White matter diffusion abnormalities in migraine and medication overuse headache: A 1.5-T tract-based spatial statistics study

Abstract

Objectives: Migraine and medication overuse headache are common, but its pathophysiology remains unclear. Differential diagnosis of chronic headache is still challenging. Conventional brain imaging techniques exclude secondary causes of headache but cannot produce a proper diagnosis. Accordingly, more sensitive diagnostic methods are needed for certain diagnosis. In the present study, we performed voxel-wise tract-based spatial statistics of 1.5-T diffusion tensor imaging in migraine patients and healthy volunteers.

Patients and methods: One hundred and three migraine patents and 46 healthy volunteers were registered. The fractional anisotropy values in the white matter of each group compared to age-matched healthy volunteers.

Results: Compared to the controls, the migraine without aura with medication overuse headache had remarkable fractional anisotropy decrease in the white matter in several regions. The migraine with aura without medication overuse headache also had significant fractional anisotropy decrease compared to the controls. The disease duration and frequency of migraine attack were not correlated with fractional anisotropy values of the corpus callosum.

Conclusion: Our 1.5-T DTI study demonstrated significantly lower fractional anisotropy in the white matter in the MoA with medication overuse headache and MwA without medication overuse headache groups, suggesting that fractional anisotropy abnormalities may be useful biomarkers in headache patients.

Keywords: Diffusion tensor imaging; Fractional anisotropy; MRI; Medication overuse headache; Migraine; Tract-based spatial statistics.