Korean J Radiol.  2018 Feb;19(1):85-92. 10.3348/kjr.2018.19.1.85.

Magnetic Resonance Image Texture Analysis of the Periaqueductal Gray Matter in Episodic Migraine Patients without T2-Visible Lesions

• Chen Z
• Chen X
• Liu M
• Liu S
• Yu S
• Ma L

• KMID: 2425113
• DOI: http://doi.org/10.3348/kjr.2018.19.1.85

Abstract

OBJECTIVE
The periaqueductal gray matter (PAG), a small midbrain structure, presents dysfunction in migraine. However, the precise neurological mechanism is still not well understood. Herein, the aim of this study was to investigate the texture characteristics of altered PAG in episodic migraine (EM) patients based on high resolution brain structural magnetic resonance (MR) images.
MATERIALS AND METHODS
The brain structural MR images were obtained from 18 normal controls (NC), 18 EM patients and 16 chronic migraine (CM) patients using a 3T MR system. A PAG template was created using the International Consortium Brain Mapping 152 gray matter model, and the individual PAG segment was developed by applying the deformation field from the structural image segment to the PAG template. A grey level co-occurrence matrix was used to calculate the texture parameters including the angular second moment (ASM), contrast, correlation, inverse difference moment (IDM) and entropy.
RESULTS
There was a significant difference for ASM, IDM and entropy in the EM group (998.629 ± 0.162 × 10−3, 999.311 ± 0.073 × 10−3, 916.354 ± 0.947 × 10−5) compared to that found in the NC group (998.760 ± 0.110 × 10−3, 999.358 ± 0.037 × 10−3 and 841.198 ± 0.575 × 10−5) (p < 0.05). The entropy was significantly lower among the patients with CM (864.116 ± 0.571 × 10−5) than that found among patients with EM (p < 0.05). The area under the receiver operating characteristic curve was 0.776 and 0.750 for ASM and entropy in the distinction of the EM from NC groups, respectively. ASM was negatively related to disease duration (DD) and the Migraine Disability Assessment Scale (MIDAS) scores in the EM group, and entropy was positively related to DD and MIDAS in the EM group (p < 0.05).
CONCLUSION
The present study identified altered MR image texture characteristics of the PAG in EM. The identified texture characteristics could be considered as imaging biomarkers for EM.

Keyword

Chronic migraine; Episodic migraine; Periaqueductal gray matter; Magnetic resonance imaging; Texture analysis

MeSH Terms

Biomarkers
Brain
Brain Mapping
Entropy
Gray Matter
Humans
Magnetic Resonance Imaging
Mesencephalon
Migraine Disorders*
Periaqueductal Gray*
ROC Curve
Biomarkers

Figure

• 

  Fig. 1 Flowchart of PAG texture calculation, including PAG template creation, individual PAG segment and GLCM texture calculation.GLCM = grey-level co-occurrence matrix, PAG = periaqueductal gray matter

• 

  Fig. 2 Comparison of PAG texture (ASM, IDM and entropy) in NC, EM, and CM patients.ASM = angular second moment, CM = chronic migraine, EM = episodic migraine, IDM = inverse difference moment, NC = normal control

• 

  Fig. 3 ROC curve among each group.ASM for NC vs. EM had largest area under curve value (0.776). ROC = receiver operating characteristics

• 

  Fig. 4 Scatter plot for ASM, entropy and IDM in EM, and CM patients.ASM was negatively related to DD (A) and MIDAS (E) in EM, and it was negatively related to VAS (C) in CM. Entropy was positively related to DD (B) and MIDAS (F) in EM, and IDM was negatively related to VAS (D) in CM. DD = disease duration, MIDAS = Migraine Disability Assessment Scale, VAS = visual analogue scale

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