Abstract
BackgroundSeveral studies have investigated white matter with diffusion tensor imaging (DTI) in those suffering from headache, but so far only in clinic based samples and with conflicting results.MethodsIn the present study, 1006 individuals (50–66 years) from the general population (Nord-Trøndelag Health Study) participated in an imaging study of the head at 1.5 T (HUNT-MRI). Hundred and ninety-six individuals were excluded because of errors in the data acquisition or brain pathology. Two hundred and forty-six of the remaining participants reported suffering from headache (69 from migraine and 76 from tension-type headache) the year prior to the scanning. DTI data were analysed with Tract-Based Spatial Statistics and automated tractography. Type of headache, frequency of attacks and evolution of headache were investigated for an association with white matter fractional anisotropy (FA), mean diffusivity (MD), axonal diffusivity (AD), radial diffusivity (RD) and tract volume. Correction for various demographical and clinical variables were performed.ResultsHeadache sufferers had widespread higher white matter MD, AD and RD compared to headache free individuals (n = 277). The effect sizes were mostly small with the largest seen in those with middle-age onset headache, who also had lower white matter FA. There were no associations between white matter microstructure and attack frequency or type of headache.ConclusionMiddle-age onset headache may be related to a widespread process in the white matter leading to altered microstructure.
Highlights
Several studies have investigated white matter with diffusion tensor imaging (DTI) in those suffering from headache, but so far only in clinic based samples and with conflicting results
The present study aimed to investigate white matter (WM) microstructure in those suffering from headache in a large sample from the general population where correction for several demographical and clinical variables were available
In a neuroimaging sub-study of HUNT3 (HUNT-MRI), 1006 individuals (530 women) between 50 and 66 years who had previously participated in HUNT1, HUNT2 and HUNT3, and lived within 45 min of the location of the scanning, underwent brain imaging with a standardized MRI protocol
Summary
Several studies have investigated white matter with diffusion tensor imaging (DTI) in those suffering from headache, but so far only in clinic based samples and with conflicting results. Ischemic strokes and white matter hyperintensities (WMH) have been reported to be more prevalent in those with migraine, in particular with aura, than in healthy controls [1, 2]. Several measures can be obtained from DTI that provide information on the white matter microstructure [6]. An FA value of 0 is present when the diffusion is isotropic (i.e. equal in all directions), which is the case for cerebrospinal fluid. An FA value of 1 on the other hand, is present when the diffusion occurs along one axis. Mean diffusivity (MD) is the total non-directional diffusion, axonal diffusivity (AD) is the diffusion along WM tracts and radial diffusivity (RD) is the diffusion perpendicular to AD, i.e. across WM tracts
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