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Study author
Dr. Massimo Filippi
(Courtesy RSNA)

MRI images show brain abnormalities in migraine sufferers

by Loren Bonner , DOTmed News Online Editor
Advances in MRI technology have allowed researchers to gain a better understanding of migraines, a debilitating condition that affects over 300 million people worldwide, according to the World Health Organization.

For several years, researchers have known that a proportion of migraine patients harbor white matter lesions, possibly of vascular origin. But more recently they have found atrophy of the outer layers of the brain (cortical regions) related to pain processing. New research from the University Ospedale San Raffaele in Italy, published online Tuesday in the journal Radiology, suggests that migraines are related to brain abnormalities present at birth and others that develop over time.

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"The aim of our study was to define the nature and topology of such cortical abnormalities," Dr. Massimo Filippi, director of the Neuroimaging Research Unit at the University Ospedale San Raffaele, told DOTmed News by e-mail.

Using a surface-based MRI method to measure cortical thickness, Filippi and his colleagues compared brain images from 63 migraine patients and 18 healthy controls. Clinical information was incorporated into the analysis as well. They found that compared to the healthy patients, migraine sufferers had reduced cortical thickness and surface area in regions related to pain processing, with cortical surface area abnormalities being more pronounced and distributed than cortical thickness abnormalities.

"These two types of abnormality do not fully overlap," said Filippi. "Interestingly, cortical surface area increases dramatically during late fetal development (as a consequence of cortical folding) and cortical thickness changes dynamically throughout the entire life span as a consequence of development and disease."

Filippi acknowledged some of the caveats of the study. These included finding enough patients to conduct credible research and standardizing the measurement methodology to make the data robust and reliable. He said he plans on conducting a follow-up study using this patient cohort to understand whether these cortical abnormalities are stable or tend to worsen over time. He's also interested in carrying out a similar study in pediatric migraine patients.

"These two projects should allow us to shed light on the meaning of the observed abnormalities," he said.

Overall, Filippi said migraine research focused on defining structural and functional abnormalities will help to identify the mechanisms leading to the disease's clinical expression and therefore to offer markers to monitor its evolution and the effects of treatment.

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