The diagnosis of migraine still relies on the patient’s description of symptoms. We do not have an objective test to confirm the diagnosis.
Several studies using functional MRI (fMRI) attempted to identify people with migraines. A new study published by Korean doctors in The Journal of Headache and Pain used a different imaging technique to achieve this goal.
The researchers used diffusion MRI, a technique that focuses on the movement of water molecules within the brain’s tissues (fMRI measures blood flow to different areas of the brain). It is particularly useful for mapping the brain’s white matter tracts, which are the pathways that connect different brain regions.
47 patients with migraine were compared to 41 healthy controls
Significant differences were found in brain regions such as the orbitofrontal cortex, temporal pole, and sensory/motor areas.
Changes in connections between deeper brain structures (like the amygdala, accumbens, and caudate nuclei) were also noted.
Using machine learning, the researchers could distinguish between migraine patients and healthy individuals based on these brain connectivity features.
Hopefully, larger studies and easier access to advanced imaging techniques may eventually lead to an objective test of migraines. More importantly, identifying specific connectivity patterns may lead to more individualized treatments. These could be treatments with pharmaceuticals or neurostimulation techniques such as transcranial magnetic stimulation (TMS), which we use in our clinic.
