Structural connectivity alterations in chronic and episodic migraine: A diffusion magnetic resonance imaging connectomics study. Cephalalgia. https://doi.org/10.1177/0333102419885392

Os pesquisadores espanhóis Álvaro Planchuelo-Gómez,  David García-Azorín, Ángel L Guerrero, Santiago Aja-Fernández,  Margarita Rodríguez, Rodrigo de Luis-García, do Imaging Processing Laboratory, Universidad de Valladolid, Valladolid, Spain; Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain; Department of Radiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.

Avaliando exames de Ressonância Magnética de pessoas com enxaqueca, os autores descobriram que conexões mais fortes ocorreram em estruturas de dor como o hipocampo e o tálamo. Conexões menores em áreas do cérebro relacionadas a inibição cortical como o lobo temporal, sugerem que o cérebro não consegue inibir a dor adequadamente.

RESUMO

Abstract

Objective: To identify possible structural connectivity alterations in patients with episodic and chronic migraine using magnetic resonance imaging data.

Methods: Fifty-four episodic migraine, 56 chronic migraine patients and 50 controls underwent T1-weighted and diffusion-weighted magnetic resonance imaging acquisitions. Number of streamlines (trajectories of estimated fiber tracts), mean fractional anisotropy, axial diffusivity and radial diffusivity were the connectome measures. Correlation analysis between connectome measures and duration and frequency of migraine was performed.

Results: Higher and lower number of streamlines were found in connections involving regions like the superior frontal gyrus when comparing episodic and chronic migraineurs with controls (p <.05 false discovery rate). Between the left caudal anterior cingulate and right superior frontal gyri, more streamlines were found in chronic compared to episodic migraine. Higher and lower fractional anisotropy, axial diffusivity, and radial diffusivity were found between migraine groups and controls in connections involving regions like the hippocampus. Lower radial diffusivity and axial diffusivity were found in chronic compared to episodic migraine in connections involving regions like the putamen. In chronic migraine, duration of migraine was positively correlated with fractional anisotropy and axial diffusivity.

Conclusions: Structural strengthening of connections involving subcortical regions associated with pain processing and weakening in connections involving cortical regions associated with hyperexcitability may coexist in migraine.