Scientists may have just found a major new clue that could help solve the frustrating and enduring mystery of migraine.
Using ultra-high resolution MRI, the researchers found that the perivascular spaces – fluid-filled spaces around blood vessels in the brain – are abnormally enlarged in patients with chronic and episodic migraine.
Although the link or role in migraine remains to be established, this finding could 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.
“In people with chronic migraine and episodic migraine without aura, there are significant changes in the perivascular spaces of a region of the brain called the centrum semiovale,” says medical scientist Wilson Xu from the University of Southern California. in Los Angeles.
“These changes have never been reported before.”
Migraine, let’s not mince words, it’s hell to live. Although the excruciating aspect of headaches is well known, migraine can also cause dizziness, visual impairment (known as aura), photosensitivity and nausea to the point of vomiting. It is not known what causes migraine, there is no cure, and in many cases the condition does not respond to treatment.
The condition affects approximately 10 percent of the world’s population. Thus, finding a cause and more effective management strategies would improve the lives of millions of people.
Xu and his colleagues were curious about the perivascular spaces in the centrum semiovale, the central region of the brain’s white matter directly 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 larger problem.
“The perivascular spaces are part of a fluid clearance system in the brain,” Xu explains. “Studying how they contribute to migraine could help us better understand the complexities of how migraines occur.”
He and his colleagues recruited 20 patients aged 25 to 60 with migraine: 10 with chronic migraine without aura and 10 with episodic migraine. Additionally, 5 healthy patients who do not suffer from migraines were included as a control group.
The team excluded patients with cognitive impairment, claustrophobia, brain tumors or who had previously had brain surgery. Next, they performed MRI scans using an ultra-high field MRI with a 7 Tesla magnet. Most hospital scanners only have magnets up to 3 tesla.
“To our knowledge, it is [the] first study using ultra-high resolution MRI to investigate microvascular changes in the brain due to migraine, particularly in the perivascular spaces,” says Xu.
“Because 7T MRI is able to create images of the brain with much higher resolution and better quality than other types of MRIs, it can be used to demonstrate much smaller changes that occur in tissue. cerebral after a migraine.”
The scans revealed that the perivascular spaces in the semi-oval center of migraine patients were significantly enlarged compared to the control group.
The researchers also found a difference in the distribution of a type of lesion known as white matter hyperintensities in migraine patients. These are caused by tiny patches of dead or partially dead tissue starved by reduced blood flow, and they’re fairly normal.
There was no difference in the frequency of these lesions between migraine patients and control patients, but the severity of deep lesions in migraineurs was higher.
This suggests, according to the researchers, that widening of the perivascular spaces could lead to the future development of more white matter lesions.
Although the nature of the link between enlarged perivascular spaces and migraine is unclear, the results suggest that migraine is accompanied by a problem with cerebral plumbing – the glymphatic system responsible for the elimination of waste products in the brain and the nervous system. It uses perivascular canals for transport.
Further work is needed to explore this correlation, but even identifying it is promising.
“The results of our study could help inspire future, larger-scale studies to continue investigating how changes in the brain’s microscopic vessels and blood supply contribute to different types of migraine,” Xu said.
“Ultimately, this could help us develop new personalized ways to diagnose and treat migraine.”
The research was presented at the 108th Scientific Assembly and Annual Meeting of the Radiological Society of North America.
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