Open AccessAltered Vascular Permeability in Migraine-associated Brain Regions: Evaluation with Dynamic Contrast-enhanced MRI
Author(s) -
Yeon Soo Kim,
Manho Kim,
Seung Hong Choi,
Sung Hyun You,
Roh Eul Yoo,
Koung Mi Kang,
Yun Tie,
Sang Kun Lee,
Jangsup Moon,
Yeong-Gil Shin
Publication year - 2019
Publication title -
radiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.118
H-Index - 295
eISSN - 1527-1315
pISSN - 0033-8419
DOI - 10.1148/radiol.2019182566
Subject(s) - medicine , migraine , perfusion , magnetic resonance imaging , rank correlation , nuclear medicine , dynamic contrast enhanced mri , perfusion scanning , gadobutrol , correlation , mann–whitney u test , receiver operating characteristic , area under the curve , prospective cohort study , radiology , geometry , mathematics , machine learning , computer science
Background Recent studies showed the possible association between inflammation-induced blood-brain barrier (BBB) structural changes followed by greater permeability of the BBB and chronic pain. Thus, measurement of BBB breakdown would be a valuable aid in the diagnosis in migraine. Dynamic contrast material-enhanced (DCE) MRI can determine perfusion and permeability properties related to the BBB. Purpose To evaluate the relationship between permeability of the BBB in migraine-associated brain regions by using DCE MRI. Materials and Methods In this prospective study, from September 2016 to December 2017, 56 study participants underwent DCE MRI after gadobutrol administration and were classified into migraine ( n = 35) and healthy control ( n = 21) groups. Automatic volumetric segmentation was performed on the pre-contrast-enhanced T1-weighted images by using FreeSurfer, and migraine-associated brain region masks were extracted by using the software NordicICE. The corresponding maps for pharmacokinetic parameters K trans (the volume transfer constant) and V p (the fractional plasma volume) were coregistered with the region-of-interest masks, and their mean values of corresponding total volume of interest were calculated. For comparison analyses, the Mann-Whitney tests were used. Receiver operating characteristic curve analysis and Spearman rank correlation tests were used to identify correlations between clinical characteristics and the aforementioned perfusion parameters. Results Mean age was younger in the migraine group (mean ± standard deviation, 57 years ± 12) than in the healthy control group (mean, 71 years ± 8) ( P < .001). In the migraine group, the mean value of V p in the left amygdala (median, 0.27 mL/100 g) was lower than that in the healthy control group (median, 0.39 mL/100 g) ( P = .04). The mean value of V p in the left amygdala was correlated with the intensity of headache attack in participants with migraine (correlation coefficient, -0.34; P = .04). Conclusion Lower fractional plasma volume in the left amygdala was observed in participants with migraine than in healthy participants. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Carroll and Ginat in this issue.