New insights into the neurovascular coupling with magnetic resonance imaging biomarkers: a study in patients with migraine

Abstract

Background and purpose: Migraine is a recurrent and incapacitating disorder, characterized by attacks of severe headache. Neurovascular coupling abnormalities

have been described for migraine. Despite its prevalence, the physiology and under- lying mechanism of migraine are poorly understood. In this context, new biomarkers

from magnetic resonance imaging (MRI) are needed to bring new knowledge into the

field. This study aims to determine vein density in patients with migraine from Sus- ceptibility Weighted Imaging (SWI), compare it with healthy controls, and whether

it relates to Resting-State functional MRI (RS-fMRI) measurements. Materials and methods: The cohort included 30 healthy controls and 70

patients with migraine who were undergoing brain 3.0 T MRI at Vall d’Hebron Uni- versity Hospital. Clinical and baseline characteristics were also collected. Vein den- sity was determined based on a Mamdani Fuzzy-Type Rule-Based System (FRBS).

RS-fMRI images were analyzed with the CONN to generate the Amplitude of Low- Frequency Fluctuations (ALFF). Vein density and ALFF measurements were par- cellated in different brain gray (GM) and white matter (WM) regions.

Results: Significant decreases in vein density were observed in migraine in some WM regions. WM vein density in either frontal, temporal or cingulate regions was associated with clinical variables, such as headache days, disability scores, and cognitive impairment (r between 0.26-0.40; p<0.05). Strong significant associations between vein density and ALFF measures were obtained in most GM for the healthy subjects (r between 0.52-0.71; p<0.01) and in WM (r between 0.37-0.58; p<0.01) for the migraine patients. Conclusions: Quantitative MRI indicators in migraine might be an interesting target that may contribute to its comprehension. A loss of association between vein density and ALFF may support the idea of abnormalities in the neurovascular coupling.