Migraine Brain Changes Neuroscience News

Summary: A new neuroimaging study finds that migraine sufferers have enlarged spaces around blood vessels in a brain region called the centromere-semiotic follicle.

source: RSNA

For the first time, a new study has identified enlargement of the spaces around blood vessels in the brains of migraine patients.

The results of the study will be presented next week at the annual meeting of the Radiological Society of North America (RSNA).

said study co-author Wilson Zhou, an MD candidate at USC’s Keck School of Medicine in Los Angeles. These changes have not been previously reported.

Migraine is a common, often debilitating condition, involving frequent severe headaches. Migraines may also cause nausea, weakness, and sensitivity to light. According to the American Migraine Foundation, more than 37 million people in the United States suffer from migraines, and as many as 148 million people worldwide suffer from chronic migraines.

The perivascular spaces are fluid-filled spaces that surround blood vessels in the brain. They are most common in the basal ganglia and white matter of the brain, and along the optic tract.

Perivascular spaces are affected by several factors, including abnormalities in the blood-brain barrier and inflammation. Enlarged perivascular spaces can be a sign of underlying small vessel disease.

“The spaces around the vessels are part of the fluid filtering system in the brain,” Xu said. “Studying how they contribute to migraines can help us better understand the complexities of how migraines occur.”

Xu and colleagues set out to determine the relationship between migraine headache and perivascular hypertrophy. The researchers used high-field 7T MRI to compare structural changes in the microvasculature in different types of migraine.

“To our knowledge, this is the first study to use super-resolution MRI to study microvascular changes in the brain due to migraine, particularly in the perivascular spaces,” Xu said.

“Because 7T MRI is able to create images of the brain with much higher resolution and better quality than other types of MRI, it can be used to show small changes that occur in brain tissue after a migraine.”

The study participants included 10 with chronic migraine, 10 with episodic migraine without aura, and five healthy, age-matched controls. All patients ranged in age from 25 to 60 years. Patients with overt cognitive impairment, brain tumors, previous intracranial surgery, MRI contraindications, and claustrophobia were excluded from the study.

The researchers calculated the enlarged perivascular areas in the midbrain (central region of white matter) and basal ganglia regions of the brain. White matter hyperintensities – lesions that ‘light up’ on MRI – were measured using the Fazekas scale.

Microbleeds were graded using the microbleed anatomical rating scale. The researchers also collected clinical data such as disease duration and severity, symptoms at the time of examination, and the presence of aura and side of headache.

Statistical analysis showed that the number of enlarged perivascular spaces in the centromeres was significantly higher in patients with migraine than in healthy controls. In addition, the amount of perivascular space enlarged in the peri-normal milieu correlates with the severity of deep white matter hyperplasia in migraine patients.

“We studied chronic migraine and episodic migraine without aura and found that for both types of migraine, the perivascular spaces were larger in the sub-normal medium,” Xu said.

See also

This indicates a DNA strand
This shows a brain scan from the study
(A) Cerebral microbleeds (CMB) visualized as circular and dark lesions (arrow) on a SWI sequence in the left temporal lobe in the case of migraine with aura. (b) Variation in appearance of cortical vessels is most prominent on the left side (arrow) ipsilateral to the CMB. Credit: RSNA and Wilson Xu

“Although we did not find any significant changes in the severity of white matter lesions in patients with or without migraine, these white matter lesions were significantly associated with the presence of enlarged perivascular spaces. This suggests that changes in the voids surrounding blood vessels can lead to future development of more white matter lesions.”

The authors hypothesize that the significant differences in perivascular spaces in migraine patients compared to healthy controls may suggest a glymphatic disturbance within the brain.

The glymphatic system is a waste disposal system that uses channels around blood vessels to help remove soluble proteins and metabolites from the central nervous system.

However, it is not known whether these changes influence migraine progression or are triggered by migraines. An ongoing study with larger case groups and longitudinal follow-up will better establish the relationship between structural changes and migraine progression and type.

“The results of our study can help inspire large-scale future studies to further investigate how changes in the brain’s microvasculature and blood supply contribute to different types of migraine,” Xu said. “Ultimately, this could help us develop new, customized ways to diagnose and treat migraines.”

Co-authors are Brendon Chu, Josep Barisano, Raymond Huang, Sonia Pinto, Danielle Chang Fung, MD, Soma Sahai-Srivastava, Alexander Lerner, MD, and Nassim Sheikh Bahaie, MD, FRCR.

About this migraine and neuroscience research news

author: Linda Brooks
source: RSNA
Contact: Linda Brooks – RSNA
picture: Image credits to RSNA and Wilson Xu

Original search: The results will be presented at the 108th Scientific Society and Annual Meeting of the Radiological Society of North America

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