4.4 Review

Structural and Functional Brain Changes in Migraine

Journal

PAIN AND THERAPY
Volume 10, Issue 1, Pages 211-223

Publisher

SPRINGER INT PUBL AG
DOI: 10.1007/s40122-021-00240-5

Keywords

Brain; Functional; Migraine; MRI; Neuroimaging; PET; Spectroscopy; Structural

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Individuals with migraine exhibit structural and functional changes in the brain, including white matter abnormalities, silent infarct-like lesions, and volumetric changes. Neuroimaging studies have helped characterize these changes, but limitations such as small sample sizes and poorly defined control groups exist.
Migraine is a prevalent primary headache disorder and is usually considered as benign. However, structural and functional changes in the brain of individuals with migraine have been reported. High frequency of white matter abnormalities, silent infarct-like lesions, and volumetric changes in both gray and white matter in individuals with migraine compared to controls have been demonstrated. Functional magnetic resonance imaging (MRI) studies found altered connectivity in both the interictal and ictal phase of migraine. MR spectroscopy and positron emission tomography studies suggest abnormal energy metabolism and mitochondrial dysfunction, as well as other metabolic changes in individuals with migraine. In this review, we provide a brief overview of neuroimaging studies that have helped us to characterize some of these changes and discuss their limitations, including small sample sizes and poorly defined control groups. A better understanding of alterations in the brains of patients with migraine could help not only in the diagnosis but may potentially lead to the optimization of a targeted anti-migraine therapy.

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