White Matter Alterations in Chronic Migraine: A Diffusion Tensor Imaging and Structural Connectivity Study

Objective: White matter alterations have been observed in patients with migraine. However, no microstructural white matter alterations have been found particularly in Episodic Migraine (EM) with respect to Chronic Migraine (CM) patients. In this study, we investigated whether there are significant differences between EM and CM, and between these groups and healthy controls, using diffusion Magnetic Resonance Imaging (dMRI) data.
Methods: We acquired high-resolution 3D brain T1-weighted and dMRI from 51 Healthy Controls (HC), 55 EM patients and 57 CM patients. Using Tract-Based Spatial Statistics, we compared Fractional Anisotropy (FA), Mean Diffusivity (MD), Radial Diffusivity (RD) and Axial Diffusivity (AD) between the different groups. We also obtained structural connectome matrices for each subject employing both dMRI and T1-weighted acquisitions. Number of streamlines, mean FA and mean AD for each white matter connection were compared between the three groups.
Results: Significant decreased AD (p <.05 Family Wise Error corrected and volume >30 mm3) were found in CM compared to EM in 38 white matter regions. Significant differences in the number of streamlines were found in 18 connections from the connectome when comparing migraine patients with healthy controls (p <.05 False Discovery Rate corrected); significant differences were also found between CM and EM in one of these connections. Furthermore, significant differences in FA and AD were found in three and four connections from the connectome respectively (p <.05 False Discovery Rate corrected); significant differences were also found between CM and EM in two of AD connections.
Conclusion: Our findings suggest global white matter structural differences between EM and CM, and structural connectivity alterations in migraine patients with respect to healthy controls, and in CM compared to EM.
Disclosure of Interest: None Declared.