TY - JOUR
T1 - Altered brainstem anatomy in migraine
AU - Marciszewski, Kasia K.
AU - Meylakh, Noemi
AU - Di Pietro, Flavia
AU - Macefield, Vaughan G.
AU - Macey, Paul M.
AU - Henderson, Luke A.
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by grants awarded by the National Health and Medical Research Council of Australia.
Publisher Copyright:
© 2017, © International Headache Society 2017.
PY - 2018/3
Y1 - 2018/3
N2 - Background: The exact mechanisms responsible for migraine remain unknown, although it has been proposed that changes in brainstem anatomy and function, even between attacks, may contribute to the initiation and maintenance of headache during migraine attacks. The aim of this investigation is to use brainstem-specific analyses of anatomical and diffusion weighted images to determine if the trigeminal system displays altered structure in individuals with migraine. Methods: Voxel-based morphometry of T1-weighted anatomical images (57 controls, 24 migraineurs) and diffusion tensor images (22 controls, 24 migraineurs) were used to assess brainstem anatomy in individuals with migraine compared with controls. Results: We found grey matter volume decreases in migraineurs in the spinal trigeminal nucleus and dorsomedial pons. In addition, reduced grey matter volume and increased free water diffusivity occurred in areas of the descending pain modulatory system, including midbrain periaqueductal gray matter, dorsolateral pons, and medullary raphe. These changes were not correlated to migraine frequency, duration, intensity or time to next migraine. Conclusion: Brainstem anatomy changes may underlie changes in activity that result in activation of the ascending trigeminal pathway and the perception of head pain during a migraine attack.
AB - Background: The exact mechanisms responsible for migraine remain unknown, although it has been proposed that changes in brainstem anatomy and function, even between attacks, may contribute to the initiation and maintenance of headache during migraine attacks. The aim of this investigation is to use brainstem-specific analyses of anatomical and diffusion weighted images to determine if the trigeminal system displays altered structure in individuals with migraine. Methods: Voxel-based morphometry of T1-weighted anatomical images (57 controls, 24 migraineurs) and diffusion tensor images (22 controls, 24 migraineurs) were used to assess brainstem anatomy in individuals with migraine compared with controls. Results: We found grey matter volume decreases in migraineurs in the spinal trigeminal nucleus and dorsomedial pons. In addition, reduced grey matter volume and increased free water diffusivity occurred in areas of the descending pain modulatory system, including midbrain periaqueductal gray matter, dorsolateral pons, and medullary raphe. These changes were not correlated to migraine frequency, duration, intensity or time to next migraine. Conclusion: Brainstem anatomy changes may underlie changes in activity that result in activation of the ascending trigeminal pathway and the perception of head pain during a migraine attack.
KW - diffusion tensor imaging
KW - grey matter volume
KW - hypothalamus
KW - periaqueductal gray matter
KW - Spinal trigeminal nucleus
UR - http://www.scopus.com/inward/record.url?scp=85044395440&partnerID=8YFLogxK
U2 - 10.1177/0333102417694884
DO - 10.1177/0333102417694884
M3 - Article
C2 - 28952339
AN - SCOPUS:85044395440
SN - 0333-1024
VL - 38
SP - 476
EP - 486
JO - Cephalalgia
JF - Cephalalgia
IS - 3
ER -