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This Is Your Brain With a Migraine

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The left arrow points to a cerebral microhemorrhage trapped in the left temporal lobe in a case of migraine with aura. The arrow on the right indicates another possible abnormality on the same side of the microhemorrhage.

The left arrow points to a cerebral microhemorrhage trapped in the left temporal lobe in a case of migraine with aura. The arrow on the right indicates another possible abnormality on the same side of the microhemorrhage.
image: RSNA and Wilson Shue

new research It seems to offer the closest view yet of how migraines affect the brain. Scientists at the University of Southern California in Los Angeles have collected detailed MRI scans from patients suffering from migraines. They found that compared to patients without migraines, these patients had a higher number of enlarged perivascular spaces, which could be a sign of damage to the small blood vessels of the brain. could one day lead to new treatments for chronic diseases, say researchers.

Migraine is a recurrent type of headache that usually causes moderate to severe pain. Often this pain precedes or accompanies other symptoms such as nausea, fatigue, and various sensory disturbances known as auras. Auras include visible bright spots, ringing in the ears, and numbness or tingling along the body. These episodes usually last several hours, but he can last from a few days to a week.

The exact cause of migraine headaches is unknown, but there appears to be a strong genetic component, as people with a family history of migraine headaches are more likely to develop them. idea It affects about 12% of the population, and women are more likely to report them than men. It is estimated that approximately 1% to 2% of the population experiences chronic migraines, or episodes occurring at least 15 days per month.

Migraine headaches can be managed acutely with pain relievers, and some people have been able to reduce migraine frequency by avoiding known triggers, such as certain foods. , approved A new class of medications that treats or prevents migraines more effectively. However, much is still unknown about the condition, and there may be other treatments and preventions to discover.

With a new study, USC scientists believe they are the first to examine the brains of migraine sufferers using a relatively new form of ultra-high-resolution MRI known as 7T MRI. They scanned the brains of 20 of him with migraines. Of these he had 10 with chronic migraine and 10 with episodic migraine without aura. For comparison, they also examined his five healthy human brains. Age-matched controls.

The arrow on the left shows the enlargement of the perivascular space in the central semi-ovule of a chronic migraine patient. A right-sided brain scan without an enlarged space is obtained from a migraine-free control.

The arrow on the left shows the enlargement of the perivascular space in the central semi-ovule of a chronic migraine patient. A right-sided brain scan without an enlarged space is obtained from a migraine-free control.
image: RSNA and Wilson Shue

In both migraine groups, the team found numerous enlargements of the perivascular space, which are fluid-filled pockets near blood vessels in certain parts of the body. brain. These spaces were most prominent in the central semiovule, the central white matter region of the brain. They also found that the presence of these spaces was associated with white matter lesions, but there was no significant difference in lesion severity between those with and without migraines. It will be presented at the annual meeting of the Radiological Society of North America (RSNA) in .

“The perivascular space is part of the fluid clearance system in the brain,” he said. Wilson Xu, MD candidate at the University of Southern California, Keck School of Medicine, said: statement Provided by RNSA. “Studying how they contribute to migraine may help us better understand the complexities of how migraines occur.”

Enlarged perivascular space linked For other neurological diseases such as dementia.but the team To tell This is the first time that changes of this kind have been identified in this specific area of ​​the brain in migraine sufferers. At the same time, they warn that the implications of their findings are: uncertain.

Some past studies have suggested a relationship between headaches and these enlarged spaces, while others, for example, notWe also don’t know why they appear in patients.scientists We speculate that this may represent a malfunction of the brain’s lymphatic system, a system that uses perivascular channels to flush waste products from the brain.Even if this hypothesis were correct, it is not clear whether these enlarged spaces appear as a result of migraine headaches or contribute to them. Finally, the findings have not yet been formally peer-reviewed. This is an important part of the scientific process.

Still, this kind of basic research might offer new lead Migraine treatment and diagnostic tests, researchers Say.

“Our findings will inspire future large-scale studies to continue investigating how alterations in the brain’s microvessels and blood supply contribute to different migraine types. It could be useful,” said Xu. “Ultimately, this could help develop new, personalized methods for diagnosing and treating migraine.”

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