MRI Study Moves Closer to Accurate Migraine Classification

Andrew N. Wilner, MD


July 08, 2016

Andrew N. Wilner, MD: This is Dr Andrew Wilner, reporting for Medscape. Today I have the pleasure of interviewing Catherine Chong, PhD, an assistant professor at the Mayo Clinic in Phoenix, Arizona.

Dr Chong, I understand that you just returned from the American Academy of Neurology meeting, where you presented some research on migraine. You've been looking at functional MRIs and at the anatomy of people with migraine. Is the anatomy of the brains of people with migraine different from the anatomy of people without migraine?

Study Design

Dr Chong: The goal of this study was to distinguish patients who have migraine from patients who do not have migraine, who are healthy controls, by looking at resting-state, functional MRI data alone. We didn't look at the brain anatomy.

Dr Wilner: You looked at functional MRI, but not the anatomy per se, assuming that these are more or less normal brains in each group.

Dr Chong: Right. We had people who had migraine and people who were healthy and didn't suffer from any chronic type of disorder.

Dr Wilner: How many in each group?

Dr Chong: We had 58 people with migraines and 50 healthy controls, and those with migraines were mostly episodic. On average, they had seven migraines or headaches per month and had lived with the disorder for approximately 16 years. We had 34 with migraines with aura and 24 without aura. All migraine patients were pain-free and were not taking any pain prophylactic medication at the time that we tested them. And they had had migraine for at least 3 years.

Dr Wilner: So the diagnosis was pretty secure.

Dr Chong: The diagnosis was made by a neurologist, yes.

Dr Wilner: What kind of testing did you do?

Dr Chong: For the demographics part, everybody underwent measurements of depression and anxiety. We used the Beck Depression Inventory and the State-Trait Anxiety Inventory to make sure groups were well-balanced. We also balanced them, of course, for age and sex.

There are no significant group differences on those measures. On the Beck Depression Inventory, there were some differences, but it's important to point out that the raw scores of the controls and migraine patients were within the average, nondepressed range.

Dr Wilner: But a little bit higher in the migraine patients, as you might expect?

Dr Chong: Again, it's going to be hard to argue what's "more healthy," as if they were all within the healthy range.

Dr Wilner: Okay.

Dr Chong: Then all participants underwent 10 minutes of resting-state data scanning using a 3T Siemens scanner. The nice thing about these resting-state designs is that they're really easy to give, because there's no task.

So, the goal here is to look at the spontaneous fluctuations of the blood oxygen level-dependent (BOLD) signal to detect regional networks, or functional connectivity patterns. We really want to better understand how certain areas of the brain communicate with one another—how they form specific functional networks.


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