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Migraines

A step toward figuring out migraines? Scans show how the condition affects the brain

Many aspects of migraines remain medical mysteries, but scientists may have taken a step toward understanding the condition with scans showing the effects it has on the brain. 

The results, which were reviewed and will be presented next week at the annual meeting of the Radiological Society of North America, were made using high-resolution MRI scans. Researchers with the medical society then examined 10 participants diagnosed with chronic migraines, 10 with episodic migraines without aura, and five people who served as controls. The participants ranged from 25 to 60 years old. 

When analyzing the results of the scans, researchers noticed those with chronic or episodic migraines had much enlarged perivascular spaces – the fluid-filled spaces that surround blood vessels in the brain and clear the area of waste – compared to those that don't have migraines.

Wilson Xu, doctoral candidate at Keck School of Medicine of the University of Southern California and co-author of the study, told USA TODAY, "seeing this kind of relationship between increased amounts of (perivascular spaces) in a certain region of the white matter in the brain, we think that there might be some sort of connection between migraine and this waste clearance system."

(A) Enlarged centrum semiovale (CSO) perivascular spaces (PVS) (arrows) on sagittal T1-weighted MRI in a case with chronic migraine. (B) Migraine-free control without enlarged CSO PVS.

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Xu said researchers are unsure of the exact relationship between migraines and  perivascular spaces, but it could involve blood flow in the brain or have other implications. 

"We think that when a migraine happens, it could cause these changes, and these changes could lead to some of the symptoms and things that we experience when we have a migraine," he said. 

Migraines are one of the most disabling conditions people throughout the world deal with. Common symptoms of migraines include severe pain, nausea, fatigue and cognitive dysfunction. 

A study published in April concluded at least 15% of the world's population, or 1.1 billion people, have a headache on any day. Of those individuals, half of them have migraines. The National Headache Foundation estimates nearly 40 million Americans suffer from migraine diseases.

Despite how many people suffer from migraines, there is no known cause – or cure – for them. Experts have identified potential triggers for them and believe it is a genetic disease, but preventive steps are the best course of action people have to deal with them. 

(A) Cerebral microbleeds (CMB) visualized as round, dark lesions (arrow) on SWI sequence in the left temporal lobe in a migraine case with aura. (B) Asymmetry in the appearance of the cortical vessels is more prominent on the left side (arrow) ipsilateral to the CMB.

Dr. Andrew Charles, neurologist and director at the University of California, Los Angeles Goldberg Migraine Program, who was not involved in the study, said the findings pique his curiosity, but he isn't sure how the results should be interpreted. 

"There's all kinds of stuff happening in the perivascular space," he said. "The question is this a cause or a consequence (of migraines.)"

Charles lauded researchers for using the high-resolution MRI approach to look at migraines, adding they are "going to be helpful and potentially revealing" when it comes to understanding migraines.

"I think the kind of thing that we would need to do with this is, as they suggest, is to do some follow-up studies and try and look at a number of other factors as well," Charles added. 

Xu noted it's too early to say how the results will help solve how migraines work or form, but it's a good start.

"We think that these findings will definitely be a first step in the right direction towards a better understanding how a migraine changes the brain," he said. 

Follow Jordan Mendoza on Twitter: @jordan_mendoza5.

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