Diffusion tensor magnetic resonance imaging at 3.0 tesla shows subtle cerebral grey matter abnormalities in patients with migraine

Background and objective: Diffusion tensor (DT) magnetic resonance imaging (MRI) has the potential to disclose subtle abnormalities in the brain of migraine patients. This ability may be increased by the use of high field magnets. A DT MRI on a 3.0 tesla scanner was used to measure the extent of tissue damage of the brain normal appearing white (NAWM) and grey matter in migraine patients with T2 visible abnormalities. Methods: Dual echo, T1 weighted and DT MRI with diffusion gradients applied in 32 non-collinear directions were acquired from 16 patients with migraine and 15 sex and age matched controls. Lesion load on T2 weighted images was measured using a local thresholding segmentation technique, and brain atrophy assessed on T1 weighted images using SIENAx. Mean diffusivity and fractional anisotropy histograms of the NAWM and mean diffusivity histograms of the grey matter were also derived. Results: Brain atrophy did not differ between controls and patients. Compared with healthy subjects, migraine patients had significantly reduced mean diffusivity histogram peak height of the grey matter (p = 0.04). No diffusion changes were detected in patients’ NAWM. In migraine patients, no correlation was found between T2 weighted lesion load and brain DT histogram derived metrics, whereas age was significantly correlated with grey matter mean diffusivity histogram peak height (p = 0.05, r = −0.52). Conclusions: DT MRI at high field strength discloses subtle grey matter damage in migraine patients, which might be associated with cognitive changes in these patients.

[1]  M Filippi,et al.  A diffusion tensor magnetic resonance imaging study of brain tissue from patients with migraine , 2003, Journal of neurology, neurosurgery, and psychiatry.

[2]  J. Ashburner,et al.  Multimodal Image Coregistration and Partitioning—A Unified Framework , 1997, NeuroImage.

[3]  Daniel Rueckert,et al.  VTK CISG Registration Toolkit: An Open Source Software Package for Affine and Nonrigid Registration of Single- and Multimodal 3D images , 2002, Bildverarbeitung für die Medizin.

[4]  C. Sotak,et al.  The role of diffusion tensor imaging in the evaluation of ischemic brain injury – a review , 2002, NMR in biomedicine.

[5]  M Cercignani,et al.  Magnetisation transfer ratio and mean diffusivity of normal appearing white and grey matter from patients with multiple sclerosis , 2001, Journal of neurology, neurosurgery, and psychiatry.

[6]  D. Le Bihan,et al.  Clinical severity in CADASIL related to ultrastructural damage in white matter: in vivo study with diffusion tensor MRI. , 1999, Stroke.

[7]  Yulin Ge,et al.  Age-related total gray matter and white matter changes in normal adult brain. Part II: quantitative magnetization transfer ratio histogram analysis. , 2002, AJNR. American journal of neuroradiology.

[8]  A. Apkarian,et al.  Chronic Back Pain Is Associated with Decreased Prefrontal and Thalamic Gray Matter Density , 2004, The Journal of Neuroscience.

[9]  Derek K. Jones,et al.  Normal-appearing white matter in ischemic leukoaraiosis: A diffusion tensor MRI study , 2001, Neurology.

[10]  Stephen M. Smith,et al.  Accurate, Robust, and Automated Longitudinal and Cross-Sectional Brain Change Analysis , 2002, NeuroImage.

[11]  J. Passchier,et al.  Interictal and Postictal Cognitive Changes in Migraine , 1999, Cephalalgia : an international journal of headache.

[12]  S. Evers Die neue IHS-Klassifikation , 2004, Der Schmerz.

[13]  T. Olsen,et al.  Timing and topography of cerebral blood flow, aura, and headache during migraine attacks , 1990, Annals of neurology.

[14]  Colin Studholme,et al.  An overlap invariant entropy measure of 3D medical image alignment , 1999, Pattern Recognit..

[15]  Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. , 1988, Cephalalgia : an international journal of headache.

[16]  M. Kaste,et al.  Diffusion-weighted MR imaging in normal human brains in various age groups. , 2002, AJNR. American journal of neuroradiology.

[17]  P. Basser,et al.  Estimation of the effective self-diffusion tensor from the NMR spin echo. , 1994, Journal of magnetic resonance. Series B.

[18]  G. Comi,et al.  In vivo assessment of the brain and cervical cord pathology of patients with primary progressive multiple sclerosis. , 2001, Brain : a journal of neurology.

[19]  H Lechner,et al.  Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis , 1988, Neurology.

[20]  Maria Assunta Rocca,et al.  Evidence of subtle gray-matter pathologic changes in healthy elderly individuals with nonspecific white-matter hyperintensities. , 2003, Archives of neurology.

[21]  P. Boesiger,et al.  SENSE: Sensitivity encoding for fast MRI , 1999, Magnetic resonance in medicine.

[22]  G. Comi,et al.  A magnetization transfer imaging study of the brain in patients with migraine , 2000, Neurology.

[23]  Karl J. Friston,et al.  Correlation between structural and functional changes in brain in an idiopathic headache syndrome , 1999, Nature Medicine.

[24]  E P Calandre,et al.  Cognitive Disturbances and Regional Cerebral Blood Flow Abnormalities in Migraine Patients: Their Relationship with the Clinical Manifestations of the Illness , 2002, Cephalalgia : an international journal of headache.

[25]  P. Boesiger,et al.  SENSE‐DTI at 3 T , 2004, Magnetic resonance in medicine.