BackgroundWhite matter alterations have been observed in patients with migraine. However, no microstructural white matter alterations have been found particularly in episodic or chronic migraine patients, and there is limited research focused on the comparison between these two groups of migraine patients.MethodsFifty-one healthy controls, 55 episodic migraine patients and 57 chronic migraine patients were recruited and underwent brain T1-weighted and diffusion-weighted MRI acquisition. Using Tract-Based Spatial Statistics (TBSS), fractional anisotropy, mean diffusivity, radial diffusivity and axial diffusivity were compared between the different groups. On the one hand, all migraine patients were compared against healthy controls. On the other hand, patients from each migraine group were compared between them and also against healthy controls. Correlation analysis between clinical features (duration of migraine in years, time from onset of chronic migraine in months, where applicable, and headache and migraine frequency, where applicable) and Diffusion Tensor Imaging measures was performed.ResultsFifty healthy controls, 54 episodic migraine and 56 chronic migraine patients were finally included in the analysis. Significant decreased axial diffusivity (p < .05 false discovery rate and by number of contrasts corrected) was found in chronic migraine compared to episodic migraine in 38 white matter regions from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas. Significant positive correlation was found between time from onset of chronic migraine and mean fractional anisotropy in the bilateral external capsule, and negative correlation between time from onset of chronic migraine and mean radial diffusivity in the bilateral external capsule.ConclusionsThese findings suggest global white matter structural differences between episodic migraine and chronic migraine. Patients with chronic migraine could present axonal integrity impairment in the first months of chronic migraine with respect to episodic migraine patients. White matter changes after the onset of chronic migraine might reflect a set of maladaptive plastic changes.

中文翻译：

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慢性和发作性偏头痛的白质变化：弥散张量成像研究

背景 在偏头痛患者中观察到白质改变。然而，特别是在发作性或慢性偏头痛患者中没有发现显微结构的白质改变，关于这两组偏头痛患者之间的比较的研究有限。 方法51名健康对照，55名发作性偏头痛患者和57名慢性偏头痛患者被招募并接受脑 T1 加权和弥散加权 MRI 采集。使用基于道的空间统计 (TBSS)，比较不同组之间的分数各向异性、平均扩散率、径向扩散率和轴向扩散率。一方面，将所有偏头痛患者与健康对照进行比较。另一方面，将每个偏头痛组的患者与健康对照组进行比较。对临床特征（偏头痛的持续时间（以年为单位）、从慢性偏头痛开始的时间（以月为单位）以及头痛和偏头痛频率（如适用））与弥散张量成像测量之间的相关性进行了分析。 结果 50 个健康对照，54 个发作性偏头痛和 56 个慢性偏头痛患者最终被纳入分析。与约翰霍普金斯大学 ICBM-DTI-81 白质图谱的 38 个白质区域的偶发性偏头痛相比，慢性偏头痛的轴向扩散率显着降低（p < .05 错误发现率和对比校正的数量）。发现慢性偏头痛发作时间与双侧外囊平均分数各向异性之间存在显着正相关，慢性偏头痛发作时间与双侧外囊平均径向扩散率之间呈负相关。结论这些发现表明发作性偏头痛和慢性偏头痛之间存在整体白质结构差异。与发作性偏头痛患者相比，慢性偏头痛患者在慢性偏头痛的头几个月可能会出现轴突完整性受损。慢性偏头痛发作后的白质变化可能反映了一系列适应不良的塑料变化。与发作性偏头痛患者相比，慢性偏头痛患者在慢性偏头痛的头几个月可能会出现轴突完整性受损。慢性偏头痛发作后的白质变化可能反映了一系列适应不良的塑料变化。与发作性偏头痛患者相比，慢性偏头痛患者在慢性偏头痛的头几个月可能会出现轴突完整性受损。慢性偏头痛发作后的白质变化可能反映了一系列适应不良的塑料变化。