MRI Reveals Enlarged Perivascular Spaces in Individuals With Migraine 

A new study presented at the annual meeting of the Radiological Society of North America (RSNA) was the first to report evidence of enlarged perivascular spaces in study participants with migraine. Researchers also documented an association between the number of enlarged perivascular spaces found in the centrum semiovale with deep white matter hyperintensity severity seen in those with migraines. Such changes may suggest disuptions in the brain’s waste disposal system, according to the study’s authors. 

"In people with chronic migraine and episodic migraine without aura, there are significant changes in the perivascular spaces of a brain region called the centrum semiovale," said study coauthor Wilson Xu, an MD candidate at Keck School of Medicine of the University of Southern California in Los Angeles. "These changes have never been reported before."

Researchers used ultra-high-field 7T MRI to analyze microvascular changes in the brain in individuals who experienced different types of migraine. This newer imaging modality provides enhanced detail and clarity, with a significant reduction in blurring between gray and white matter sometimes seen in other forms of MRI. Specific variables measured in the study included the size of enlarged perivascular spaces, white matter hyperintensities, and cerebral microbleeds. Perivascular spaces, often known as Virchow-Robin spaces, are associated with the dispersal of neural and blood-derived messengers. Twenty participants with migraine ranging in age from 25 to 60 years were enrolled in the study (10 with chronic migraine, 10 with episodic migraine with aura) along with 5 aged-matched participants without reported migraine. 

The study authors hypothesize that the reported changes in brain structure seen on MRI may be suggestive of disruptions in the glymphatic system. Additional research is needed to clarify the association between various types of migraine and structural changes in the brain.

"The results of our study could help inspire future, larger-scale studies to continue investigating how changes in the brain's microscopic vessels and blood supply contribute to different migraine types," Xu said. "Eventually, this could help us develop new, personalized ways to diagnose and treat migraine."