title: Brain gray matter changes in migraine patients with T2-visible lesions: a 3-T MRI study.
abstract: OBJECTIVE
  In migraine patients, functional imaging studies have shown changes in several brain gray matter (GM) regions. However, 1.5-T MRI has failed to detect any structural abnormality of these regions. We used a 3-T MRI scanner and voxel-based morphometry (VBM) to assess whether GM density abnormalities can be seen in patients with migraine with T2-visible abnormalities and to grade their extent.
  
  
  METHODS
  In 16 migraine patients with T2-visible abnormalities and 15 matched controls, we acquired a T2-weighted and a high-resolution T1-weighted sequence. Lesion loads were measured on T2-weighted images. An optimized version of VBM analysis was used to assess regional differences in GM densities on T1-weighted scans of patients versus controls. Statistical parametric maps were thresholded at P<0.001, uncorrected for multiple comparisons.
  
  
  RESULTS
  Compared with controls, migraine patients had areas of reduced GM density, mainly located in the frontal and temporal lobes. Conversely, patients showed increased periacqueductal GM (PAG) density. Compared with patients without aura, migraine patients with aura had increased density of the PAG and of the dorsolateral pons. In migraine patients, reduced GM density was strongly related to age, disease duration, and T2-visible lesion load (r ranging from -0.84 to -0.73).
  
  
  CONCLUSIONS
  Structural GM abnormalities can be detected in migraine patients with brain T2-visible lesions using VBM and a high-field MRI scanner. Such GM changes comprise areas with reduced and increased density and are likely related to the pathological substrates associated with this disease.
authors.affiliation: Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Rocca
authors.forename: Antonia
authors.initials: A
authors.lastname: Ceccarelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Falini
authors.forename: Bruno
authors.initials: B
authors.lastname: Colombo
authors.forename: Paola
authors.initials: P
authors.lastname: Tortorella
authors.forename: Luca
authors.initials: L
authors.lastname: Bernasconi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Comi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Scotti
authors.forename: Massimo
authors.initials: M
authors.lastname: Filippi
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000473:pathology*; D009474:Neurons / Q000473:pathology; D010487:Periaqueductal Gray / Q000473:pathology; D011149:Pons / Q000473:pathology