Hypothalamic subregional perfusion alterations in migraine: a 3D-PCASL study

BACKGROUND: Migraine is a common neurological disorder with hypothalamic involvement, yet cerebral blood flow (CBF) and volume changes in specific hypothalamic subregions remain unclear. This study used three-dimensional pseudo-continuous arterial spin labeling (3D-PCASL) to investigate perfusion and volume differences among episodic migraine (EM), chronic migraine (CM), and normal control (NCs) groups. METHODS: Forty-three participants underwent 3.0T MRI scanning. The hypothalamus was segmented into 10 subregions using FreeSurfer, and volume and CBF values were extracted. A general linear model adjusted for age and total intracranial volume (TIV) assessed intergroup differences. ROC curve analysis and correlation analysis were performed to evaluated clinical significance. RESULTS: = 0.028). CONCLUSION: Migraine patients exhibit specific hypothalamic subregional perfusion abnormalities without macroscopic volumetric changes. Left anterior inferior hypoperfusion may represent a preliminary imaging marker of migraine, whereas right-sided hypothalamic perfusion alterations may be associated with CM. The association between hypothalamic perfusion and cognitive function requires validation in larger samples.