Ultra-high-res MRI reveals how migraine changes the brain

“In people with chronic migraine and episodic migraine without aura, there are significant changes in the perivascular spaces of a brain region called the centrum semiovale,” said study co-author Wilson Xu, an M.D. candidate at Keck School of Medicine of the University of Southern California in Los Angeles. “These changes have never been reported before.” 

Migraine is a common, often debilitating condition, involving a severe recurring headache. Migraines may also cause nausea, weakness and light sensitivity. According to the American Migraine Foundation, over 37 million people in the U.S. are affected by migraine, and up to 148 million people worldwide suffer from chronic migraine. Perivascular spaces are fluid-filled spaces surrounding blood vessels in the brain. They are most commonly located in the basal ganglia and white matter of the cerebrum, and along the optic tract. Perivascular spaces are affected by several factors, including abnormalities at the blood-brain barrier and inflammation. Enlarged perivascular spaces can be a signal of underlying small vessel disease. “Perivascular spaces are part of a fluid clearance system in the brain,” Xu said. “Studying how they contribute to migraine could help us better understand the complexities of how migraines occur.” 

Xu and colleagues set out to determine the association between migraine and enlarged perivascular spaces. The researchers used ultra-high-field 7T MRI to compare structural microvascular changes in different types of migraine. “To our knowledge, this is first study using ultra-high-resolution MRI to study microvascular changes in the brain due to migraine, particularly in perivascular spaces,” Xu said. “Because 7T MRI is able to create images of the brain with much higher resolution and better quality than other MRI types, it can be used to demonstrate much smaller changes that happen in brain tissue after a migraine.”