Assessment of White Matter Alterations in Patients of Migraine Using Diffusion Tensor Imaging

Background:Vascular hypotheses was previously considered to play a major role in pathophysiology of migraine. Recently, neurological mechanisms have been proposed with implication of the trigemino-vascular pathway. Deciphering the pathophysiology of this disorder is extremely important for diagnosis, assessment of progression and to explore targeted treatment options.Objectives:To assess white matter alterations in patients of migraine by using Diffusion Tensor Imaging.Materials and Methods:We performed Diffusion Tensor Imaging in migraine patients to assess changes in microstructural integrity of white matter tracts involved in pain processing to localize the tracts involved in migraine. This is a cross-sectional observational study involving 50 subjects (30 patients of migraine diagnosed as per ICHD-III and 20 age and sex matched controls). DTI was performed on 3T MRI and the mean diffusivity and fractional anisotropy values of the cases were compared with controls.Results and Conslusion:Significant changes were noted in the multiple white matter tracts implicated in pain processing compared to the controls. Significant association was also noted between the DTI parameters and the type and frequency of migraine. DTI can thus assist in the diagnosis, assessing the extent of neurological damage in patients of migraine and follow up post treatment.