PT  - JOURNAL ARTICLE
AU  - Messina, Roberta
AU  - Rocca, Maria A.
AU  - Colombo, Bruno
AU  - Pagani, Elisabetta
AU  - Falini, Andrea
AU  - Goadsby, Peter J.
AU  - Filippi, Massimo
TI  - Gray matter volume modifications in migraine
AID  - 10.1212/WNL.0000000000005819
DP  - 2018 Jul 17
TA  - Neurology
PG  - e280--e292
VI  - 91
IP  - 3
4099  - http://n.neurology.org/content/91/3/e280.short
4100  - http://n.neurology.org/content/91/3/e280.full
SO  - Neurology2018 Jul 17; 91
AB  - Objective To explore cross-sectional and longitudinal gray matter (GM) volume changes in patients with migraine and their association with patients' clinical characteristics and disease activity.Methods Brain T2-weighted and 3-dimensional T1-weighted scans were acquired from 73 episodic migraineurs and 46 age- and sex-matched nonmigraine controls at baseline. Twenty-four migraineurs and 25 controls agreed to be reexamined after a mean follow-up of 4 years. Using a general linear model and SPM12, a whole-brain analysis was performed to assess GM volume modifications.Results At baseline, compared to controls, patients with migraine showed lower cerebellar GM volume and higher volume of regions of the frontotemporal lobes. At follow-up, migraineurs were significantly older than controls. Over the follow-up, migraineurs developed an increased volume of frontotemporoparietal regions, which was more prominent in patients with a higher baseline disease activity: long disease duration and high attack frequency. Migraineurs also developed decreased GM volume of visual areas, which was related to higher pain severity. Patients with an increased attack frequency at follow-up experienced both increased and decreased volume of nociceptive regions. In migraineurs, reduced GM volume of extrastriate visual areas during the follow-up was significantly correlated to baseline disease activity: shorter disease duration and lower attack frequency.Conclusion In this cohort, the migraine brain changes dynamically over time, and different pathophysiologic mechanisms can occur in response to patients' disease severity. The interaction between predisposing brain traits and experience-dependent responses might vary across different nociceptive and visual areas, thus leading to distinct patterns of longitudinal GM volume changes.GM=gray matter; HF=high attack frequency; HIT-6=6-item Headache Impact Test; IoS=improved or stable migraine; LDD=long disease duration; LF=low attack frequency; MIDAS=Migraine Disability Assessment; MNI=Montreal Neurological Institute; NRS=Numerical Rating Scale; SDD=short disease duration; WM=white matter; Wo=worsening migraine