Neuromelanin Locus Coeruleus MRI Contrast in Migraine With Aura

Abstract

Introduction The locus coeruleus (LC) is one of the brainstem nuclei that may be activated during migraine attack. As LC contains neuromelanin, a by‐product of norepinephrine synthesis, it can be delineated in vivo using neuromelanin sensitive magnetic resonance imaging (MRI). The neuromelanin content in LC has been suggested to reflect previous LC activation. We investigated LC MRI contrast in patients with migraine with aura (MWA) and its correlation with migraine features. Methods This matched cohort study compared 23 MWA patients aged 30‐55 and without comorbidity, to 23 sex‐ and age‐matched healthy controls. The study was conducted in a University Hospital. LC contrast was measured with T1 neuromelanin‐sensitive‐weighted 3T MRI. Voxels were manually selected by 2 independent researchers and comparison was made twice using intersection and union of the voxels selected by the 2 observers. Results No difference was found in neuromelanin LC contrast between MWA patients and controls with both the INTER method (0.224 ± 0.042 vs 0.228 ± 0.048; difference: 0.0001 (95%CI: −0.032 to 0.026), P = .799) and UNION method (0.218 ± 0.043 vs 0.222 ± 0.047; difference: −0.0012 (95%CI: −0.031 to 0.026), P = .775). Global LC volume was also similar between the 2 groups with INTER method (15.087 ± 3.965 vs 13.739 ± 3.583; difference: 2 (95%CI: −1 to 4), P = .233) and UNION method (17.522 ± 4.440 vs 16.087 ± 4.274; difference: 1 (95%CI: −2 to 4), P = .270). Moreover, no correlations were found between neuromelanin LC contrast and migraine features (duration of migraine and frequency of attacks). Conclusion These negative findings do not support the use of neuromelanin LC contrast as a biomarker of MA.

Headache Medicine Grand Challenge: Headache: A New Frontier, A New Challenge

“…No diagnostic study can accurately diagnose primary headache disorders. Attempts at finding markers ( 70 ) in the blood ( 71 , 72 ), cerebrospinal fluid ( 73 ), neuroimaging ( 42 , 74 , 75 ), and immunologic factor ( 76 ) have not proven adequate. Even when we are close ( 72 , 77 ), such as measuring CGRP in jugular venous blood, the measurement itself becomes subject to debate within laboratories on the adequacy of the specific methods used to measure it.…”

Locus Coeruleus Magnetic Resonance Imaging in Neurological Diseases

“…LC impairment has been suggested to play a role also in other neurological diseases, such as migraine [86] and epilepsy [87], as well as in psychiatric disorders [88,89]. While no studies on LC-MRI have been yet performed in epileptic patients, in 2020, Gollion and colleagues performed an LC-MRI assessment in patients suffering from migraine with aura and they did not find any difference between patients and controls [90]. Concerning psychiatric disorders, LC intensity was found to be reduced in depression [50,51], while LC volume was increased in subjects suffering from post-traumatic stress disorders (PTSD) and anxiety disorders [91].…”