Migraine sufferers may have brain abnormalities

Migraines are related to brain abnormalities present at birth and others that develop over time, a new study suggests.
Patients who suffer from migraines have reduced cortical thickness and surface area in pain-processing regions of the brain, compared to individuals who never have migraines, Italian researchers found.
More than 300 million people suffer from migraines worldwide, according to the World Health Organisation.
In the new study, researchers used a surface-based MRI method to measure cortical thickness.
"For the first time, we assessed cortical thickness and surface area abnormalities in patients with migraine, which are two components of cortical volume that provide different and complementary pieces of information," said Massimo Filippi, director of the Neuroimaging Research Unit at the University Ospedale San Raffaele.

"Indeed, cortical surface area increases dramatically during late foetal development as a consequence of cortical folding, while cortical thickness changes dynamically throughout the entire life span as a consequence of development and disease," Filippi said in a RSNA statement.

Filippi and colleagues used magnetic resonance imaging (MRI) to acquire T2-weighted and 3-D T1-weighted brain images from 63 migraine patients and 18 healthy controls.
Compared to controls, migraine patients showed reduced cortical thickness and surface area in regions related to pain processing, the journal Radiology reported.
There was only minimal anatomical overlap of cortical thickness and cortical surface area abnormalities, with cortical surface area abnormalities being more pronounced and distributed than cortical thickness abnormalities.

The presence of aura and white matter hyperintensities - areas of high intensity on MRI that appear to be more common in people with migraine - was related to the regional distribution of cortical thickness and surface area abnormalities, but not to disease duration and attack frequency.
"The most important finding of our study was that cortical abnormalities that occur in patients with migraine are a result of the balance between an intrinsic predisposition, as suggested by cortical surface area modification, and disease-related processes, as indicated by cortical thickness abnormalities," Filippi said.
"Whether the abnormalities are a consequence of the repetition of migraine attacks or represent an anatomical signature that predisposes to the development of the disease is still debated.