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Based on node-to-node measurements of radial diffusivity and mean diffusivity, fibertract profiles differ between patients with migraines and patients with persistent posttraumatic headaches, according to a study published in Cephalalgia.
Researchers examined changes in fibertract profiles, disease characteristics, and headache frequency in three cohorts of patients: those with migraines, those with persistent posttraumatic headaches, and healthy controls, to determine potential differences in the neuropathological mechanisms. Questionnaires were used to collect data on demographics, headache history, depression symptoms, situational anxiety, and traumatic brain injuries. Magnetic resonance imaging was used to measure radial diffusivity and mean diffusivity of node-by-node parameters along 18 major brain fibertract bundles.
Of the 41 patients in the migraine cohort, 15 were men, on average aged 39 years, the average Beck Depression Inventory score was 7.9, the average State Anxiety Inventory score was 34, and the average number of years with headaches was 22.2. Of the 49 patients in the persistent posttraumatic headaches cohort, 32 were men, on average aged 37.7 years, the average Beck Depression Inventory score was 16.9, the average State Anxiety Inventory score was 37.5, and the average number of years with headaches was 10. Of the 41 participants in the healthy control cohort, 22 were men, on average aged 38.1 years, the average Beck Depression Inventory score was 2.43, and the average State Anxiety Inventory score was 27.6.
The difference in fibertract profiles between the migraine cohort and the persistent posttraumatic headache cohort included the bilateral anterior thalamic radiations, bilateral cingulum, bilateral inferior longitudinal fasciculi, bilateral uncinate fasciculi, the left cortico-spinal tract, and the right superior longitudinal fasciculus–parietal portion. Differences in fibertract profiles between the healthy control cohort and both the migraine cohort and the persistent posttraumatic headache cohort included a weaker mean diffusivity in the anterior thalamic radiations and stronger radial diffusivity in the left corticospinal tract, and stronger mean diffusivity in the forceps major. Using a posthoc correlation test, the migraine cohort had a significant relationship between headache frequency and the mean diffusivity of forceps major (MQ2: r=0.3291, P =.0381), and the persistent posttraumatic headaches cohort had significant relationship between headache frequency the mean diffusivity of the right cingulum angular bundle (MQ3: r=0.3481, P =.0142), the mean diffusivity of the left cingulum angular bundle (MQ4: r=0.3459, P =.016), the radial diffusivity of the right cingulum angular bundle (MQ1: r=0.3438, P =.0156; MQ2: r=0.3251, P =.0227), and the radial diffusivity of the left cingulum angular bundle (MQ3: r=0.3276, P =.023; MQ4: r=0.3097, P =.0322).
Limitations of this study include not differentiating between episodic and chronic migraines, not controlling for mood imbalances between the migraine cohort and the persistent posttraumatic headaches cohort, and not assessing medication overuse or full psychiatric history.
The researchers concluded that “radial diffusivity and mean diffusivity indicate unique differences in fibertract profiles between those with migraine [vs] persistent post-traumatic headache. Although for both migraine and persistent post-traumatic headache there was a positive relationship between fibertract alterations and headache frequency, there were disease-specific differences between headache frequency and fibertract injury patterns. These findings might suggest potential differences in the neuropathological mechanisms underlying migraine and persistent post-traumatic headache.”
Reference
Chong CD, Peplinski, Berisha V, Ross K, Schwedt TJ. Differences in fibertract profiles between patients with migraine and those with persistent post-traumatic headache [published online March 26, 2019]. Cephalalgia. doi: 10.1177/0333102418815650
This article originally appeared on Neurology Advisor
