Gray and White Matter Changes in Migraineurs: a Review of Literature
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IMAGING
Gray and White Matter Changes in Migraineurs: a Review of Literature Hania Hasan 1 & Rafia Irfan Waheed 1 & Taha Bin Arif 1
&
Sidra Saleem 2 & Arsalan Anwar 3
Accepted: 4 October 2020 # Springer Nature Switzerland AG 2020
Abstract Several neuroimaging studies with advanced techniques have shown changes in gray and white matter in the brain of migraineurs. This narrative review highlights the structural and functional alterations and causality factors of migraine for the introduction of new treatment modalities. PubMed, Google Scholar, and Scopus were searched without any language restriction for the articles depicting gray and white matter changes in migraineurs. Using magnetic resonance imaging scans, multiple studies have demonstrated a reduction in white matter volume and presence of white matter hyperintensities and demyelinated white matter areas, especially in the frontal and parietal lobes. Similarly, voxel-based morphometry analysis has shown a greater reduction in gray matter in the frontal and cingulate cortex of chronic and episodic migraineurs. An overactivation of the frontal and cingulate cortex has been observed during the interictal period. These parts of gray matter are involved in cognitive, emotional, and autonomic aspects of nociception. Moreover, constituents of the limbic system, particularly the thalamus, hippocampus, amygdala, and cingulate gyrus, have also depicted predominant functional disturbances during migraine episodes. Recent studies highlighted a decrease in gray matter volume in the spinal trigeminal nucleus. These findings suggest that such changes might be the reason for dysfunction and pain regulation. Modern neuroimaging thus clearly helps in understanding the pathophysiology of migraine, which calls for novel therapeutic interventions in unresponsive or chronic migraineurs. Keywords Gray matter . White matter . Migraine . Migraineurs . Voxel-based morphometry . Magnetic resonance imaging . Aura
Introduction Migraine is defined as recurrent pulsating or throbbing pain usually involving one side of the head. It is considered as one of the most prevalent neurological disorders in adult females [1, 2]. Migraine is frequently associated with subjective sensory disturbances, such as flashes of light, vision changes, or tingling sensations called aura [3]. The prevalence of migraine
This article is part of the Topical Collection on Imaging * Taha Bin Arif [email protected] 1
Department of Medicine, Dow Medical College, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
2
Department of Neurology, University of Toledo, Toledo, OH, USA
3
Department of Neurology, Mercy Health St. Vincent Medical Center, Toledo, OH, USA
varies from 2.6 to 21.7% in different regions of the world [4–7]. The pathophysiology of migraine is not completely understood, but it is considered as an interplay of genetic and environmental factors linked with alterations in the brainstem and serotonin levels [2]. The advent of neuroimaging particularly magnetic reson
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