Until recent years it was believed that migraine with aura was a disorder causing intermittent neurological symptoms, with no impact on brain structure. However, recent MRI studies have reported increased cortical thickness of visual and somatosensory areas in patients with migraine with aura, suggesting that such structural alterations were either due to increased neuronal density in the areas involved, or a result of multiple episodes of cortical spreading depression as part of aura attacks. Subsequent studies have yielded conflicting results, possibly due to methodological reasons, e.g. small number of subjects. In this cross-sectional study, we recruited females aged 30–60 years from the nationwide Danish Twin Registry. Brain MRI of females with migraine with aura (patients), their co-twins, and unrelated migraine-free twins (controls) were performed at a single centre and assessed for cortical thickness in predefined cortical areas (V1, V2, V3A, MT, somatosensory cortex), blinded to headache diagnoses. The difference in cortical thickness between patients and controls adjusted for age, and other potential confounders was assessed. Comparisons of twin pairs discordant for migraine with aura were also performed. Comparisons were based on 166 patients, 30 co-twins, and 137 controls. Compared with controls, patients had a thicker cortex in areas V2 [adjusted mean difference 0.032 mm (95% confidence interval 0.003 to 0.061), V3A [adjusted mean difference 0.037 mm (95% confidence interval 0.008 to 0.067)], while differences in the remaining areas examined were not statistically significant [adjusted mean difference (95% confidence interval): V1 0.022 (−0.007 to 0.052); MT: 0.018 (−0.011 to 0.047); somatosensory cortex: 0.020 (−0.009 to 0.049)]. We found no association between the regions of interest and active migraine, or number of lifetime aura attacks. Migraine with aura discordant twin pairs (n = 30) only differed in mean thickness of V2 (0.039 mm, 95% CI 0.005 to 0.074). In conclusion, females with migraine with aura have a thicker cortex corresponding to visual areas and our results indicate this may be an inherent trait rather than a result of repeated aura attacks.

中文翻译：

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偏头痛伴视觉先兆伴有较厚的视觉皮层

直到最近几年，人们一直认为偏头痛先兆是一种引起间歇性神经系统症状的疾病，对脑结构没有影响。但是，最近的MRI研究报告称，先兆性偏头痛患者的视觉和躯体感觉区域的皮质厚度增加，表明这种结构改变是由于相关区域神经元密度的增加，或者是由于皮质扩散性抑郁症的多发性发作所致。光环攻击的一部分。随后的研究产生了矛盾的结果，可能是由于方法论上的原因，例如受试者人数少。在这项横断面研究中，我们从全国范围的丹麦双胞胎登记处招募了30-60岁的女性。偏头痛伴有先兆的女性（患者）的脑部MRI，双胞胎，和无关的无偏头痛双胞胎（对照）在单个中心进行，并在预定的皮层区域（V1，V2，V3A，MT，体感皮层）中评估了皮层厚度，对头痛的诊断不知情。根据年龄和其他潜在的混杂因素，评估了患者和对照组之间皮层厚度的差异。还对偏头痛与先兆不一致的双胞胎进行了比较。比较基于166例患者，30例双胞胎和137例对照。与对照组相比，患者在V2区域的皮层较厚[调整后的平均差异0.032 mm（95％置信区间0.003至0.061），V3A [调整后的平均差异0.037 mm（95％的置信区间0.008至0.067）]，其余区域的差异无统计学意义[校正后的平均差异（95％置信区间）：V1 0.022（-0.007至0.052）；MT：0.018（-0.011至0.047）；体感皮层：0.020（-0.009至0.049）]。我们发现感兴趣的区域与活动性偏头痛或终生先兆发作次数之间没有关联。偏头痛与先兆不和谐双胞胎（n = 30）仅在V2的平均厚度上有所不同（0.039 mm，95％CI 0.005至0.074）。总之，具有偏头痛先兆的女性大脑皮层较厚，与视觉区域相对应，我们的结果表明，这可能是一种固有特征，而不是反复先兆发作的结果。