White matter changes in chronic and episodic migraine: a diffusion tensor imaging study

Abstract

Background: White matter alterations have been observed in patients with migraine. However, no microstructural white matter alterations have been found particularly in episodic or chronic migraine patients, and there is limited research focused on the comparison between these two groups of migraine patients. Methods: Fifty-one healthy controls, 55 episodic migraine patients and 57 chronic migraine patients were recruited and underwent brain T1-weighted and diffusion-weighted MRI acquisition. Using Tract-Based Spatial Statistics (TBSS), fractional anisotropy, mean diffusivity, radial diffusivity and axial diffusivity were compared between the different groups. On the one hand, all migraine patients were compared against healthy controls. On the other hand, patients from each migraine group were compared between them and also against healthy controls. Correlation analysis between clinical features (duration of migraine in years, time from onset of chronic migraine in months, where applicable, and headache and migraine frequency, where applicable) and Diffusion Tensor Imaging measures was performed. Results: Fifty healthy controls, 54 episodic migraine and 56 chronic migraine patients were finally included in the analysis. Significant decreased axial diffusivity (p < .05 false discovery rate and by number of contrasts corrected) was found in chronic migraine compared to episodic migraine in 38 white matter regions from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas. Significant positive correlation was found between time from onset of chronic migraine and mean fractional anisotropy in the bilateral external capsule, and negative correlation between time from onset of chronic migraine and mean radial diffusivity in the bilateral external capsule. Conclusions: These findings suggest global white matter structural differences between episodic migraine and chronic migraine. Patients with chronic migraine could present axonal integrity impairment in the first months of chronic migraine with respect to episodic migraine patients. White matter changes after the onset of chronic migraine might reflect a set of maladaptive plastic changes.

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

“…Patients with a migraine were firstly screened and recruited from the headache outpatient unit at the Hospital Clínico Universitario de Valladolid (Valladolid, Spain). The participants from this study have been part of previous studies [ 7 , 17 ]. A total of 50 healthy controls (HCs), 54 patients with EM and 56 with CM were included in the sample.…”

“…Moreover, the association between the duration of migraine (total duration or time from onset of CM) and DTI and AMURA measures was assessed. To analyze trends within each type of migraine and following the previous study with the same sample [ 7 ], we acquired the correlation values in patients with EM and CM independently. The inverse warp fields of the FA images to the MNI space transformation from the TBSS processing steps were obtained and used to obtain individual label maps based on the John Hopkins University ICBM-DTI-81 White Matter atlas.…”

“…In addition, only three dMRI studies with TBSS as assessment methods compared simultaneously patients with EM and CM, and controls. One study found significantly lower axial diffusivity (AD) values in CM compared to EM [ 7 ], another study found lower FA and higher mean diffusivity (MD) values in CM [ 8 ], and the other one found no significant differences [ 9 ].…”

Diffusion tensor imaging of white matter microstructure in chronic pain: a tract-based spatial statistics study and a systematic review

“…(42)), comparisons between patient groups (e.g. (61) or correlations of DTI parameters with clinical characteristics are not shown. Considering all studies on white matter microstructure in chronic pain, the results of the DTI parameters are inconclusive.…”

Acupuncture affects different ways for migraineurs of long- and short- courses on the efficiency of structural brain network

“…However, several studies [26][27][28] suggested that migraineurs hadn't significant changes in their white matter. Besides, a case-control study [29] indicated that microstructural white matter changes were not observed in the chronic and episodic migraineurs, yet recent research [30] reported the structural differences in brain white matter between the two of them. It seemed that the white matter of migraineurs was destroyed slowly in the process of migraines [31,32].…”