According to research that has been presented at the 108th Scientific Assembly and Annual Meeting of the Radiological Society of North America, mysterious changes have been identified in the brains of people who get migraines.
Scientists may have just found a major new clue that could help solve the frustrating and ongoing mystery of the migraine.
Researchers discovered that patients who suffer from episodic and chronic migraine had significantly enlarged perivascular spaces, the fluid-filled regions around the brain’s blood arteries.
The discovery might represent a new study path that has not yet been explored, even though the connection to or role in migraine has not yet been determined.
The discovery was announced at the Radiological Society of North America’s 108th Scientific Assembly and Annual Meeting.
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“In people with chronic migraine and episodic migraine without aura, there are significant changes in the perivascular spaces of a brain region called the centrum semiovale,” says medical scientist Wilson Xu of the University of Southern California in Los Angeles.
“These changes have never been reported before.”
Let’s not mince words: Living with a migraine is horrible. Although migraines are most famous for their excruciating headaches, they can also cause vertigo, visual impairment (also known as an aura), photosensitivity, and nausea that may result in vomiting. There is no recognised reason for migraines, no known treatment for them, and often they do not respond to it.
Ten percent of the world’s population is thought to be impacted by the condition. Therefore, identifying a cause and developing better management techniques would improve millions of people’s lives.
The perivascular areas in the centrum semiovale, the primary area of brain white matter directly beneath the cerebral cortex, piqued the interest of Xu and his coworkers. Although the purpose of these areas is not fully known, they do contribute to fluid outflow and their expansion may be a sign of more serious issues.
“Perivascular spaces are part of a fluid clearance system in the brain,” Xu says. “Studying how they contribute to migraine could help us better understand the complexities of how migraines occur.”
He and his colleagues gathered 20 migraine patients between the ages of 25 and 60: 10 of whom had chronic migraine without aura and 10 of whom had episodic migraine. A control group of 5 healthy patients who don’t get migraines was also included.
Patients with cognitive impairment, claustrophobia, brain tumours, or previous brain surgery were disqualified by the researchers. Then, they used an ultra-high-field MRI using a 7-tesla magnet to perform MRI images. The majority of hospital scanners only use 3 tesla magnets.
“To our knowledge, this is [the] first study using ultra-high-resolution MRI to study microvascular changes in the brain due to migraine, particularly in perivascular spaces,” Xu explains.
“Because 7T MRI is able to create images of the brain with much higher resolution and better quality than other MRI types, it can be used to demonstrate much smaller changes that happen in brain tissue after a migraine.”
The scans showed that migraine patients’ perivascular spaces in the centrum semiovale were substantially larger than those of the control group.
Additionally, white matter hyperintensities, a particular kind of lesion, were discovered to be distributed differently in migraine sufferers. These are rather common and are brought on by little areas of dead or partially dead tissue that are starved by reduced blood flow.
The incidence of these lesions was the same in both migraine patients and control subjects, but the severity of deep lesions was greater in migraine patients.
This shows, in the opinion of the researchers, that the expansion of perivascular spaces may eventually result in the formation of additional white matter lesions.
The results indicate that migraine is associated with a problem with the brain’s plumbing, specifically the glymphatic system, which is in charge of clearing waste from the brain and nervous system, even though the nature of the connection between enlarged perivascular spaces and migraine is unclear. It transports through perivascular channels.
Even though further research is needed to fully understand this correlation, its discovery is encouraging.
“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 migraine types,” Xu says.
“Eventually, this could help us develop new, personalized ways to diagnose and treat migraine.”