Brainstem nuclei changes in migraine detected by transcranial sonography

Abstract

The aim of this study was to estimate the role of transcranial sonography in detecting basal ganglia changes as structural biomarkers in migraine. Transcranial sonography was performed on Aloka prosound α-10. Semiquantitative and planimetric methods were applied when basal ganglia changes were detected. Comparison between groups was performed by unpaired Student’s t test and Spearman’s correlation test. We analyzed 30 migraine patients and 30 age-/sex-matched controls. Substantia nigra hyperechogenicity was detected in 36.7% migraineurs and in 13.3% controls (t test, p = 0.036888). Hyperechogenic substantia nigra was found in 70% aura patients and in 20% patients without aura (p = 0.007384). Mean substantia nigra echogenic size of all migraine patients was 0.16 ± 0.07 and 0.12 ± 0.043 cm² in controls (t test, p = 0.0011). Lentiform nucleus hyperechogenicity was seen in 50% migraine patients and 13.3% controls (t test, p = 0.002267). Mean lentiform nucleus echogenic size of all migrenous patients was 0.34 ± 0.08 cm² and in controls 0.20 ± 0.008 cm² (t test, p = 0.0021). Caudate nucleus hyperechogenicity was found in 26.7% migraine patients and in 6.6% controls (t test, p = 0.037667). Mean frontal horn width in migraine patients was 8.73 ± 1.76 mm and in controls 7.10 ± 1.71 (t test, p = 0.0006). Substantia nigra hyperechogenicity correlated with disease duration (rho = −0.35521, p = 0.05467) and third ventricle width (rho = −0.68221, p = 0.02976). No other differences between migraineurs and controls were found. Our study has revealed differences in transcranial findings between migraineurs and controls, but overall significance of those findings are still to be evaluated.