Patients with chronic migraine without history of medication overuse are characterized by a peculiar white matter fiber bundle profile

J Headache Pain. 2020 Jul 18;21(1):92. doi: 10.1186/s10194-020-01159-6.


Background: We investigated intracerebral fiber bundles using a tract-based spatial statistics (TBSS) analysis of diffusion tensor imaging (DTI) data to verify microstructural integrity in patients with episodic (MO) and chronic migraine (CM).

Methods: We performed DTI in 19 patients with MO within interictal periods, 18 patients with CM without any history of drug abuse, and 18 healthy controls (HCs) using a 3 T magnetic resonance imaging scanner. We calculated diffusion metrics, including fractional anisotropy (FA), axial diffusion (AD), radial diffusion (RD), and mean diffusion (MD).

Results: TBSS revealed no significant differences in the FA, MD, RD, and AD maps between the MO and HC groups. In comparison to the HC group, the CM group exhibited widespread increased RD (bilateral superior [SCR] and posterior corona radiata [PCR], bilateral genu of the corpus callosum [CC], bilateral posterior limb of internal capsule [IC], bilateral superior longitudinal fasciculus [LF]) and MD values (tracts of the right SCR and PCR, right superior LF, and right splenium of the CC). In comparison to the MO group, the CM group showed decreased FA (bilateral SCR and PCR, bilateral body of CC, right superior LF, right forceps minor) and increased MD values (bilateral SCR and right PCR, right body of CC, right superior LF, right splenium of CC, and right posterior limb of IC).

Conclusion: Our results suggest that chronic migraine can be associated with the widespread disruption of normal white matter integrity in the brain.

Keywords: Chronic pain; Descending pain control; Diffusive metrics; Microstructure; Migraine; White matter.

MeSH terms

  • Adult
  • Brain / diagnostic imaging*
  • Diffusion Tensor Imaging / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / diagnostic imaging*
  • Migraine Disorders / epidemiology
  • Nerve Net / diagnostic imaging*
  • Prescription Drug Overuse*
  • Prospective Studies
  • White Matter / diagnostic imaging*