Multiplatform Morphometric Profiling of Whole-Brain, Cerebellar Subregional, and Thalamic Nuclei Alterations in...

Objectives: To investigate morphometric alterations associated with pediatric migraine without aura at the whole-brain, cerebellar subregional, and thalamic nuclei levels using a multiplatform magnetic resonance imaging (MRI) approach integrating the complementary strengths of different neuroimaging platforms. Methods: This retrospective study included 74 patients aged 12-17 years with migraine without aura and 70 control subjects with structurally normal cranial MRI findings. High-resolution isotropic three-dimensional T1-weighted MRI datasets were analyzed using a multiplatform segmentation workflow integrating vol2Brain, FreeSurfer, and 3D Slicer. Multiple comparisons were corrected using the Benjamini-Hochberg false discovery rate method. Significant volumetric measurements were subsequently normalized for total intracranial volume (TIV) and reanalyzed. Results: Compared with controls, patients with migraine exhibited lower bilateral amygdala and right thalamic volumes, as well as reduced cortical thickness in the right anterior insula, left anterior cingulate gyrus, and precuneus (all FDR-adjusted q < 0.05). Cerebellar analyses demonstrated reduced bilateral Lobule VI volume and gray matter volume, together with cortical thinning in the right Crus I and right Crus II (all FDR-adjusted q < 0.05). Thalamic nuclei analyses revealed lower volumes of the bilateral mediodorsal and pulvinar nuclei and the right ventral anterior and ventral posterolateral nuclei (all FDR-adjusted q < 0.05). All volumetric findings remained significant after TIV normalization. Conclusions: By integrating whole-brain morphometry with detailed cerebellar subregional and thalamic nuclei analyses, this study expands conventional morphometric assessment and provides a more integrated perspective on structural brain alterations associated with pediatric migraine without aura.