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J Headache Pain. 2019 Sep 2;20(1):93. doi: 10.1186/s10194-019-1045-5.

Structural changes of cerebellum and brainstem in migraine without aura.

Qin Z1, He XW2,3, Zhang J1, Xu S1, Li GF2,3, Su J2, Shi YH2,3, Ban S1, Hu Y2,3, Liu YS2, Zhuang MT2, Zhao R2,3, Shen XL2, Li J1, Liu JR4,5, Du X6.

Author information

1
Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Electronic Science, East China Normal University, 3663 North Zhong-Shan Road, 200062, Shanghai, People's Republic of China.
2
Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, 200011, Shanghai, People's Republic of China.
3
Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
4
Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, 200011, Shanghai, People's Republic of China. liujr021@sjtu.edu.cn.
5
Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China. liujr021@sjtu.edu.cn.
6
Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Electronic Science, East China Normal University, 3663 North Zhong-Shan Road, 200062, Shanghai, People's Republic of China. xxdu@phy.ecnu.edu.cn.

Abstract

BACKGROUND:

Increasing evidence has suggested that the cerebellum is associated with pain and migraine. In addition, the descending pain system of the brainstem is the major site of trigeminal pain processing and modulation and has been discussed as a main player in the pathophysiology of migraine. Cerebellar and brainstem structural changes associated with migraineurs remain to be further investigated.

METHODS:

Voxel-based morphometry (VBM) (50 controls, 50 migraineurs without aura (MWoAs)) and diffusion tensor imaging (DTI) (46 controls, 46 MWoAs) were used to assess cerebellum and brainstem anatomical alterations associated with MWoAs. We utilized a spatially unbiased infratentorial template toolbox (SUIT) to perform cerebellum and brainstem optimized VBM and DTI analysis. We extracted the average diffusion values from a probabilistic cerebellar white matter atlas to investigate whether MWoAs exhibited microstructure alterations in the cerebellar peduncle tracts.

RESULTS:

MWoAs showed decreased fractional anisotropy (FA) in the vermis VI extending to the bilateral lobules V and VI of the cerebellum. We also found higher axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) in the right inferior cerebellum peduncle tract in MWoAs. MWoAs exhibited both reduced gray matter volume and increased AD, MD and RD in the spinal trigeminal nucleus (SpV).

CONCLUSION:

MWoAs exhibited microstructural changes in the cerebellum and the local brainstem. These structural differences might contribute to dysfunction of the transmission and modulation of noxious information, trigeminal nociception, and conduction and integration of multimodal information in MWoAs. These findings further suggest involvement of the cerebellum and the brainstem in the pathology of migraine without aura.

KEYWORDS:

Migraine; brainstem; cerebellum; diffusion tensor images; voxel-based morphometry

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