MRI analyses suggest that migraine is not associated with altered brain white matter

Patients with various types of migraine did not show altered brain white matter compared with healthy controls in an MRI study comparing patients with/without aura and episodic/chronic migraine versus healthy participants.

A cross-sectional case-control study assessed white matter of patients with migraine using baseline data from the Registry for Migraine (REFORM) study [1,2]. Participants and controls underwent 1 brain MRI session, including diffusion tensor imaging (DTI). White matter was assessed using the Tract Based Spatial Statistics method, which was used to extract 4 values of DTI corresponding to fractional anisotropy (axonal loss or damage), mean diffusivity (tissue damage including demyelination), axial diffusivity (axonal damage or loss), and radial diffusivity (demyelination).

In total, 293 patients with migraine were included, of which 190 had migraine without aura, 103 had migraine with aura, 112 had episodic migraine, and 181 had chronic migraine. All 4 DTI variables were compared between patients with migraine and healthy controls, among migraine subgroups of patients and controls (with vs without aura; aura vs healthy controls; without aura vs controls, chronic vs episodic migraine, chronic vs healthy controls), as well as among subgroups stratified by types of pain (ictal vs no pain episode; ictal pain vs healthy controls; pain side vs pain-free side). The relation to clinical variables, such as mean migraine days, mean headache days, and pain Numerical Rating Scale, was also assessed.

Overall, patients with migraine did not show significant differences in any DTI parameters among the mentioned comparisons. “This is an encouraging finding, and a positive finding for our patients,” said Dr Cédric Gollion (University Hospital Centre of Toulouse, France), as “we can tell them that there are no microstructural abnormalities of the white matter. The fact that there were no correlations between the DTI measures and clinical measurements further reinforces the finding of intact white matter. We can further say that there is no cumulative damage in the course of migraine,” concluded Dr Gollion.

In summary, cerebral white matter was found to be intact in people with migraine, suggesting that structural alterations in white matter do not play a central role in migraine pathophysiology.

1. Gollion C, et al. Intact white matter in adults with migraine: a REFORM MRI study. 18^th European Headache Congress, 4–7 December 2024, Rotterdam, the Netherlands.
2. Karlsson WK, et al. J Headache Pain. 2023 Jun 12;24(1):70.

Copyright ©2024 Medicom Medical Publishers



Posted on 6 January 20256 January 2025