Dynamic fluctuations in brain iron content during migraine attacks: insights from relaxometry and diffusion tensor imaging.

BACKGROUND

There is evidence that iron metabolism may play a role in the underlying pathophysiological mechanism of migraine. Studies using (=1/ ) relaxometry, a common MRI-based iron mapping technique, have reported increased values in various brain structures of migraineurs, indicating iron accumulation compared to healthy controls.

PURPOSE

To investigate whether there are short-term changes in during a migraine attack.

POPULATION

26-year-old male patient diagnosed with episodic migraine with aura according to ICHD-3 criteria.

SEQUENCE

3 T, 64-channel head coil, for quantification of relaxation a multi-echo gradient echo (GRE) sequence with TE = 4.92, 9.84, 14.7, 19.6, 24.6 and 29.51 ms, TR = 35 ms, flip angle = 15°, and 0.9 × 0.9 × 0.9 mm isotropic resolution was used.

ASSESSMENT

Quantitative MRI, including relaxometry and diffusion tensor imaging (DTI), was acquired from a migraine patient on 21 consecutive days, including migraine-free days and days with a migraine attack.

STATISTICAL TEST

Statistical analysis was performed using R, the Shapiro-Wilk test, the -test and Mann Whitney test, analysis of variance (ANOVA) or Kruskal-Wallis test, depending on the distribution of the data. -value <0.05 was considered significant.

RESULTS

Significant difference in was found between the left and right hemispheres during a migraine attack. An increase in was observed in the left hemisphere, whereas in the right hemisphere was found to decrease. In the left cerebral white matter, increased by 1.8% ( = 0.021), in the right cerebral white matter, anisotropy decreased by 17% ( = 0.011) during a migraine attack.

DATA CONCLUSION

Our study showed a decrease and increase in iron content during the migraine cycle. Furthermore, during a migraine attack, white matter iron content increased, accompanied by a decrease in anisotropic tissue components, suggesting additional changes in vascular components.