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'Aura with migraine' patients have smaller brain structures than healthy subjects - Printable Version

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'Aura with migraine' patients have smaller brain structures than healthy subjects - C C - Oct 12, 2019

https://www.ajmc.com/newsroom/patients-who-have-aura-with-migraine-have-smaller-brain-structures-than-healthy-subjects

RELEASE: A recent study sought to identify possible differences in subcortical structures between patients who have migraine with aura (MwA) and healthy subjects, and also to determine the correlations between the characteristics of migraine aura and the volumes of subcortical structures. Various features of the cerebral cortex and white matter have been extensively investigated in MwA, but the morphological characteristics of subcortical structures have been largely neglected.

Aura in migraine affects about 20% to 30% of patients; it is a phenomenon whose manifestations coincide with a wave of cortical spreading depolarization/depression (CSD) through the cerebral cortex and/or through the 3 different types of white matter nerve fibers (associative, commissural, and projective). Imaging studies have described multiple changes in the migraineur brain.

A few studies have investigated the role of subcortical structures in the pathophysiology of migraine, revealing decreased volumes of the left caudate, putamen, right nucleus accumbens, and striatum; in addition, it was found that the basal ganglia play a significant role in the pathophysiology of pain in episodic migraine. However, previous studies did not examine the role of subcortical structures in the pathophysiology of MwA, nor did they look at the volume and shape abnormalities in distinct subcortical structures. Therefore, the aim of this study was to compare the volumes of subcortical structures between patients with MwA and healthy subjects, using advanced structural neuroimaging techniques, as well as the correlations between the characteristics of MwA and the volumes of subcortical structures.

Thirty-two patients with MwA were matched by age and sex to 32 healthy subjects. Regional subcortical brain volumes were automatically calculated using the FSL/FMRIB Image Registration and Segmentation Tool software. A general linear model analysis was used to investigate differences in the volume of subcortical structures between the 2 groups. A partial correlation test was used to assess correlations between the volume of subcortical structures and characteristics of patients with MwA.

The volumes of the right globus pallidus, left globus pallidus, and left putamen were significantly smaller in the brains of patients with MwA than in those without: mean (SD): 1427 (135) mm3 versus 1557 (136) mm3 (P <.001); 1436 (126) mm3 versus 1550 (139) mm3 (P = .001); and 4235 (437) mm3 versus 4522 (412) mm3 (P = .006); respectively. There were no significant relationships between subcortical structures and clinical parameters.

These findings suggest that both the globus pallidi and left putamen play significant roles in the pathophysiology of the MwA. Future studies should determine the cause-and-effect relationships, since these could not be found in this study due to its cross-sectional design.


RE: 'Aura with migraine' patients have smaller brain structures than healthy subjects - Syne - Oct 12, 2019

I always wondered why I never had any visual symptoms/sensitivities when I use to have migraines.


RE: 'Aura with migraine' patients have smaller brain structures than healthy subjects - stryder - Oct 13, 2019

Funnily enough last night I had a severe headache and was doing a little research, I considered at the time perhaps a post on headaches should be put on the forum but in the end I didn't post one. (Coincidence?)

In my particular instance I rarely suffer headaches, I mean it's an absolute rarity. Don't get me wrong I've taken pain killers, however usually it's not for a head pain but from the sensation of a head swell (as if pressure is building up) which to my knowledge was down to a tooth that got infected. So to have a migraine (which felt like like some Lovelacian tendrilled mind flaying horror inducing pain) was something I wanted to know why I was suffering.

In the end I managed to draw a conclusion... it's actually down to my seat.

The seat itself is just a piece of office furniture, a swivel executive chair with fixed back and arms. When I originally bought it I went to great lengths to try and find one that fitted the criteria of having an independent support bracket for holding the back of the seat to it's base. (a previous chair had no such bracket and an arm coming off was enough to wreck the chair). All was fine until the chairs back started to get pushed further back by my seating position, it slowly started to shift backwards like a recliner. It turns out while the bracket was solid, the chipboard that it was screwed into was not and that has slowly been giving in to constant pressure.

What this has meant is that while I lent back, my position of orientation would change slowly over time because of the continued reclining angle (in fact I've had to wedge it upright from behind with various nicknacks to stop it going completely.) The change in elevation has obviously caused me to tilt my head in response and in turn stretched my spinal cord through my neck angle, that's what was causing the tendrilled migraine effect.

The only cure/salvation was to sleep it off, and to not allow myself to slump to the seats position in the near future. It just goes to prove that it isn't always "in your head".


RE: 'Aura with migraine' patients have smaller brain structures than healthy subjects - confused2 - Oct 16, 2019

I get the Aura (no surprise there). I'm ok with lack of sleep and ok with stress and ok with normality but given all three I tend to fail when dealing with normality - like zizzy lightning splits in vision and being unable to see or feel my own hand. Difficult to explain to a customer that I can't see my own hand or the money they are handing me.