Disease-duration-associated ALPS asymmetry in migraine: a case-control DTI-ALPS study
Abstract
Abstract Background Migraine ALPS studies have reported mixed case-control findings. Because averaging hemispheres may obscure clinically relevant laterality, we tested whether hemisphere-specific ALPS variation showed patient-internal associations with disease duration beyond the pooled case-control contrast, and secondarily whether baseline hemisphere-specific ALPS was associated with later acute medication use. Methods We analyzed 89 participants (25 controls, 64 migraine patients) recruited between December 2021 and June 2023. Bilateral ALPS was tested with age-, sex-, and BMI-adjusted Gaussian GEE. In patients, disease duration was related to left, right, mean, right-minus-left, and absolute-difference ALPS metrics in five FDR-controlled HC3-robust models adjusted for baseline MMD, age, sex, and BMI, plus a baseline-MMD-adjusted hemisphere-aware GEE. A secondary two-model family examined left and right baseline ALPS in relation to follow-up acute medication days (AMD) assessed in February 2026, adjusting for baseline AMD, baseline MMD, disease duration, age, sex, and BMI. Results Case-control status was not associated with ALPS. Right-hemisphere ALPS was lower than left in the bilateral GEE (β=-0.0653, 95% CI -0.1149 to -0.0156, p = 0.010), without a patient-by-side interaction. Within the migraine cohort, longer duration was associated with higher right-minus-left ALPS difference (β = 0.0053, p = 0.003, FDR-corrected p = 0.015) and lower absolute ALPS difference…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 89 participants or records.
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