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Gray and White Matter Changes in Migraineurs: a Review of Literature

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Abstract

Several neuroimaging studies with advanced techniques have shown changes in gray and white matter in the brain of migraineurs. This narrative review highlights the structural and functional alterations and causality factors of migraine for the introduction of new treatment modalities. PubMed, Google Scholar, and Scopus were searched without any language restriction for the articles depicting gray and white matter changes in migraineurs. Using magnetic resonance imaging scans, multiple studies have demonstrated a reduction in white matter volume and presence of white matter hyperintensities and demyelinated white matter areas, especially in the frontal and parietal lobes. Similarly, voxel-based morphometry analysis has shown a greater reduction in gray matter in the frontal and cingulate cortex of chronic and episodic migraineurs. An overactivation of the frontal and cingulate cortex has been observed during the interictal period. These parts of gray matter are involved in cognitive, emotional, and autonomic aspects of nociception. Moreover, constituents of the limbic system, particularly the thalamus, hippocampus, amygdala, and cingulate gyrus, have also depicted predominant functional disturbances during migraine episodes. Recent studies highlighted a decrease in gray matter volume in the spinal trigeminal nucleus. These findings suggest that such changes might be the reason for dysfunction and pain regulation. Modern neuroimaging thus clearly helps in understanding the pathophysiology of migraine, which calls for novel therapeutic interventions in unresponsive or chronic migraineurs.

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Authors and Affiliations

  1. Department of Medicine, Dow Medical College, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan

    Hania Hasan, Rafia Irfan Waheed & Taha Bin Arif

  2. Department of Neurology, University of Toledo, Toledo, OH, USA

    Sidra Saleem

  3. Department of Neurology, Mercy Health St. Vincent Medical Center, Toledo, OH, USA

    Arsalan Anwar

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  1. Hania Hasan
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  3. Taha Bin Arif
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Contributions

All authors (Hania Hasan, HH; Rafia Irfan Waheed, RIW; Taha Bin Arif, TBA; Sidra Saleem, SS; Arsalan Anwar, AA) had full access to the data, contributed to the study, approved the final version for publication, and take responsibility for its accuracy and integrity.

Concept and design of study: HH

Acquisition of data: HH and RIW

Interpretation of data: HH, RIW, and TBA

Drafting of the manuscript: HH, RIW, and TBA

Critical revision for important intellectual content: SS and AA

All authors have approved and proof read the manuscript and gone through the tables. All authors accept that all material in the manuscript is correct to the best of their knowledge.

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Correspondence to Taha Bin Arif.

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Hasan, H., Irfan Waheed, R., Bin Arif, T. et al. Gray and White Matter Changes in Migraineurs: a Review of Literature. SN Compr. Clin. Med. 2, 2185–2196 (2020). https://doi.org/10.1007/s42399-020-00576-7

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