Gray matter volume differences of adult migraine patients using voxel-based morphometry

BACKGROUND: Migraine is a primary headache disorder that has a high prevalence and burden of disease throughout the world. Migraine symptoms include throbbing head pain, nausea, hypersensitivity to light, sound, and smell, and autonomic, cognitive, emotional, and motor disturbances. About a third of migraineurs have aura symptoms which are transient neurological symptoms with gradual onset before the migraine attack, visual disturbances, sensory loss, and/or communication impairment. The trigeminovascular system, central descending modulation, and brainstem descending modulation have been implicated in the pathophysiology of migraine. However, the exact neurovascular mechanism for migraine has not been determined. Several imaging techniques have been used to find structural and functional brain changes in migraineurs. OBJECTIVE: In order to further existing knowledge of migraine pathophysiology, structural brain differences were investigated using imaging between migraineurs and healthy individuals and differences within migraineurs. METHODS: Thirty-two patients with migraine (25 females) and 32 healthy control subjects (25 females) age-, ethnicity-, and gender-matched participated in our study. Magnetic resonance imaging (MRI) scans were collected from each participant. Then, voxel-based morphometry (VBM) was utilized to find any gray matter (GM) volume differences between migraine patients and controls. Also, VBM was performed in specific regions-of-interest (ROIs) to compare 11 migraine patients with aura (MA) and 11 migraine patients without aura (MO). RESULTS: A significant increase in regional gray matter volume difference was observed for migraine patients compared to control subjects in the intracalcarine gyrus of the visual cortex (corrected, p<0.05). In the VBM analysis of ROIs, the similarities between the MO and MA subjects included increases in the anterior cingulate cortex (ACC), hippocampus, insula, and intracalcarine cortex, along with decreases in the ACC and insula (uncorrected, p<0.05). MO subjects had decreases in the amygdala, hippocampus, intracalcarine cortex, and thalamus, but not in the MA subjects (uncorrected, p<0.05). The MA patients had increases in the amygdala and thalamus, but not in the MO patients (uncorrected, p