Korean J Radiol.  2018 Aug;19(4):767-776. 10.3348/kjr.2018.19.4.767.

Migraine with Aura: Surface-Based Analysis of the Cerebral Cortex with Magnetic Resonance Imaging

• Petrusic I
• Dakovic M
• Kacar K
• Zidverc-Trajkovic J

• KMID: 2413706
• DOI: http://doi.org/10.3348/kjr.2018.19.4.767

Abstract

OBJECTIVE
Previous migraine studies have reported gray matter alterations in various cortical regions with conflicting results. This study aimed to explore a cortical morphometric difference in migraineurs with aura (MA) compared to healthy subjects (HS) and to delineate a possible difference between the cortical morphological features and different aura phenotypes.
MATERIALS AND METHODS
Forty-eight MA and 30 HS that were balanced by sex, age, and educational level were selected for this study. T2-weighted and three-dimensional T1-weighted magnetic resonance imaging (MRI) of the brain were acquired using a 1.5T MRI scanner. Surface-based morphometry from the MRI data was used to identify differences between the MA and HS group, and then between MA subgroups. The MA group was subdivided into migraineurs who experienced only visual aura (MVA) and migraineurs who had visual, somatosensory and dysphasic symptoms (MVA+).
RESULTS
The MVA+ group had significantly reduced cortical surface area of the left rostral middle frontal cortex compared with the MVA group (p < 0.001). Migraine patients had significantly reduced volume of the left fusiform gyrus relative to HS (p < 0.001). Also, the sulcal depth increased at the level of the left temporal pole in the MVA+ group relative to the MVA group (p < 0.001). The vertex-by-vertex analysis did not exhibit any significant difference in cortical thickness between MA and HS, and between MVA+ and MVA, when corrected for multiple comparisons.
CONCLUSION
Migraineurs with aura demonstrates different morphometric features from HS in multiple cortical regions. MVA+ have different morphometric features in the left frontal and temporal lobe relative to MVA, which could be a source of distinct symptoms and serve as potential biomarkers of different MA subtypes.

Keyword

Migraine; Aura; Dysphasia; Gray matter morphometry; MRI

MeSH Terms

Aphasia
Biomarkers
Brain
Cerebral Cortex*
Epilepsy
Frontal Lobe
Gray Matter
Healthy Volunteers
Humans
Magnetic Resonance Imaging*
Migraine Disorders*
Migraine with Aura*
Phenotype
Temporal Lobe
Biomarkers

Figure

• 

  Fig. 1 Freesurfer whole-brain vertex-wise analysis of cortical surface area.Statistical maps controlling for effect of age and sex display decreasing (red color) and increasing (blue color) patterns in MA patients relative to HS group. Color bar shows logarithmic scale of p values (−log10). In order to visually demonstrate widespread changes, significant thresholds were set at p < 0.001, uncorrected. MA = migraineurs with aura, HS = healthy subjects

• 

  Fig. 2 Freesurfer whole-brain vertex-wise analysis of cortical surface area.Statistical maps controlling for effect of age and sex display decreasing (red color) patterns in MVA+ patients relative to MVA group. Color bar shows logarithmic scale of p values (−log10). In order to visually demonstrate widespread changes, significant thresholds were set at p < 0.001, uncorrected. MVA = migraineurs who experienced only visual aura, MVA+ = migraineurs who had visual, somatosensory and dysphasic symptoms

• 

  Fig. 3 Freesurfer whole-brain vertex-wise analysis of sulcal depth in cortex.Statistical maps controlling for effect of age and sex display increasing (blue color) and decreasing (red color) patterns in MA patients relative to HS. Color bar shows logarithmic scale of p values (−log10). In order to visually demonstrate widespread changes, significant thresholds were set at p < 0.001, uncorrected.

• 

  Fig. 4 Freesurfer whole-brain vertex-wise analysis of sulcal depth in cortex.Statistical maps controlling for effect of age and sex display increasing (blue color) and decreasing (red color) patterns in MVA+ patients relative to MVA group. Color bar shows logarithmic scale of p values (−log10). In order to visually demonstrate widespread changes, significant thresholds were set at p < 0.001, uncorrected.

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