White matter microstructural alterations in migraine: A diffusion-weighted MRI study

Abstract

Migraine is a common and disabling neurological disease. The pathomechanism that underlies the disorder is not entirely understood, and reliable biomarkers are missing. In the current analysis we looked for microstructural alterations of the brain white matter in migraine patients by means of diffusion-weighted magnetic resonance imaging. The measurements were carried out with a novel approach based on fine-tuned nonlinear registration and nonparametric permutation test in an alignment-invariant tract representation (Tract-Based Spatial Statistics). We found reduced fractional anisotropy in the right frontal white matter cluster of migraine patients. In the same region we also found increased mean diffusivity and increased radial diffusivity. The probabilistic tractography showed connection of this cluster to other parts of the pain network (orbitofrontal cortex, insula, thalamus, dorsal midbrain). We speculate that these findings reflect maladaptive plastic changes or white matter disintegration.

Altered processing of sensory stimuli in patients with migraine

“…125,126,144,146 Diffusion weighted MRI studies showed that microstructural alterations of white matter, and thus of functional connectivity, are present across the orbitofrontal cortex, insula, thala mus and dorsal midbrain. 147 These alterations might reflect maladaptive plastic changes driven by dysrupted exo genous and endogeneous multimodal task process ing. 147 In another fMRI study, thalamic sensitization cor related with widespread mechanical allodynia during the migraine attack.…”

“…147 These alterations might reflect maladaptive plastic changes driven by dysrupted exo genous and endogeneous multimodal task process ing. 147 In another fMRI study, thalamic sensitization cor related with widespread mechanical allodynia during the migraine attack. 148 Moreover, in a diffusion tensor MRI study, our research group found dynamic ictal and inter ictal microstructural variations in the thalamus that were related to the time since the last migraine attack, and seemed to mimic the cyclic neurophysiological changes described above.…”

Complex regional pain syndrome: The matter of white matter?

“…Diffusion tensor imaging abnormalities have been found in a variety of chronic‐pain conditions, such as migraine (Szabó et al., 2012; Yu et al., 2013), temporomandibular disorder (Moayedi et al., 2012), and irritable bowel syndrome (Chen, Blankstein, Diamant, & Davis, 2011). Our current findings indicate that the white‐matter integrity in the chronic CRPS is widely affected.…”

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.…”