No Microstructural White Matter Alterations in Chronic and Episodic Migraineurs: A Case–Control Diffusion Tensor Magnetic Resonance Imaging Study

Abstract

No microstructural white matter changes could be observed in middle-aged chronic and episodic migraineurs using DTI. CM does not seem to be a risk factor for progressive microstructural changes in DTI.

Assessment of gray and white matter structural alterations in migraineurs without aura

“…Liu et al did not find that the migraineurs without aura exhibited significant microstructural alterations of white matter at a 1-year follow-up evaluation [44]. In line with our results, Need et al demonstrated no microstructural white matter changes in episodic and chronic migraine patients based on Tract-based spatial statistics (TBSS) analysis [22]. …”

“…Migraineurs exhibited several microstructural alterations in previous DTI studies [18–21]. Conversely, Need et al did not identify microstructural white matter alterations in chronic and episodic migraine patients [22]. The results of structural studies of migraine patients seem contradictory and inconsistent, and the patients groups are characterized sample heterogeneity.…”

Brain structural investigation and hippocampal tractography in medication overuse headache: a native space analysis

“…Concerning grey matter volume, some studies found significant modifications, mostly decreased volume [28, 35, 36], whereas other studies did not identify any significant changes [4, 5]. The same observation could be applied to white matter analyses, since some studies did not identify any significant alteration [36], whereas others, such as Chong & Schwedt’s one found increased diffusivity in thalamus, inferior longitudinal fasciculi and corticospinal tract, but no FA modification [37]. All these studies used standardized anatomical brain space analyses which require a normalisation step of MRI images.…”

Detection of changes in the periaqueductal gray matter of patients with episodic migraine using quantitative diffusion kurtosis imaging: preliminary findings

“…Therefore, it remains unclear whether non-specific iron deposition plays a causative role in the development of migraine or is a consequence of repetitive attacks. DTI studies have reported both positive and negative results in terms of alterations of white matter structures in migraineurs [10,[15][16][17]22], which suggests that DTI changes are unlikely to characterize migraine. Therefore, our results of selective alterations in DKI metrics of the PAG represent a specific and pathognomonic imaging finding to evaluate patients with migraine.…”

“…Susceptibility MR imaging studies suggested that iron accumulates in the deep nuclei, including the PAG, of episodic/chronic migraine patients [4,8]. Diffusion tensor imaging (DTI) studies revealed that decreased fractional anisotropy (FA) of the trigeminal somatosensory pathway and PAG occurred in patients with episodic/chronic migraine [9], while major white matter structures showed no substantial changes in the DTI metrics of migraine patients [10].…”