Why some people get migraines while others don’t? New research indicates that it might be due to specific brain changes in migraine sufferers, particularly, in the centrum semiovale, a white matter region underneath the cerebral cortex.
New data presented at the yearly meeting of the Radiological Society of North America points towards brain differences among patients with chronic and episodic migraine (without aura) and normal controls.
Previous research had identified the presence of white matter hyper intensities –lesions– in people having migraines, but the researchers investigated the perivascular spaces as well since these fluid-filled gaps surrounding brain blood vessels are crucial for maintenance of the glymphatic system, the brain’s clearance system.
Brain scans in 10 patients with migraine (10 chronic and 10 episodic) and 5 controls showed significant changes in the perivascular spaces within the centrum semiovale in participants who had migraines. In this group, the quantity of these changes correlated to the presence of white matter lesions. The bigger perivascular changes observed in patients with migraine may point out to a deregulated lymphatic system and brain toxicity as the guilty party in migraine development. Although no differences in the severity of white matter lesions were found between controls and patients with migraine, its correlation with perivascular changes might indicate that they are a precursor of further brain lesions.
Despite the interesting findings, this research is only correlational. Further research should focus on investigating the implication of the lymphatic system and perivascular spaces in migraine development, as this research might have important treatment implications for this incapacitating type of headache.