Is migraine associated to brain anatomical alterations? New data and coordinate-based meta-analysis

Abstract

A growing number of studies investigate brain anatomy in migraine using voxel- (VBM) and surface-based morphometry (SBM), as well as diffusion tensor imaging (DTI). The purpose of this article is to identify consistent patterns of anatomical alterations associated with migraine. First, 19 migraineurs without aura and 19 healthy participants were included in a brain imaging study. T1-weighted MRIs and DTI sequences were acquired and analyzed using VBM, SBM and tract-based spatial statistics. No significant alterations of gray matter (GM) volume, cortical thickness, cortical gyrification, sulcus depth and white-matter tract integrity could be observed. However, migraineurs displayed decreased white matter (WM) volume in the left superior longitudinal fasciculus. Second, a systematic review of the literature employing VBM, SBM and DTI was conducted to investigate brain anatomy in migraine. Meta-analysis was performed using Activation Likelihood Estimation (ALE) on GM volume data. Alterations of GM volume, WM volume, cortical thickness or white-matter tract integrity were reported in 72%, 50%, 56% and 33% of published studies respectively. Spatial distribution and direction of the disclosed effects were highly inconsistent across studies. The ALE analysis revealed no significant decrease of GM volume in migraine. A significant increase of GM volume in the left superior temporal and angular gyri was detected in migraine, a result however based on a small number of studies. Overall there is to this day no strong evidence of specific brain anatomical alterations reliably associated to migraine. Possible explanations of this conflicting literature are discussed.

Cortical thickness in migraine: a coordinate-based meta-analysis

“…Of the 17 datasets included in the CBMA, the sample sizes range from 11 to 166 (mean 51.3) in the patient groups and from 11 to 309 (mean 59.3) in the HC groups, of which the majority (n = 13) enrolled participants with small sample size less than 50 subjects per group. Only three studies included in the CBMA conducted prior statistical power calculations with different sample sizes required [25][26][27]. The ndings from these studies with small sample sizes were probably false that affected the generalizability of the obtained results.…”

“…Migraine is a heterogeneous neurological disease. Some datasets only enrolled episodic migraineurs [12,15,16,22,[24][25][26]28], while some other datasets included both episodic and chronic migraineurs [13,14] or only chronic migraineurs [11,44]. Majority of the datasets (n = 14) in the CBMA included patients with mixed gender [10, 11, 13-17, 22, 25-28, 44], while two datasets only included female migraine patients [23,24] and one only male migraine patients [12].…”

“…Majority of the datasets (n = 14) in the CBMA included patients with mixed gender [10, 11, 13-17, 22, 25-28, 44], while two datasets only included female migraine patients [23,24] and one only male migraine patients [12]. Some datasets only included patients with aura [16,23,25,28] or without aura [13,22,[24][25][26], while some other studies included both patients with migraine without aura and with aura [10,11,15,17]. Individual CTh studies showed that the observed regional pattern of CTh abnormalities in patients with migraine was in uenced by age [10,11], gender [12], gender [12], disease duration [11, [13][14][15], attack frequency [13][14][15]44], pain intensity [14], the presence of aura [15][16][17], and photosensitivity [18].…”

Is there a reliable brain morphological signature for migraine?

“…Coordinate-based meta-analysis (CBMA) is a powerful approach to quantitatively pool individual neuroimaging studies to identify consistent and reliable findings [6,7]. Several CBMA have been conducted to find consistent brain GM abnormalities in patients with migraine [8][9][10][11]. The first CBMA published online on March 15, 2015 using the activation likelihood estimation (ALE) approach included five VBM studies and found GM reductions in the middle and inferior frontal cortices in migraine [8].…”

“…Published on January 19, 2017, the third CBMA of eight VBM studies using ALE by Jia and Yu was performed, who found GM reductions in the bilateral inferior frontal gyri, right precentral gyrus, left middle frontal gyrus, and the left cingulate gyrus in migraine [10]. A most recent CBMA using ALE published as a medRxiv preprint on February 20, 2020 by Masson et al included 27 VBM studies and detected no significant decrease of GM volume in migraine [11]. We noted that these CBMA studies also demonstrated divergent results.…”