
Brain MRIs were analyzed for EPVS in the centrum semiovale (CS), basal ganglia, and midbrain (MB).
Logistic regression assessed the association between chronic migraine and high-grade EPVS, adjusting for covariates.

Main Results:

Prevalence of high-grade EPVS in the CS and MB significantly differed across groups.
Chronic migraine patients had a higher prevalence of high-grade EPVS in the CS and MB compared to controls.
Chronic migraine was independently associated with high-grade EPVS in the CS (aOR=9.345) and MB (aOR=4.026).

Conclusions:

Chronic migraine is linked to increased high-grade EPVS in specific brain regions.
This suggests underlying glymphatic system dysfunction in chronic migraine.
EPVS show potential as an imaging biomarker for chronic migraine.