Migraine with visual aura associated with thicker visual cortex

David Gaist, Anders Hougaard, Ellen Garde, Nina Linde Reislev, Rikke Wiwie, Pernille Iversen, Camilla Gøbel Madsen, Morten Blaabjerg, Helle Hvilsted Nielsen, Thomas Krøigård, Kamilla Østergaard, Kirsten Ohm Kyvik, Jacob Hjelmborg, Kristoffer Madsen, Hartwig Roman Siebner, Messoud Ashina

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Until recent years it was believed that migraine with aura was a disorder causing intermittent neurological symptoms, with no impact on brain structure. However, recent MRI studies have reported increased cortical thickness of visual and somatosensory areas in patients with migraine with aura, suggesting that such structural alterations were either due to increased neuronal density in the areas involved, or a result of multiple episodes of cortical spreading depression as part of aura attacks. Subsequent studies have yielded conflicting results, possibly due to methodological reasons, e.g. small number of subjects. In this cross-sectional study, we recruited females aged 30-60 years from the nationwide Danish Twin Registry. Brain MRI of females with migraine with aura (patients), their co-twins, and unrelated migraine-free twins (controls) were performed at a single centre and assessed for cortical thickness in predefined cortical areas (V1, V2, V3A, MT, somatosensory cortex), blinded to headache diagnoses. The difference in cortical thickness between patients and controls adjusted for age, and other potential confounders was assessed. Comparisons of twin pairs discordant for migraine with aura were also performed. Comparisons were based on 166 patients, 30 co-twins, and 137 controls. Compared with controls, patients had a thicker cortex in areas V2 [adjusted mean difference 0.032 mm (95% confidence interval 0.003 to 0.061), V3A [adjusted mean difference 0.037 mm (95% confidence interval 0.008 to 0.067)], while differences in the remaining areas examined were not statistically significant [adjusted mean difference (95% confidence interval): V1 0.022 (-0.007 to 0.052); MT: 0.018 (-0.011 to 0.047); somatosensory cortex: 0.020 (-0.009 to 0.049)]. We found no association between the regions of interest and active migraine, or number of lifetime aura attacks. Migraine with aura discordant twin pairs (n = 30) only differed in mean thickness of V2 (0.039 mm, 95% CI 0.005 to 0.074). In conclusion, females with migraine with aura have a thicker cortex corresponding to visual areas and our results indicate this may be an inherent trait rather than a result of repeated aura attacks.

OriginalsprogEngelsk
TidsskriftBrain
Vol/bind141
Udgave nummer3
Sider (fra-til)776–785
ISSN0006-8950
DOI
StatusUdgivet - 1. mar. 2018

Fingeraftryk

Migraine with Aura
Visual Cortex
Confidence Intervals
Registries
Cross-Sectional Studies

Citer dette

Gaist, D., Hougaard, A., Garde, E., Reislev, N. L., Wiwie, R., Iversen, P., ... Ashina, M. (2018). Migraine with visual aura associated with thicker visual cortex. Brain, 141(3), 776–785. https://doi.org/10.1093/brain/awx382
Gaist, David ; Hougaard, Anders ; Garde, Ellen ; Reislev, Nina Linde ; Wiwie, Rikke ; Iversen, Pernille ; Madsen, Camilla Gøbel ; Blaabjerg, Morten ; Nielsen, Helle Hvilsted ; Krøigård, Thomas ; Østergaard, Kamilla ; Kyvik, Kirsten Ohm ; Hjelmborg, Jacob ; Madsen, Kristoffer ; Siebner, Hartwig Roman ; Ashina, Messoud. / Migraine with visual aura associated with thicker visual cortex. I: Brain. 2018 ; Bind 141, Nr. 3. s. 776–785.
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title = "Migraine with visual aura associated with thicker visual cortex",
abstract = "Until recent years it was believed that migraine with aura was a disorder causing intermittent neurological symptoms, with no impact on brain structure. However, recent MRI studies have reported increased cortical thickness of visual and somatosensory areas in patients with migraine with aura, suggesting that such structural alterations were either due to increased neuronal density in the areas involved, or a result of multiple episodes of cortical spreading depression as part of aura attacks. Subsequent studies have yielded conflicting results, possibly due to methodological reasons, e.g. small number of subjects. In this cross-sectional study, we recruited females aged 30-60 years from the nationwide Danish Twin Registry. Brain MRI of females with migraine with aura (patients), their co-twins, and unrelated migraine-free twins (controls) were performed at a single centre and assessed for cortical thickness in predefined cortical areas (V1, V2, V3A, MT, somatosensory cortex), blinded to headache diagnoses. The difference in cortical thickness between patients and controls adjusted for age, and other potential confounders was assessed. Comparisons of twin pairs discordant for migraine with aura were also performed. Comparisons were based on 166 patients, 30 co-twins, and 137 controls. Compared with controls, patients had a thicker cortex in areas V2 [adjusted mean difference 0.032 mm (95{\%} confidence interval 0.003 to 0.061), V3A [adjusted mean difference 0.037 mm (95{\%} confidence interval 0.008 to 0.067)], while differences in the remaining areas examined were not statistically significant [adjusted mean difference (95{\%} confidence interval): V1 0.022 (-0.007 to 0.052); MT: 0.018 (-0.011 to 0.047); somatosensory cortex: 0.020 (-0.009 to 0.049)]. We found no association between the regions of interest and active migraine, or number of lifetime aura attacks. Migraine with aura discordant twin pairs (n = 30) only differed in mean thickness of V2 (0.039 mm, 95{\%} CI 0.005 to 0.074). In conclusion, females with migraine with aura have a thicker cortex corresponding to visual areas and our results indicate this may be an inherent trait rather than a result of repeated aura attacks.",
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author = "David Gaist and Anders Hougaard and Ellen Garde and Reislev, {Nina Linde} and Rikke Wiwie and Pernille Iversen and Madsen, {Camilla G{\o}bel} and Morten Blaabjerg and Nielsen, {Helle Hvilsted} and Thomas Kr{\o}ig{\aa}rd and Kamilla {\O}stergaard and Kyvik, {Kirsten Ohm} and Jacob Hjelmborg and Kristoffer Madsen and Siebner, {Hartwig Roman} and Messoud Ashina",
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Gaist, D, Hougaard, A, Garde, E, Reislev, NL, Wiwie, R, Iversen, P, Madsen, CG, Blaabjerg, M, Nielsen, HH, Krøigård, T, Østergaard, K, Kyvik, KO, Hjelmborg, J, Madsen, K, Siebner, HR & Ashina, M 2018, 'Migraine with visual aura associated with thicker visual cortex', Brain, bind 141, nr. 3, s. 776–785. https://doi.org/10.1093/brain/awx382

Migraine with visual aura associated with thicker visual cortex. / Gaist, David; Hougaard, Anders; Garde, Ellen; Reislev, Nina Linde; Wiwie, Rikke; Iversen, Pernille; Madsen, Camilla Gøbel; Blaabjerg, Morten; Nielsen, Helle Hvilsted; Krøigård, Thomas; Østergaard, Kamilla; Kyvik, Kirsten Ohm; Hjelmborg, Jacob; Madsen, Kristoffer; Siebner, Hartwig Roman; Ashina, Messoud.

I: Brain, Bind 141, Nr. 3, 01.03.2018, s. 776–785.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Migraine with visual aura associated with thicker visual cortex

AU - Gaist, David

AU - Hougaard, Anders

AU - Garde, Ellen

AU - Reislev, Nina Linde

AU - Wiwie, Rikke

AU - Iversen, Pernille

AU - Madsen, Camilla Gøbel

AU - Blaabjerg, Morten

AU - Nielsen, Helle Hvilsted

AU - Krøigård, Thomas

AU - Østergaard, Kamilla

AU - Kyvik, Kirsten Ohm

AU - Hjelmborg, Jacob

AU - Madsen, Kristoffer

AU - Siebner, Hartwig Roman

AU - Ashina, Messoud

N1 - © The Author(s) (2018). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Until recent years it was believed that migraine with aura was a disorder causing intermittent neurological symptoms, with no impact on brain structure. However, recent MRI studies have reported increased cortical thickness of visual and somatosensory areas in patients with migraine with aura, suggesting that such structural alterations were either due to increased neuronal density in the areas involved, or a result of multiple episodes of cortical spreading depression as part of aura attacks. Subsequent studies have yielded conflicting results, possibly due to methodological reasons, e.g. small number of subjects. In this cross-sectional study, we recruited females aged 30-60 years from the nationwide Danish Twin Registry. Brain MRI of females with migraine with aura (patients), their co-twins, and unrelated migraine-free twins (controls) were performed at a single centre and assessed for cortical thickness in predefined cortical areas (V1, V2, V3A, MT, somatosensory cortex), blinded to headache diagnoses. The difference in cortical thickness between patients and controls adjusted for age, and other potential confounders was assessed. Comparisons of twin pairs discordant for migraine with aura were also performed. Comparisons were based on 166 patients, 30 co-twins, and 137 controls. Compared with controls, patients had a thicker cortex in areas V2 [adjusted mean difference 0.032 mm (95% confidence interval 0.003 to 0.061), V3A [adjusted mean difference 0.037 mm (95% confidence interval 0.008 to 0.067)], while differences in the remaining areas examined were not statistically significant [adjusted mean difference (95% confidence interval): V1 0.022 (-0.007 to 0.052); MT: 0.018 (-0.011 to 0.047); somatosensory cortex: 0.020 (-0.009 to 0.049)]. We found no association between the regions of interest and active migraine, or number of lifetime aura attacks. Migraine with aura discordant twin pairs (n = 30) only differed in mean thickness of V2 (0.039 mm, 95% CI 0.005 to 0.074). In conclusion, females with migraine with aura have a thicker cortex corresponding to visual areas and our results indicate this may be an inherent trait rather than a result of repeated aura attacks.

AB - Until recent years it was believed that migraine with aura was a disorder causing intermittent neurological symptoms, with no impact on brain structure. However, recent MRI studies have reported increased cortical thickness of visual and somatosensory areas in patients with migraine with aura, suggesting that such structural alterations were either due to increased neuronal density in the areas involved, or a result of multiple episodes of cortical spreading depression as part of aura attacks. Subsequent studies have yielded conflicting results, possibly due to methodological reasons, e.g. small number of subjects. In this cross-sectional study, we recruited females aged 30-60 years from the nationwide Danish Twin Registry. Brain MRI of females with migraine with aura (patients), their co-twins, and unrelated migraine-free twins (controls) were performed at a single centre and assessed for cortical thickness in predefined cortical areas (V1, V2, V3A, MT, somatosensory cortex), blinded to headache diagnoses. The difference in cortical thickness between patients and controls adjusted for age, and other potential confounders was assessed. Comparisons of twin pairs discordant for migraine with aura were also performed. Comparisons were based on 166 patients, 30 co-twins, and 137 controls. Compared with controls, patients had a thicker cortex in areas V2 [adjusted mean difference 0.032 mm (95% confidence interval 0.003 to 0.061), V3A [adjusted mean difference 0.037 mm (95% confidence interval 0.008 to 0.067)], while differences in the remaining areas examined were not statistically significant [adjusted mean difference (95% confidence interval): V1 0.022 (-0.007 to 0.052); MT: 0.018 (-0.011 to 0.047); somatosensory cortex: 0.020 (-0.009 to 0.049)]. We found no association between the regions of interest and active migraine, or number of lifetime aura attacks. Migraine with aura discordant twin pairs (n = 30) only differed in mean thickness of V2 (0.039 mm, 95% CI 0.005 to 0.074). In conclusion, females with migraine with aura have a thicker cortex corresponding to visual areas and our results indicate this may be an inherent trait rather than a result of repeated aura attacks.

KW - Journal Article

KW - Visual cortex

KW - Cortical thickness

KW - Headache: imaging

KW - Migraine

KW - Migraine with aura

KW - Humans

KW - Middle Aged

KW - Male

KW - Migraine with Aura/diagnostic imaging

KW - Visual Cortex/diagnostic imaging

KW - Magnetic Resonance Imaging

KW - Image Processing, Computer-Assisted

KW - Denmark

KW - Adult

KW - Female

U2 - 10.1093/brain/awx382

DO - 10.1093/brain/awx382

M3 - Journal article

VL - 141

SP - 776

EP - 785

JO - Brain

JF - Brain

SN - 0006-8950

IS - 3

ER -

Gaist D, Hougaard A, Garde E, Reislev NL, Wiwie R, Iversen P et al. Migraine with visual aura associated with thicker visual cortex. Brain. 2018 mar 1;141(3):776–785. https://doi.org/10.1093/brain/awx382