Alternative Microstructural Measures to Complement Diffusion Tensor Imaging in Migraine Studies with Standard MRI Acquisition.

Álvaro Planchuelo-Gómez,Ángel L Guerrero,Santiago Aja-Fernández,David García-Azorín,Margarita Rodríguez,Rodrigo De Luis-García

doi:10.3390/brainsci10100711

Abstract

The white matter state in migraine has been investigated using diffusion tensor imaging (DTI) measures, but results using this technique are conflicting. To overcome DTI measures, we employed ensemble average diffusion propagator measures obtained with apparent measures using reduced acquisitions (AMURA). The AMURA measures were return-to-axis (RTAP), return-to-origin (RTOP) and return-to-plane probabilities (RTPP). Tract-based spatial statistics was used to compare fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity from DTI, and RTAP, RTOP and RTPP, between healthy controls, episodic migraine and chronic migraine patients. Fifty healthy controls, 54 patients with episodic migraine and 56 with chronic migraine were assessed. Significant differences were found between both types of migraine, with lower axial diffusivity values in 38 white matter regions and higher RTOP values in the middle cerebellar peduncle in patients with a chronic migraine (p < 0.05 family-wise error corrected). Significantly lower RTPP values were found in episodic migraine patients compared to healthy controls in 24 white matter regions (p < 0.05 family-wise error corrected), finding no significant differences using DTI measures. The white matter microstructure is altered in a migraine, and in chronic compared to episodic migraine. AMURA can provide additional results with respect to DTI to uncover white matter alterations in migraine.

Highlights

Headache attacks in a migraine are characterized by episodes of unilateral pain of moderate to severe intensity, pulsating quality, aggravated by routine physical activity and accompanied by other symptoms, such as nausea and/or vomiting, photophobia and phonophobia, which last between 4 and 72 h [1]
Fifty healthy controls (HCs), 54 patients with episodic migraine (EM) and 56 patients with chronic migraine (CM) were included in the sample
With apparent measures using reduced acquisitions (AMURA), significant differences between patients with CM and EM were obtained with the return-to-plane probabilities (RTPP), a result provided by axial diffusivity (AD) and diffusion tensor imaging (DTI)

Summary

Introduction

Headache attacks in a migraine are characterized by episodes of unilateral pain of moderate to severe intensity, pulsating quality, aggravated by routine physical activity and accompanied by other symptoms, such as nausea and/or vomiting, photophobia and phonophobia, which last between 4 and 72 h [1]. Two main migraine types are currently distinguished: episodic migraine (EM) and chronic migraine (CM) The difference between both types is the frequency of headache days per month, which is 15 or more days in CM, and lower than 15 in EM, during at least three months [1]. Despite the advances of dMRI techniques, most of the migraine studies are based on the analysis of measures derived from diffusion tensor imaging (DTI). The reported values of the fractional anisotropy (FA) were lower in migraine compared to controls in whole brain studies with tract-based spatial statistics (TBSS) [2,3,4,5], the most employed technique in dMRI migraine studies. Only three dMRI studies with TBSS as assessment methods compared simultaneously patients with EM and CM, and controls

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