Doctors detect strange changes in the brains of migraine patients

Migraine, a common condition that affects 10% of people around the world, is a great unknown for science. Its causes are unknown, and there is no treatment that can alleviate its symptoms, which are often debilitating, ranging from excruciating headaches to dizziness, nausea, and visual impairment.

However, that scenario could change completely now that a group of scientists have identified, using high-resolution MRI scans, strange changes in the brains of people with this chronic and periodic condition.

The aforementioned alterations consist of the unusual enlargement of the perivascular spaces – fluid-filled areas that are located around the cerebral blood vessels – of a region of the brain called centrum semiovale.

In this sense, the authors detailed, this enlargement could be a sign of underlying disease of the small vessels. “These changes have never been reported before,” said Wilson Xu, a physician at the University of California, Los Angeles, who led the study.

“Perivascular spaces are part of a fluid removal system in the brain,” Xu said in a Radiological Society of North America (RSNA) news release. “Studying how they contribute to migraine could help us better understand the complexities of how migraines occur,” he added.

For their study, Xu and his colleagues recruited 10 people with chronic migraine headaches, 10 with episodic migraine without aura—a type in which vision is impaired—and five healthy individuals who served as a control group. All were between the ages of 25 and 60.

Using a type of ultra-high-resolution MRI, they collected information about the size of brain microbleeds. To these data they added the duration, severity and symptoms of each patient.

After comparing the results of the participants, they concluded that the number of enlarged perivascular spaces was significantly higher in patients experiencing migraine.

“Although we did not find significant changes in the severity of white matter lesions in patients with and without migraine, these white matter lesions were significantly associated with the presence of enlarged perivascular spaces. This suggests that changes in the perivascular spaces could lead to the development of more white matter lesions in the future,” Xu said.

The researchers hypothesize that these differences could signify a glymphatic disturbance within the brain. The glymphatic system is a waste disposal system that uses perivascular channels to remove soluble proteins and metabolites.

The results of the research will be presented at the 108th RSNA Scientific Assembly and Annual Meeting.