title: Cortical abnormalities in patients with migraine: a surface-based analysis.
abstract: OBJECTIVE
  To explore the patterns of cortical thickness and cortical surface area abnormalities in patients with migraine (with the expectation of seeing reduced cortical thickness and surface area in regions subserving nociception and increased cortical thickness and surface area in regions involved in migraine pathogenesis) and to assess their correlation with clinical and radiologic manifestations of the disease.
  
  
  METHODS
  Approval of the local ethical committee was obtained, as well as written informed consent from each participant. T2-weighted and three-dimensional T1-weighted magnetic resonance images of the brain were acquired in 63 migraineurs and 18 matched healthy control subjects. Cortical thickness and cortical surface area were estimated. By using a general linear model approach, a vertex-by-vertex statistical analysis (P < .01) was used to assess between-group comparisons (migraineurs vs control subjects, the aura effect, the effect of white matter hyperintensities [WMHs]) and the correlations between cortical thickness and surface area measurements and patients' clinical and radiologic characteristics.
  
  
  RESULTS
  Compared with control subjects, patients with migraine showed reduced cortical thickness and surface area in regions subserving pain processing (P < .01). These two metrics were increased in regions involved in executive functions and visual motion processing (P < .01). The anatomic overlap of cortical thickness and cortical surface area abnormalities was only minimal, with cortical surface area abnormalities being more pronounced and more widely distributed than cortical thickness abnormalities. Cortical thickness and surface area abnormalities were related to aura and WMHs (P < .01) but not to disease duration and attack frequency.
  
  
  CONCLUSIONS
  Cortical abnormalities occur in migraineurs and may represent the results of a balance between an intrinsic predisposition, as suggested by cortical surface area abnormalities, and disease-related processes, as indicated by cortical thickness abnormalities.
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, Milan 20132, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Messina
authors.forename: Maria A
authors.initials: MA
authors.lastname: Rocca
authors.forename: Bruno
authors.initials: B
authors.lastname: Colombo
authors.forename: Paola
authors.initials: P
authors.lastname: Valsasina
authors.forename: Mark A
authors.initials: MA
authors.lastname: Horsfield
authors.forename: Massimilano
authors.initials: M
authors.lastname: Copetti
authors.forename: Andrea
authors.initials: A
authors.lastname: Falini
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Comi
authors.forename: Massimo
authors.initials: M
authors.lastname: Filippi
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000473:pathology*; D011446:Prospective Studies; D018709:Statistics, Nonparametric