Abstract text (incl. figure legends and references)

Question: Do patients with episodic menstrual migraine exhibit white-matter microstructural changes?

Methods: 14 women with episodic menstrual migraine (35±8yrs) were assessed during interictal phase together with 11 healthy women (29±10yrs) during a matching phase of their menstrual cycle (post-ovulation). 2D-EPI multi-shell DWI data were acquired on a 3T Siemens Vida (64-ch coil) and preprocessed using DESIGNER[1]. Diffusion tensor / kurtosis imaging (DTI/DKI) parameter maps were estimated and skeletonised[2] and histogram-metrics were computed for each subject: median, peak height, width, and value.

Results: Voxelwise statistical analysis [3] revealed multiple white-matter regions with lower MD and AD in patients, with no differences in FA and RD. Interestingly, migraineurs showed increased MK, AK and RK. Moreover, significant groups differences (Mann-Whitney test with Bonferroni correction) were found in histogram-metrics MD peak value, AD median and peak height and AK median. Median AK was positively associated (Spearman correlation) with disease duration but not with attack frequency and pain intensity.

Conclusion: Our findings extended previous reports of white-matter microstructural changes in migraineurs across multiple brain regions [4][5]. DKI histogram-metrics showed potential as disease biomarkers.

References:

[1] Ades-Aron et al., Neuroimage, 183, 532–543, 2018.

[2] S. M. Smith et al., Neuroimage, vol. 31, no. 4, pp. 1487–1505, 2006.

[3] A. M. Winkler, et al., Neuroimage, vol. 92, pp. 381–397, 2014.

[4] D. Yu et al., Cephalalgia, vol. 33, no. 1, pp. 34–42, Jan. 2013.

[5] B. Ades-Aron et al., in Proc. Intl. Soc. Mag. Reson. Med. 27, 2019, p. 0293.

Fig.1 – Results from voxelwise analysis of mean diffusivity (MD), axial diffusivity (AD), mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis (RK) maps between controls and patients (p-value in blue-green); red represents mean FA skeleton of all subjects.