Mysterious changes found in the brains of migraine sufferers

(ORDO NEWS) — Scientists may have just found a major new piece of evidence that could help unravel the depressing and ongoing migraine mystery.

Using ultra-high-resolution MRI, the researchers found that perivascular spaces – the fluid-filled spaces around blood vessels in the brain – are unusually enlarged in patients with both chronic and episodic migraine.

Although the link to migraine or its role in its development has yet to be established, this discovery may 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.

“People with chronic migraine and episodic migraine without aura show significant changes in the perivascular spaces of an area of ​​the brain called the centrum semiovale,” says medical scientist Wilson Xu of the University of Southern California in Los Angeles.

“These changes have never been reported before.”

Migraine, let’s not hide it, is a hell with which you have to live. While the excruciating headache is well known, migraines can also cause dizziness, blurred vision (known as an aura), photosensitivity, and nausea, up to and including vomiting. It is not known what causes migraine, there is no cure, and in many cases the condition is not treatable.

This disease affects approximately 10 percent of the world’s population. Therefore, finding the cause and more effective treatment strategies will improve the lives of millions of people.

Xu and colleagues became interested in perivascular spaces in the centrum semiovale, the central region of the white matter of the brain, located 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 enlargement may be a symptom of a more serious problem.

“The perivascular spaces are part of the fluid drainage system in the brain,” says Xu. “Studying how they contribute to the development of migraine may help us better understand the complexity of migraine.”

He and colleagues recruited 20 patients aged 25 to 60 with migraine: 10 people with chronic migraine without aura and 10 people with episodic migraine. In addition, 5 healthy non-migraine patients were included as controls.

The team excluded patients with cognitive impairment, claustrophobia, a brain tumor, or those 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.

“To our knowledge, this is the first study using ultra-high-resolution MRI to study migraine-induced microvascular changes in the brain, especially in the perivascular spaces,” Xu explains.

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

The scan showed that the perivascular spaces in the centrum semiovale of the migraine patients were significantly enlarged compared to the control group.

The researchers also found a difference in the distribution of lesion types known as white matter hyperintensity in migraine patients. They are caused by tiny patches of dead or partially dead tissue starving due to reduced blood flow, and are quite normal.

There was no difference in the incidence of these lesions between migraine patients and controls, but the severity of deep lesions was higher in migraine sufferers.

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

Although the nature of the link between dilated perivascular spaces and migraine is unclear, the findings suggest that migraine is due to problems with the brain’s aqueduct, the glymphatic system responsible for clearing waste from the brain and nervous system. It uses perivascular channels for transportation.

More work is needed to explore this relationship, but even identifying it is promising.

“The results of our study may inspire further, larger studies to further explore how changes in microscopic brain vessels and blood supply contribute to the development of different types of migraine,” says Xu.

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

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

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