Mysterious changes identified in brains of people who get migraines: ScienceAlert

Mysterious changes identified in brains of people who get migraines: ScienceAlert

Scientists may have just found a major new clue that could help solve the frustrating and ongoing mystery of migraines.

Using ultra-high resolution MRIresearchers found that the perivascular spaces—fluid-filled spaces around the brain’s blood vessels—were abnormally enlarged in patients who had both chronic and episodic migraine.

Although a link or role in migraine has yet to be established, the discovery could represent an as yet unexplored avenue for future research.

The discovery was presented at the 108th Scientific Assembly and Annual Meeting of the Radiological Society of North America.

“In people with chronic migraine and episodic migraine without the aura, there are significant changes in the perivascular spaces of the brain region called the semioval center,” says medical scientist Wilson Xu from the University of Southern California in Los Angeles.

“These changes have never been reported before.”

Migraine is, to put it mildly, a living hell. Although the excruciating headache aspect is well known, migraine can also cause it dizzinessvisual impairment (known as aura), photosensitivity and nausea until vomiting. It is not known what causes migraine, there is no cure, and in many cases the condition does not respond to treatment.

The condition affects the assessment 10 percent of the world’s population. Therefore, finding the cause and more effective management strategies would improve the lives of millions.

Xu and his colleagues were curious about the perivascular spaces in the centrum semiovale, the central region of the brain’s white matter just below the cerebral cortex. The function of these spaces is not fully understood; they play a role in the drainage of fluid movement, and their increase can be a a symptom of a bigger problem.

“Perivascular spaces are part of the brain’s fluid clearance system,” Xu says. “Studying their contribution to migraine could help us better understand the complexity of how migraines occur.”

He and his colleagues recruited 20 patients aged 25 to 60 with migraine: 10 with chronic migraine without aura and 10 with episodic migraine. In addition, 5 healthy patients without migraines were included as a control group.

The team excluded patients with cognitive impairment, claustrophobia, brain tumors or who had previous brain surgery. They then performed an MRI scan using an ultra-high-field MRI with a 7-tesla magnet. Most hospital scanners only have magnets up to 3 tesla.

“According to our knowledge, this is [the] the first study to use ultra-high-resolution MRI to study microvascular changes in the brain due to migraine, particularly in the perivascular spaces,” Xu explains.

“Because 7T MRI can create images of the brain with much higher resolution and better quality than other types of MRI, it can be used to demonstrate the much smaller changes that occur in brain tissue after a migraine.”

The images showed that the perivascular spaces in the centrum semiovale of patients with migraine were significantly increased compared to the control group.

The researchers also found a difference in the distribution of a type of lesion known as white matter hyperintensities in migraine patients. They are caused by tiny patches of dead or partially dead tissue starved from reduced blood flow, and are quite normal.

There was no difference in the frequency of these lesions between migraineurs and controls, but the severity of deep lesions was greater in migraineurs.

This suggests, the researchers believe, that the expansion of perivascular spaces could lead to the future development of more white matter lesions.

Although the nature of the link between enlarged perivascular spaces and migraine is not clear, the results suggest that migraine comes with a problem with the brain system— glymphatic system responsible for cleaning waste in the brain and nervous system. It uses perivascular channels for transport.

More work is needed to investigate this correlation, but even identifying it is promising.

“The results of our study could prompt future, larger studies to continue investigating how changes in microscopic brain vessels and blood supply contribute to different types of migraine,” Xu says.

“Ultimately, this could help us develop new, personalized ways to diagnose and treat migraine.”

The research was presented at 108th Scientific Assembly and Annual Meeting of the Radiological Society of North America.

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