Patients with episodic migraine show increased T2 values of the trapezius muscles - an investigation by quantitative high-resolution magnetic resonance imaging

Cephalalgia. 2021 Jul;41(8):934-942. doi: 10.1177/0333102421996374. Epub 2021 Feb 20.

Abstract

Background: Neck pain is frequent in patients with migraine. Likewise, evidence for inflammatory processes in the trapezius muscles is accumulating. However, non-invasive and objectively assessable correlates are missing in vivo.

Methods: Twenty-one subjects with episodic migraine (mean age: 24.6 ± 3.1 years, 18 females) and 22 controls (mean age: 23.0 ± 2.2 years, 17 females) without any history of headache prospectively underwent physical examination and quantitative magnetic resonance imaging of the trapezius muscles. A T2-prepared turbo spin-echo sequence was acquired for manual segmentation of the trapezius muscles and extraction of mean T2 values.

Results: There were no statistically significant differences regarding age, sex, body mass index, or number of myofascial trigger points (mTrPs) between groups. All patients with migraine presented with mTrPs in the trapezius muscles. T2 of the entire trapezius muscles was significantly higher in the migraine group when compared to controls (31.1 ± 0.8 ms vs. 30.1 ± 1.1 ms; p = 0.002).

Conclusions: Elevated T2 values of the trapezius muscles may indicate subtle inflammatory processes within musculature among patients with migraine because T2 increase is likely to stem from edematous changes. Future work may validate this finding in larger cohorts, but muscle T2 might have potential to develop into a viable in vivo biomarker for muscular affection in migraine.

Keywords: Magnetic resonance imaging; T2 mapping; migraine; myofascial trigger points; trapezius muscle; trigemino-cervical complex.

MeSH terms

  • Adult
  • Case-Control Studies
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Migraine Disorders / diagnostic imaging
  • Myofascial Pain Syndromes / physiopathology*
  • Neck Muscles / diagnostic imaging
  • Neck Pain / etiology
  • Neck Pain / physiopathology*
  • Prospective Studies
  • Superficial Back Muscles / diagnostic imaging*
  • Superficial Back Muscles / physiopathology*
  • Trigger Points / physiopathology*
  • Young Adult