Brain Diffusion Abnormalities in Children with Tension-Type and Migraine-Type Headaches

Abstract

This study identifies early cerebral diffusion changes in patients with tension-type and migraine-type headaches compared with controls. The hypothesized mechanisms of nociception in migraine-type and tension-type headaches may explain the findings as a precursor to structural changes seen in adult patients with chronic headache.

Subclinical post-traumatic stress symptomology and brain structure in youth with chronic headaches

“…One study using voxel-based morphometry found that compared to healthy age- and sex-matched controls, pediatric headache patients had significantly smaller gray matter volumes in several frontal and temporal regions ( Rocca et al, 2014 ). Similar to the present study, however, Santoro et al ( Santoro et al, 2018 ) found no significant differences in regional brain volumes between pediatric patients with either tension-type or migraine-type headaches compared to healthy controls ( Santoro et al, 2018 ). Using atlas-based diffusion weighted imaging they found significantly greater mean diffusivity (a diffusion parameter with higher values possibly indicative of cell loss) in the hippocampus and brain stem of pediatric patients with either tension-type or migraine-type headaches as compared to healthy controls ( Santoro et al, 2018 ).…”

“…Similar to the present study, however, Santoro et al ( Santoro et al, 2018 ) found no significant differences in regional brain volumes between pediatric patients with either tension-type or migraine-type headaches compared to healthy controls ( Santoro et al, 2018 ). Using atlas-based diffusion weighted imaging they found significantly greater mean diffusivity (a diffusion parameter with higher values possibly indicative of cell loss) in the hippocampus and brain stem of pediatric patients with either tension-type or migraine-type headaches as compared to healthy controls ( Santoro et al, 2018 ). Further, patients with migraine-type headaches had increased mean diffusivity values in the thalamus, and were trending towards greater mean diffusivity values within the amygdala ( Santoro et al, 2018 ).…”

Interictal Abnormalities of Neuromagnetic Gamma Oscillations in Migraine Following Negative Emotional Stimulation

“…A previous study ( Stankewitz and May, 2011 ) demonstrated that the presence of interictal dysfunction of limbic-brainstem connectivity through the periaqueductal gray (PAG) is related to the frequency of migraine attacks and sensitization of the amygdala during migraine attack. More functional MRI studies showed that the abnormality of connections between amygdala and other brain regions may contribute to the pathogenesis of migraine and the process of pain chronicization ( Androulakis et al, 2017 ; Chen et al, 2017 ; Santoro et al, 2018 ), even the connections between repetitive episodes of cortical spreading depression (CSD) and the development of migraine pain ( Hadjikhani et al, 2013 ). The results of the present study have provided new evidence that abnormal response to negative emotional stimuli in the limbic system is a characteristic of migraine, especially CM.…”

Mechanisms of migraine as a chronic evolutive condition

“…In the paediatric population of migraine these structural changes were not correlated with disease duration and attack frequency [63]. A more recent study that used MRI apparent diffusion coefficient (ADC) found no volumetric changes in paediatric migraine patients, but demonstrated increased ADC in the region of the hippocampus, brain stem and the thalamus [64]. Although these studies used a smaller number of patients, data suggest that brain abnormalities do occur early on in migraine patients and the absence of correlation with patient clinical characteristics suggest that they may represent a phenotype developed as a consequence of genetic susceptibility.…”