Intact white matter in adults with migraine: A REFORM MRI study

BackgroundDiffusion tensor imaging (DTI) provides valuable insights into the white matter integrity of people with migraine. The present study compares the microstructural white matter integrity between a large sample of people with migraine and healthy controls, as well as across different migraine subtypes.MethodsThis cross-sectional case-control study included adults with migraine and age- and sex-matched healthy controls. Each participant and control underwent a single brain magnetic resonance imaging session, including DTI, to assess microstructural white matter integrity using tract-based spatial statistics by voxel-wise comparison using a general linear model (GLM). The DTI outcome measures included fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity. Comparisons were made between participants with migraine and controls, as well as among different migraine subtypes (migraine with aura, migraine without aura, episodic migraine and chronic migraine). Additional comparisons were conducted between participants during and outside of migraine attacks, as well as between hemispheres ipsilateral and contralateral to the pain side in those scanned during unilateral migraine attacks.ResultsIn total, 293 participants with migraine and 154 healthy controls provided DTI data eligible for analysis. Among the participants, 181 (61.7%) had chronic migraine, 103 (35.1%) had migraine with aura and 79 (26.9%) were scanned during a migraine attack. No significant differences in white matter integrity were identified between participants with migraine and controls, nor among the different migraine subtypes.ConclusionsOur results suggest that migraine does not result in microstructural alterations within the cerebral white matter. Further research is necessary to explore other potential radiologic biomarkers and pathophysiologic mechanisms underlying migraine.