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CHICAGO -- Powerful MRI scanners have detected white matter spots in the brain that appear to be associated with migraines, a researcher reported here.

On ultra-high-field 7T MRI, the number of enlarged perivascular spaces (PVS) in the centrum semiovale was significantly higher for patients with chronic or episodic migraine versus healthy controls (P=0.04), according to Wilson Xu, BA, a medical student at the University of Southern California in Los Angeles.

However, the higher number of enlarged PVS was not seen in the basal ganglia in the migraine patients versus controls, he said in a presentation at the Radiological Society of North America annual meeting.

"What we observed," Xu told MedPage Today, "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. Eventually, this could help us develop new, personalized ways to diagnose and treat migraine."

However, he said, the current research does not reveal if the changes in PVS -- part of a fluid clearance system in the brain -- are caused by migraines, or if they have a role in migraine development, frequency, or severity.

The researchers recruited 10 individuals with chronic migraine (headaches occurring more than 15 days a month), 10 individuals with episodic migraine without aura, and five healthy controls with no history of migraine (all ages 25-60). Exclusion criteria were overt cognitive impairment, brain tumor, prior intracranial surgery, MRI contraindications, and claustrophobia. All the scans were done when patients were not having migraine, Xu said.

Xu said his group also looked for potential differences between migraine patients and controls in terms of white matter hyperintensities (WMH) and cerebral microbleeds.

Frequency of WMH and cerebral microbleeds in migraine did not differ significantly from that of controls, but a correlation between enlarged PVS quantity in centrum semiovale and deep WMH severity was observed in migraine patients (P=0.04). "This suggests that changes in PVS could lead to future development of more white matter lesions," according to Xu.

He said the next steps would be to look at a larger group of patients and do longitudinal follow-up to better establish the relationship between structural changes and migraine development and type.

The research-only scanner "gives us much better resolution of the brain, and its scans are much faster than the other devices" used in clinical practice, Xu explained.

"By using these 7T MRI scans, the researchers were able to take a closer look at these white matter spots," Max Wintermark, MD, chief of neuroradiology at the University of Texas MD Anderson Cancer Center in Houston, told MedPage Today.

"Some of these spots," noted Wintermark, who was not involved in the research "were in the perivascular space around the tiny vessels in the brain tissue. It looks like those spaces are enlarged among the people who report they have migraines. This gives us another place to look to see if we can find the mechanism that may cause migraines."

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