Volumetric Analysis of Pain Centers in Migraine Patients

Purpose: To investigate patterns of abnormalities in pain centers among patients with chronic pain, particularly those with migraines. The study aims to explore the potential correlation with pain duration and migraine types, and to propose new interventions for managing chronic pain Methods: Radiologic data of 32 migraine patients and 28 healthy controls underwent three-dimensional iso T1-weighted brain MRI between 2019 and 2023 at our university hospital were examined. Structured questionnaires collected data on age, gender, disease duration since migraine diagnosis, average pain intensity, and medication use. Patients with a minimum migraine duration of 3 years were included and divided into two groups based on the absence (Group 1) or presence (Group 2) of aura. Furthermore, patients were categorized into groups according to migraine attacks (episodic and chronic). Volumetric analysis, including cortical and subcortical pain-related structures, was performed using volBrain software. Results: Significant differences were observed in grey matter (p=0.037), cortical grey matter (p=0.022), cerebrum grey matter (p=0.026), anterior cingulate cortex (ACC) (p=0.017), middle cingulate cortex (MCC) (p=0.014), and posterior cingulate cortex (PCC) (p=0.008) volumes among the groups. Group comparisons revealed significant differences in the ACC, MCC, and PCC between Groups 0 and 1 (p=0.047, p=0.040, and p=0.047, respectively) and PCC between Groups 0 and 2 (p=0.026), possibly related to aura pathogenesis. Patients without aura exhibited non-significantly thinner postcentral gyrus (p=0.079), suggesting potential cortical involvement. Conclusions: This study provides insights into pain center abnormalities in migraine patients and their potential relevance to pain duration and migraine type.