In recent years we have been enormously expanding our knowledge about the pathology of migraines, which has even allowed us to develop specific drugs for this particular type of headache.
In this line, a new study carried out by analyzing images of the brain of patients has revealed that people with migraine present a series of characteristic changes in the anatomy of the brain.
Enlarged perivascular spaces
In this work, which is presented this week at the annual meeting of the Radiological Society of North America and whose results are reported on the portal EurekAlert!the authors detail having observed a enlargement of the perivascular spaces in patients suffering from chronic migraine or episodic migraine without aura.
Specifically, they note that “in people with chronic migraine and episodic migraine without aura, there are significant changes in the perivascular spaces of a brain region called the centro semiovale.” This region is made up of white matter and is located between the cerebral cortex and the central gray nuclei; thus, there are two semioval centers, one on each side of the brain.
Perivascular spaces, in turn, are spaces filled with fluid that surround the blood vessels of the brain. They are most commonly found in the basal ganglia (subcortical gray matter structures involved in motor function) and white matter as well as along the optic tract (the pathway of the optic nerve). It is not uncommon for them to be affected by various factors, including abnormalities in the blood-brain barrier (a ‘filter’ that determines the exchange of substances between the blood and the brain) or inflammation. For example, enlargement of these spaces may be indicative of underlying small vessel disease.
A possible problem in the ‘cleaning’ of the brain
To determine the association between migraine and enlarged perivascular spaces, the authors used an imaging technique called ultra-high field MRI 7Twith which they observed the brain of healthy patients and with different types of migraine.
The advantage of this technique, they argue, is that it allows a much higher resolution than other magnetic resonance procedures, which makes it possible to catalog much smaller changes in brain tissue.
A statistical analysis of these images revealed that patients with migraine had a greater number of enlarged perivascular spaces in the semioval center compared to healthy controls. This, they believe, could suggest a glymphatic disruption (the glymphatic system is a recently discovered brain structure that functions as a clearing pathway for metabolic waste from the brain). That yes, what is not clear is if the migraine causes these lesions or, conversely, if it is the lesions that cause the migraine.
Radiological Society of North America. Ultra-high-res MRI reveals migraine brain changes. EurekAlert! (2022). Consulted online at https://www.eurekalert.org/news-releases/971466 on 11/29/2022.