Impaired Glymphatic and Meningeal Lymphatic Functions in Patients with Chronic Migraine

This study was undertaken to investigate migraine glymphatic and meningeal lymphatic vessel (mLV) functions. Migraine patients and healthy controls (HCs) were prospectively recruited between 2020 and 2023. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) index for glymphatics...

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Bibliographic Details
Published in:Annals of neurology 2024-03, Vol.95 (3), p.583-595
Main Authors: Wu, Chia-Hung, Chang, Feng-Chi, Wang, Yen-Feng, Lirng, Jiing-Feng, Wu, Hsiu-Mei, Pan, Li-Ling Hope, Wang, Shuu-Jiun, Chen, Shih-Pin
Format: Article
Language:English
Subjects:
Headache
Image analysis
Image processing
Magnetic resonance imaging
Migraine
Pain
Parameters
Pathogenesis
Sleep
Tensors
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Summary:This study was undertaken to investigate migraine glymphatic and meningeal lymphatic vessel (mLV) functions. Migraine patients and healthy controls (HCs) were prospectively recruited between 2020 and 2023. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) index for glymphatics and dynamic contrast-enhanced magnetic resonance imaging parameters (time to peak [TTP]/enhancement integral [EI]/mean time to enhance [MTE]) for para-superior sagittal (paraSSS)-mLV or paratransverse sinus (paraTS)-mLV in episodic migraine (EM), chronic migraine (CM), and CM with and without medication-overuse headache (MOH) were analyzed. DTI-ALPS correlations with clinical parameters (migraine severity [numeric rating scale]/disability [Migraine Disability Assessment (MIDAS)]/bodily pain [Widespread Pain Index]/sleep quality [Pittsburgh Sleep Quality Index (PSQI)]) were examined. In total, 175 subjects (112 migraine + 63 HCs) were investigated. DTI-ALPS values were lower in CM (median [interquartile range] = 0.64 [0.12]) than in EM (0.71 [0.13], p = 0.005) and HCs (0.71 [0.09], p = 0.004). CM with MOH (0.63 [0.07]) had lower DTI-ALPS values than CM without MOH (0.73 [0.12], p 
ISSN:0364-5134
1531-8249
DOI:10.1002/ana.26842