Alternative Microstructural Measures to Complement Diffusion Tensor Imaging in Migraine Studies with Standard MRI Acquisition

Abstract

The white matter state in migraine has been investigated using diffusion tensor imaging (DTI) measures, but results using this technique are conflicting. To overcome DTI measures, we employed ensemble average diffusion propagator measures obtained with apparent measures using reduced acquisitions (AMURA). The AMURA measures were return-to-axis (RTAP), return-to-origin (RTOP) and return-to-plane probabilities (RTPP). Tract-based spatial statistics was used to compare fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity from DTI, and RTAP, RTOP and RTPP, between healthy controls, episodic migraine and chronic migraine patients. Fifty healthy controls, 54 patients with episodic migraine and 56 with chronic migraine were assessed. Significant differences were found between both types of migraine, with lower axial diffusivity values in 38 white matter regions and higher RTOP values in the middle cerebellar peduncle in patients with a chronic migraine (p < 0.05 family-wise error corrected). Significantly lower RTPP values were found in episodic migraine patients compared to healthy controls in 24 white matter regions (p < 0.05 family-wise error corrected), finding no significant differences using DTI measures. The white matter microstructure is altered in a migraine, and in chronic compared to episodic migraine. AMURA can provide additional results with respect to DTI to uncover white matter alterations in migraine.

Viability of AMURA biomarkers from single-shell diffusion MRI in Migraine Clinical Studies

“…Advanced diffusion descriptors such as RTOP, RTAP and APA have shown to be useful for the analysis of the WM of the brain 24,27,28 . However, their conventional calculation requires acquisition protocols including several b-values, a high number of diffusion gradient directions and very long processing times.…”

“…Besides, to consider statistically significant results within regions, p < 0.05, family-wise error corrected with the TFCE option, and regions of interest (ROI) greater than 30 mm3 were used as threshold. The same basic procedure as in 27,28 was followed.…”

“…One additional advantage of AMURA is that it can be easily integrated into the processing pipeline of current existing single-shell dMRI protocols and databases to unveil anatomical details that may remain hidden in traditional DT-based studies. AMURA has proved its potential in some exploratory studies with clinical data focusing on Parkinson and Mild Cognitive Impairment 24,26 , as well a recent clinical study on migraine 27 .…”

“…A recent study identified statistically significant differences in migraine using advanced diffusion measures calculated with AMURA 27 . This study identified higher RTOP values in CM patients compared to EM, and lower RTPP values in EM compared to HC.…”

Abnormalities of Thalamic Functional Connectivity in Patients with Migraine: A Resting-State fMRI Study

“…It can be seen that the results obtained from the different tests vary relatively widely. Also, these studies suffered from a lack of rigorous correction or correction of false positives [21,22].…”