Is there a reliable brain morphological signature for migraine?

Abstract

Voxel-based morphometry (VBM) is a popular non-invasive magnetic resonance imaging technique to investigate brain gray matter (GM) differences between groups. Recently, two VBM studies in migraine have been published in The Journal of Headache and Pain. Reviewing the two and those previous published VBM studies, we found considerable variations of the results. Spatially diverse brain regions with decreased and increased GM alterations and null findings have been reported. It is interesting to know whether there is a reliable brain morphological signature for migraine. Coordinate-based meta-analysis (CBMA) is increasingly used to quantitatively pool individual neuroimaging studies to identify consistent and reliable findings. Several CBMA have been conducted, however, their results were inconsistent. The algorithms for CBMA have evolved and more eligible VBM studies in migraine have been published. We therefore conducted an updated CBMA using the latest algorithms for CBMA, seed-based d mapping with permutation of subject images (SDM-PSI). The present CBMA of 32 VBM studies (41 datasets comprising 1252 patients and 1025 healthy controls) found no evidence of consistent GM alterations in migraine. Sensitivity analysis, subgroup meta-analyses, and meta-regression analyses revealed that the result was robust. This negative result indicates that there is no reliable brain morphological signature for migraine. VBM investigations in migraine remain a heterogeneous field. Many potential confounding factors, such as underpowered sample sizes, variations in demographic and clinical characteristics, and differences in MRI scanners, head coils, scanning parameters, preprocessing procedures, and statistical strategies may cause the inconsistences of the results. Future VBM studies are warranted to enroll well-characterized and homogeneous subtype samples with appropriate sample sizes, comprehensively assess comorbidities and medication status, and use well-validated and standardized imaging protocols and processing and analysis pipelines to produce robust and replicable results in migraine.

No structural brain alterations in new daily persistent headache – a cross sectional VBM/SBM study

“…Coordinate-based meta-analysis (CBMA) is able to objectively identify consistent and reliable findings across different studies. Several CBMA were conducted, but results were inconsistent (39). Two very recent CBMA analyses questioned the existence of a morphological signature for migraine using the latest algorithms for CBMA, applying seed-based mapping with permutation of subject images (SDM-PSI).…”

Gray Matter Atrophy in Amnestic Mild Cognitive Impairment: A Voxel-Based Meta-Analysis

“…The current study has several strengths. The most important one is the use of SDM-PSI, an updated CBMA, which has been presented and recommended in several previous studies (Yu et al, 2017 ; Albajes-Eizagirre et al, 2019b ; Sheng et al, 2020a , b ; Wang et al, 2020 ). This technique has made significant methodological improvements to overcome the drawbacks of alternative procedures and produce accurate results (Albajes-Eizagirre et al, 2019a ).…”

“…Moreover, a statistical method of the meta-analysis has been optimized (Albajes-Eizagirre et al, 2019a , b ). A new-generation algorithm for coordinate-based meta-analysis (CBMA), seed-based d mapping with the permutation of subject images (SDM-PSI), has been successfully used in previous VBM meta-analysis studies (Albajes-Eizagirre et al, 2019b ; Wang et al, 2020 ). This method has led to significant improvements, such as using threshold-free cluster enhancement (TFCE) statistics, small bias estimates of the overall size estimates, and multiple imputations of the study image, to avoid bias associated with single imputation (Albajes-Eizagirre et al, 2019a ).…”

Early alterations of cortical thickness and gyrification in migraine without aura: a retrospective MRI study in pediatric patients

“…Since CT displays some variability due to physiologic and pathologic processes, changes induced by migraine appear realistic. Although cortical thickness in adult [14,36,47] and pediatric [11,58] migraine patients has been widely investigated, no "reliable brain morphological signature for migraine" [67] has been demonstrated so far.…”