Published Online
on May 25, 2006

A more recent version of this article appeared on July 1, 2006

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Submitted on January 2, 2006
Revised on March 27, 2006
Accepted on April 13, 2006

Brain Gray Matter Changes in Migraine Patients With T2-Visible Lesions. A 3-T MRI Study

Maria A. Rocca MD; Antonia Ceccarelli MD; Andrea Falini MD; Bruno Colombo MD; Paola Tortorella MD; Luca Bernasconi MD; Giancarlo Comi MD; Giuseppe Scotti MD; and Massimo Filippi MD^*

From the Neuroimaging Research Unit (M.A.R., A.C., P.T., M.F.), CERMAC (M.A.R., A.F., G.S., M.F.), Department of Neuroradiology (A.F., G.S.), and Department of Neurology (B.C., L.B., G.C., M.F.), Scientific Institute and University Ospedale San Raffaele, Milan, Italy.

^* To whom correspondence should be addressed. E-mail: massimo.filippi{at}hsr.it.

Background and Purpose--In migraine patients, functional imaging studies have shown changes in several brain gray matter (GM) regions. However, 1.5-T MRI has failed to detect any structural abnormality of these regions. We used a 3-T MRI scanner and voxel-based morphometry (VBM) to assess whether GM density abnormalities can be seen in patients with migraine with T2-visible abnormalities and to grade their extent.

Methods--In 16 migraine patients with T2-visible abnormalities and 15 matched controls, we acquired a T2-weighted and a high-resolution T1-weighted sequence. Lesion loads were measured on T2-weighted images. An optimized version of VBM analysis was used to assess regional differences in GM densities on T1-weighted scans of patients versus controls. Statistical parametric maps were thresholded at P<0.001, uncorrected for multiple comparisons.

Results--Compared with controls, migraine patients had areas of reduced GM density, mainly located in the frontal and temporal lobes. Conversely, patients showed increased periacqueductal GM (PAG) density. Compared with patients without aura, migraine patients with aura had increased density of the PAG and of the dorsolateral pons. In migraine patients, reduced GM density was strongly related to age, disease duration, and T2-visible lesion load (r ranging from -0.84 to -0.73).

Conclusions--Structural GM abnormalities can be detected in migraine patients with brain T2-visible lesions using VBM and a high-field MRI scanner. Such GM changes comprise areas with reduced and increased density and are likely related to the pathological substrates associated with this disease.

Key words: magnetic resonance imaging • migraine

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