Migraine changes the brain on a microscopic level

Migraine changes the brain on a microscopic level

The work of American researchers has shed light on microscopic changes in the brain of patients suffering from migraine.

Using magnetic resonance imaging, researchers have identified a distinct anatomical change that occurs in the brains of migraine patients. This is the first time a study has demonstrated this effect with this level of precision. This work may lead to new therapeutic approaches to address them.

Migraine is a recurrent headache, often very violent, and usually affects only one side of the head. They are often accompanied by a slew of other disabling symptoms. One can cite in particular the famous “aura” that accompanies some types of migraine, which gave rise to the term “ocular migraine”.

The headache is still misunderstood

Without migraine being a major public health problem, it can still disable, sometimes almost disable, people who suffer from it. This represents a large number of patients. According to this study, 12% of the world’s population suffers from episodic migraines. 1 to 2% will experience chronic migraine.

The problem is that their exact origin is still quite a mystery. At present, no one can say for sure what physiological mechanisms cause these headaches. So there is no satisfactory remedial solution that would take the problem to its root. In most cases, the people involved have to content themselves with fighting the symptoms, often with the use of analgesics.

But that may start to change thanks to the work of researchers at the University of Southern California (USC). They used fairly recent magnetic resonance imaging (MRI) technology to monitor the brains of migraine patients, with very exciting results.

The technique involved is called 7T MRI (for 7 Tesla, the unit that represents magnetic field strength). It provides images with extremely high spatial resolution and contrast. This allows researchers (and even doctors today) to perform very comprehensive examinations. The perfect tool for tracking subtle changes in the human body.

Small holes in the brain

The researchers used it to explore the ciboulot of 25 people. 20 of them were prone to episodic or chronic migraines. The other five were healthy subjects who served as a control group.

In 20 people with migraines, they identified a peculiarity in structures called Virchow-Robin spaces, or perivascular spaces. These are small, fluid-filled spaces that surround blood vessels. Specialists are of the opinion that they play an important role in maintaining the brain.

Small black dots correspond to enlarged perivascular spaces, or EPEs. © Xu et al.

Sometimes these spaces widen; If they are present, they appear on MRI scans as tiny black holes. This is a normal phenomenon that is observed even in healthy brains. But several studies suggest that a large number of enlargements can be a warning sign of a neurodegenerative disease.

However, the USC team discovered that the number of dilatations was significantly higher in the brains of migraine patients. These spaces were remarkably concentrated in the semi-oval centre. It’s an abundant layer of white matter (very clichéd, matter made up of the “tails” of nerve cells) located in the middle of the brain.

According to the authors, this is the first time that this type of change has been identified in this region of the brain. So this study opens a new avenue of research that can help understand the mechanisms of migraine.

The white dots correspond to small lesions associated with enlargement of the perivascular spaces. © Xu et al.

These perivascular spaces are part of the brain’s drainage system says Wilson Shaw, MD, a physician at the University of Southern California. ” Studying how they contribute to migraines can help us understand how they arise he suggests.

A weak but promising line of research

The researchers also provide the first element of a response in this direction. They also showed that there was a relationship between enlarged perivascular spaces (EPE) and the small lesions observed in the white matter. ” These lesions are most closely associated with the presence of EPEs Shaw says. “ This indicates that these changes can lead to the emergence of new lesions. “.

But the authors also point out that we should be careful about this last hypothesis. In practice, we are faced with a The chicken and egg problem. Are these lesions at the origin of EPE, which may cause migraine? Or is it some other physiological changes associated with these headaches that cause the observed changes in the brain? It is very difficult to determine the exact causal relationship.

So the USC researchers hope their findings will pave the way for more work on a larger scale. ” The results of our study could inspire more large-scale studies to investigate how these microscopic changes in the brain contribute to different types of migraine. Shaw says. ” Ultimately, this could help us develop new ways to diagnose and treat migraines. “, Concludes.

The transcript of the study will be available here on December 1, at the end of the Radiological Society of North America annual meeting.

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