Subcortical nuclei and glymphatic system alterations in migraine with aura: a comparative 7T multimodal MRI analysis
Abstract
BACKGROUND: Although cortical spreading depression is well-established in migraine with aura (MA), the potential involvement of subcortical nuclei and the glymphatic system (GS) in its pathogenesis—and their utility in distinguishing MA from migraine without aura (MO)—remains poorly investigated. Therefore, we employed multimodal 7T MRI—integrating functional, structural, quantitative susceptibility mapping (QSM), and GS metrics (perivascular space (PVS) morphology, choroid plexus volume, and analysis along the perivascular space (ALPS) index)—to enhance the understanding of MA and to characterize alterations specific to MA relative to MO and healthy controls (HCs). METHODS: In this cross-sectional study, 7T MRI scans were acquired from 35 MA patients, 45 MO patients, and 39 HCs. Group differences were evaluated using general linear models adjusted for age, anxiety, and depression scores (and intracranial volume when evaluating volumetric measures), with false discovery rate (FDR) correction. Partial correlation analyses were performed between abnormal imaging metrics and clinical parameters. RESULTS: Both MA and MO showed lower regional homogeneity (ReHo) in the hippocampus(L), thalamus(R), and pallidum(R) compared to HCs (PFDR<0.05). In the volumetric comparisons, MO patients tended to have smaller volumes (especially in the amygdala) than HCs (PFDR<0.05) whereas MA patients showed relatively preserved volumes in these regions. QSM revealed higher iron content in the…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 45 participants or records.
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