Though they are common and can have severely debilitating effects, the precise cause of migraines remains a mystery. A study has shed important new light on the topic by leveraging cutting-edge imaging technology to gain a new perspective on structures in the brain, which revealed enlarged spaces around the blood vessels in people suffering the condition.
The research centers on what are known as perivascular spaces, which are gaps around the blood vessels that help clear fluids from the brain. Enlargement of these spaces had previously been linked to small vessel disease, and things like inflammation and abnormalities in the blood-brain barrier can impact their shape and size.
The authors of the new study sought to explore the relationship between enlarged perivascular spaces and migraines. To do so, the team enlisted five healthy controls, 10 subjects with chronic migraines and 10 subjects with episodic migraines without aura, which are migraines without tingling and the visual disturbances. An advanced imaging technology called 7T MRI was then used to compare tiny differences in their brains.
“To our knowledge, this is first study using ultra-high-resolution MRI to study microvascular changes in the brain due to migraine, particularly in perivascular spaces,” said study co-author Wilson Xu, from the University of Southern California in Los Angeles. “Because 7T MRI is able to create images of the brain with much higher resolution and better quality than other MRI types, it can be used to demonstrate much smaller changes that happen in brain tissue after a migraine.”
Among these changes were cerebral microbleeds, along with enlarged perivascular spaces in the centrum semiovale region of the brain, in the migraine sufferers.
“In people with chronic migraine and episodic migraine without aura, there are significant changes in the perivascular spaces of a brain region called the centrum semiovale,” said Xu. “These changes have never been reported before.”
There are still plenty of questions for the scientists to answer from here. One of them is whether these changes occur as a result of migraines, or the condition drive their development. The team does hypothesize that the differences in the perivascular spaces may be indicative of disruption to the glymphatic system, which works with the perivascular spaces to clear waste from the brain. The researchers hope to resolve these mysteries though larger studies on more diverse cohorts, over longer time frames.
“The results of our study could help inspire future, larger-scale studies to continue investigating how changes in the brain’s microscopic vessels and blood supply contribute to different migraine types,” Xu said. “Eventually, this could help us develop new, personalized ways to diagnose and treat migraine.”
The scientists are presenting their work at the annual meeting of the Radiological Society of North America next week.
Source: Radiological Society of North America via EurekAlert