Evaluation of Changes in Cerebral Structures in Migraine Patients with Diffusion and Perfusion MRI

Abstract

OBJECTIVE: The purpose of this study is to determine the ischemic lesions throughout the brain parenchyma with magnetic resonance imaging (MR) diffusion technique, evaluate vascular architecture and possible abnormalities with MR perfusion technique in migraine patients and to compare these values with healthy individuals within a similar age group

METHODS: A total of 45 migraine patients in interictal period (19 patients were diagnosed with migraine with aura) with ages between 19-70 (mean 37.89±12.138) and 21 healthy volunteers patients with ages between 24-62 (mean 36,95±13.77) were included in the study. Conventional MRI, diffusion and perfusion MRI scans were obtained.

RESULTS: Hyperintense ischemic foci were encountered in 35.6% of patients. These lesions were scattered throughout whole brain parenchyma; were more intense at corona radiata and frontal lobe. No pathologic findings were encountered in diffusion-weighted images and no significant difference in ADC values between patient and control group (p>0.05). In MR perfusion studies in migraineurs demonstrated a decrease in rCBF, prolonged MTT and TTP at occipital cortex, prolonged TTP at occipital white matter, centrum semiovale, cerebellum, bilateral pons, bitemporal white matter and thalamus, decreased rCBF and prolonged MTT at bilateral corona radiata, prolonged MTT at right frontal white matter, prolonged MTT and decreased rCBF and rCBV at cerebellar cortex.

CONCLUSION: In migraine patients, changes in cerebral vascular structures that occur as a consequence of physiopathological events during interictal periods can be evaluated with MR perfusion and MR diffusion. Further studies and studies that compare both ictal and interictal periods are needed to confirm these findings.