J Clin Neurol.  2019 Oct;15(4):448-453. 10.3988/jcn.2019.15.4.448.

Subcortical Volume Changes in Migraine with Aura

• Petrusic I
• Dakovic M
• Zidverc-Trajkovic J

• KMID: 2467752
• DOI: http://doi.org/10.3988/jcn.2019.15.4.448

Abstract

BACKGROUND AND PURPOSE
Various features of the cerebral cortex and white matter have been extensively investigated in migraine with aura (MwA), but the morphological characteristics of subcortical structures have been largely neglected. The aim of this study was to identify possible differences in subcortical structures between MwA patients and healthy subjects (HS), and also to determine the correlations between the characteristics of migraine aura and the volumes of subcortical structures.
METHODS
Thirty-two MwA patients and 32 HS matched by sex and age were analyzed in this study. Regional subcortical brain volumes were automatically calculated using the FSL/FMRIB Image Registration and Segmentation Tool software (https://fsl.fmrib.ox.ac.uk/fsl/fslwiki/Glossary). A general linear model analysis was used to investigate differences in the volume of subcortical structures between the MwA patients and HS. A partial correlation test was used to assess correlations between the volume of subcortical structures and characteristics of MwA.
RESULTS
The volumes of the right globus pallidus, left globus pallidus, and left putamen were significantly smaller in MwA patients than in HS (mean±SD): 1,427±135 mm³ vs. 1,557±136 mm³ (p<0.001), 1,436±126 mm³ vs. 1,550±139 mm³ (p=0.001), and 4,235±437 mm³ vs. 4,522±412 mm³ (p=0.006), respectively. There were no significant relationships between subcortical structures and clinical parameters.
CONCLUSIONS
These findings suggest that both the globus pallidi and left putamen play significant roles in the pathophysiology of the MwA. Future studies should determine the cause-and-effect relationships, since these could not be discriminated in this study due to its cross-sectional design.

Keyword

migraine with aura; basal ganglia; globus pallidus; putamen

MeSH Terms

Basal Ganglia
Brain
Cerebral Cortex
Epilepsy
Globus Pallidus
Healthy Volunteers
Humans
Linear Models
Migraine Disorders*
Migraine with Aura*
Putamen
White Matter

Figure

• 

  Fig. 1 Example of registered subcortical structures on the standardized template.

• 

  Fig. 2 Three-dimensional visualization of the results of shape analysis of the subcortical structures that were significantly smaller in MwA patients than in healthy subjects. MwA patients showed significant inward deformations of the right globus pallidus, left globus pallidus, and left putamen (A, upper view; B, lower view). Significant inward deformations are quantified on a -log(p) scale, with blue indicating the greatest inward deformations. The results are uncorrected for multiple comparisons, and hence are for illustrative purposes only. MwA: migraine with aura.

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