Abstract

In one of the largest MRI-based cross-sectional (n = 119) and prospective observational studies (n = 49) of patients with and without migraine, Messina et al. investigated morphometric brain changes associated with episodic migraine and migraine severity. While migraineurs were older than control patients in this investigation, there was no difference in total brain volume or gray matter volume at baseline or after a median of 4 years of follow-up. Some regions, such as those dedicated to vision and nociception, however, appear to remodel over time—either growing or shrinking. In response, Dr. Vinod Gupta notes that the small sample size may have contributed to a type II error, and that key migraine components (such as lateralization, stress, and hydration status) may also confound these data. Messina et al. suggest that future MRI studies of gray matter volume and other functional MRI measures in migraine and other pain disorders may show distinctive patterns of brain remodeling. In one of the largest MRI-based cross-sectional (n = 119) and prospective observational studies (n = 49) of patients with and without migraine, Messina et al. investigated morphometric brain changes associated with episodic migraine and migraine severity. While migraineurs were older than control patients in this investigation, there was no difference in total brain volume or gray matter volume at baseline or after a median of 4 years of follow-up.

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