Signs of Cortical Inflammation in Migraine Measured with Quantitative Magnetic Resonance Imaging: A Registry for Migraine (REFORM) Study

IF 7.7 1区医学 Q1 CLINICAL NEUROLOGY Annals of Neurology Pub Date : 2025-02-04 DOI:10.1002/ana.27197

Rune H. Christensen MD, Håkan Ashina MD, PhD, Haidar M. Al-Khazali MD, Mario Ocampo-Pineda PhD, Reza Rahmanzadeh MD, PhD, Nouchine Hadjikhani MD, PhD, Cristina Granziera MD, PhD, Faisal Mohammad Amin MD, PhD, Messoud Ashina MD, PhD, DMSc

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Abstract

Objective

The involvement of cortical inflammation in migraine, particularly migraine with aura, has been a subject of considerable interest, but has proved challenging to demonstrate. We aimed to detect and characterize signs of cortical inflammation in adults with migraine using a novel, multimodal magnetic resonance imaging (MRI) technique.

Methods

We used T2 mapping to measure water content/cellularity, T1 mapping to measure tissue microstructure integrity, and apparent diffusion coefficient (ADC) mapping to measure intra- or extracellular edema. We compared these values between participants with migraine (with and without aura) and healthy controls using general linear models adjusted for age and sex.

Result

Two hundred ninety-six adult participants with migraine and 155 age- and sex-matched healthy controls provided eligible imaging data. Among the participants with migraine, 103 had migraine with aura, 180 chronic migraine, and 88 were ictal during the scan. Participants with migraine had higher quantitative T2 (qT2) in the left occipital cortex than healthy controls (p < 0.0001). In migraine with aura, the higher qT2 was more widespread and located bilaterally in the occipital cortices, compared with controls (left, p < 0.0001; right p = 0.004). Post-hoc analysis revealed overlapping ADC elevations in migraine with aura compared with controls (p = 0.0069).

Interpretation

Quantitative MRI changes compatible with cortical inflammation were detected in participants with migraine, and appeared driven by the subgroup with aura. Higher occipital qT2 in migraine with aura might represent either extracellular edema or accumulation of inflammatory microglia or astrocytes. These results support the importance of cortical inflammation in migraine pathophysiology, particularly in migraine with aura. ANN NEUROL 2025;97:1168–1179

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定量磁共振成像测量偏头痛皮质炎症的征象：偏头痛登记（改革）研究。

目的：皮层炎症在偏头痛，特别是先兆偏头痛中的参与，一直是一个相当有趣的主题，但证明具有挑战性。我们的目的是使用一种新型的多模态磁共振成像（MRI）技术检测和表征成人偏头痛患者的皮质炎症迹象。方法：我们使用T2作图测量含水量/细胞度，T1作图测量组织微观结构完整性，表观扩散系数（ADC）作图测量细胞内或细胞外水肿。我们使用调整了年龄和性别的一般线性模型，比较了偏头痛患者（有或没有先兆）和健康对照组的这些值。结果：226名成年偏头痛患者和155名年龄和性别匹配的健康对照者提供了合格的影像学数据。在患有偏头痛的参与者中，103人患有先兆偏头痛，180人患有慢性偏头痛，88人在扫描期间处于危急状态。偏头痛患者的左枕叶皮质定量T2 （qT2）高于健康对照组(p)解释：偏头痛患者的定量MRI变化与皮质炎症相一致，并且似乎是由先兆亚组驱动的。先兆偏头痛的枕部qT2升高可能代表细胞外水肿或炎性小胶质细胞或星形胶质细胞的积累。这些结果支持了皮层炎症在偏头痛病理生理学中的重要性，特别是在先兆偏头痛中。Ann neurol 2025。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Neurology 医学-临床神经学

CiteScore

18.00

自引率

1.80%

发文量

270

审稿时长

3-8 weeks

期刊介绍： Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.