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. 2023 Jul;10(7):1160-1169.
doi: 10.1002/acn3.51798. Epub 2023 Jun 6.

Enlarged perivascular spaces in patients with migraine: a case-control study based on 3T MRI

Ziyu Yuan  1 , Wei Li  2 , Hefei Tang  1 , Yanliang Mei  1 , Dong Qiu  1 , Min Zhang  3 , Qian Sun  4 , Wei Wang  1 , Peng Zhang  1 , Zhaochao Ma  5 , Xueyan Zhang  6 , Yaqing Zhang  1 , Yonggang Wang  1 , Xueying Yu  1
Affiliations

Enlarged perivascular spaces in patients with migraine: a case-control study based on 3T MRI

Ziyu Yuan et al. Ann Clin Transl Neurol. 2023 Jul.

Abstract

Objective: To explore whether MRI-visible enlarged perivascular spaces (EPVS) are associated with migraine and may serve as a predictor of migraine. Then further explore its correlation with migraine chronification.

Methods: A total of 231 participants (healthy control [HC] = 57, episodic migraine [EM] = 59, chronic migraine [CM] = 115) were included in this case-control study. A 3T MRI device and the validated visual rating scale were used to assess the grades of EPVS in centrum semiovale (CSO), midbrain (MB), and basal ganglia (BG). Comparisons between the two groups were made using the chi-square or Fisher's exact tests to initially determine whether high-grade EPVS were associated with migraine and migraine chronification. A multivariate logistic regression model was constructed to further investigate the role of high-grade EPVS in migraine.

Results: The prevalence of high-grade EPVS in CSO and MB were significantly higher in patients with migraine than in HCs (CSO: 64.94% vs. 42.11%, P = 0.002; MB: 55.75% vs. 29.82%, P = 0.001). Subgroup analysis showed no statistical difference between patients with EM and CM (CSO: 69.94% vs. 62.61%, P = 0.368; MB: 50.85% vs. 58.26%, P = 0.351). Individuals with high-grade EPVS in CSO (odds ratio [OR]: 2.324; 95% confidence interval [CI]: 1.136-4.754; P = 0.021) and MB (OR: 3.261; 95% CI: 1.534-6.935; P = 0.002) were more likely to suffer from migraine.

Interpretation: This case-control study showed that high-grade EPVS in CSO and MB in clinical practice with the underlying mechanism of dysfunction of the glymphatic system could be a predictor of migraine, but no significant correlation had been found with migraine chronification.

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Conflict of interest statement

There is no potential competing interest to be declared by the authors.

Figures

Figure 1
Figure 1
Flowchart of the participant inclusion process. HCs, healthy controls; CM, chronic migraine; EM, episodic migraine.
Figure 2
Figure 2
Examples of high‐grade EPVS distributed in three regions in patients with migraine based on the axial T2w‐PROPELLER sequence of 3T MRI. (A) High‐grade EPVS in MB; (B) High‐grade EPVS in BG; (C) High‐grade EPVS in CSO. EPVS, enlarged perivascular spaces; MB, midbrain; BG, basal ganglia; CSO, centrum semiovale.
See this image and copyright information in PMC

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