Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2015

Open Access 01-12-2016 | Research article

Nonspecific periaqueductal gray lesions on T2WI in episodic migraine

Authors: Zhiye Chen, Xiaoyan Chen, Mengqi Liu, Shuangfeng Liu, Lin Ma, Shengyuan Yu

Published in: The Journal of Headache and Pain | Issue 1/2015

Login to get access

Abstract

Background

The specific periaqueductal gray (PAG) lesions with migraine-like headache were easily identified on conventional MR images in clinical practice, and the aim of this study is to investigate the nonspecific periaqueductal gray (PAG) lesions in episodic migraine (EM) patients based on T2 weighted imaging (T2WI).

Methods

T2WI images were obtained from 18 EM patients and 18 normal controls (NC) on 3.0 T MR system. The images were observed by two experienced radiologists, and the lesions were identified on T2WI by consensus by 2 experienced neuroradiologists blinded to the patient identity. Chi-Square test was performed for the significance test.

Results

Ring-like hyperintensity lesions (HILs) around the PAG region were observed in 14 EM patients and in 5 NCs on T2WI. Four EM patients and 13 NCs were normal in PAG region. The significance was revealed by Chi-Square test (P = 0.003).

Conclusion

HIL of PAG may be the direct evidence of the EM genesis, and the further structural and functional study should be performed to elucidate the neuromechanism of migraine pathogenesis.
Literature
1.
Welch KM, Nagesh V, Aurora SK, Gelman N (2001) Periaqueductal gray matter dysfunction in migraine: cause or the burden of illness? Headache 41:629–637CrossRefPubMed
2.
Smith GST, Savery D, Marden C, López Costa JJ, Averill S, Priestley JV, Rattray M (1994) Distribution of messenger RNAs encoding enkephalin, substance P, somatostatin, galanin, vasoactive intestinal polypeptide, neuropeptide Y, and calcitonin gene-related peptide in the midbrain periaqueductal grey in the rat. J Comp Neurol 350:23–40.CrossRefPubMed
3.
Raskin NH, Yoshio H, Sharon L (1987) Headache may arise from perturbation of brain. Headache J Head Face Pain 27:416–420CrossRef
4.
Kruit MC, Launer LJ, Overbosch J, van Buchem MA, Ferrari MD (2009) Iron accumulation in deep brain nuclei in migraine: a population-based magnetic resonance imaging study. Cephalalgia 29:351–359CrossRefPubMed
5.
Tepper SJ, Lowe MJ, Beall E, Phillips MD, Liu K, Stillman MJ, Horvat M, Jones SE (2012) Iron deposition in pain-regulatory nuclei in episodic migraine and chronic daily headache by MRI. Headache 52:236–243CrossRefPubMed
6.
Gee JR, Chang J, Dublin AB, Vijayan N (2005) The association of brainstem lesions with migraine-like headache: an imaging study of multiple sclerosis. Headache 45:670–677CrossRefPubMed
7.
Haas DC, Kent PF, Friedman DI (1993) Headache caused by a single lesion of multiple sclerosis in the periaqueductal gray area. Headache 33:452–455CrossRefPubMed
8.
Lin GY, Wang CW, Chiang TT, Peng GS, Yang FC (2013) Multiple sclerosis presenting initially with a worsening of migraine symptoms. J Headache Pain 14:70CrossRefPubMedPubMedCentral
9.
Tortorella P, Rocca MA, Colombo B, Annovazzi P, Comi G, Filippi M (2006) Assessment of MRI abnormalities of the brainstem from patients with migraine and multiple sclerosis. J Neurol Sci 244:137–141CrossRefPubMed
10.
Fragoso YD, Brooks JB (2007) Two cases of lesions in brainstem in multiple sclerosis and refractory migraine. Headache 47:852–854CrossRefPubMed
11.
Wang Y, Wang XS (2013) Migraine-like headache from an infarction in the periaqueductal gray area of the midbrain. Pain Med 14:948–949CrossRefPubMed
12.
Rocca MA, Ceccarelli A, Falini A, Colombo B, Tortorella P, Bernasconi L, Comi G, Scotti G, Filippi M (2006) Brain gray matter changes in migraine patients with T2-visible lesions: a 3-T MRI study. Stroke 37:1765–1770CrossRefPubMed
13.
Fazekas F, Koch M, Schmidt R, Offenbacher H, Payer F, Freidl W, Lechner H (1992) The prevalence of cerebral damage varies with migraine type: a MRI study. Headache 32:287–291CrossRefPubMed
14.
Headache Classification Committee of the International Headache Society (IHS) (2013) The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 33:629–808.CrossRef
15.
Maier W, Buller R, Philipp M, Heuser I (1988) The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord 14:61–68CrossRefPubMed
16.
Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296CrossRefPubMed
17.
Scher AI, Gudmundsson LS, Sigurdsson S, Ghambaryan A, Aspelund T, Eiriksdottir G, van Buchem MA, Gudnason V, Launer LJ (2009) Migraine headache in middle age and late-life brain infarcts. JAMA 301:2563–2570CrossRefPubMedPubMedCentral
18.
Gomez-Beldarrain M, Oroz I, Zapirain BG, Ruanova BF, Fernandez YG, Cabrera A, Anton-Ladislao A, Aguirre-Larracoechea U, Garcia-Monco JC (2015) Right fronto-insular white matter tracts link cognitive reserve and pain in migraine patients. J Headache Pain 17:4CrossRefPubMed
19.
Yu S, Liu R, Zhao G, Yang X, Qiao X, Feng J, Fang Y, Cao X, He M, Steiner T (2012) The prevalence and burden of primary headaches in China: a population-based door-to-door survey. Headache 52:582–591CrossRefPubMed
20.
Lipton RB (2009) Tracing transformation: chronic migraine classification, progression, and epidemiology. Neurology 72:S3–S7CrossRefPubMed
21.
Chen Z, Chen X, Liu M, Liu S, Shu S, Ma L, Yu S (2016) Altered functional connectivity of the marginal division in migraine: a resting-state fMRI study. J Headache Pain 17:89CrossRefPubMedPubMedCentral
22.
Schwedt TJ, Larson-Prior L, Coalson RS, Nolan T, Mar S, Ances BM, Benzinger T, Schlaggar BL (2014) Allodynia and descending pain modulation in migraine: a resting state functional connectivity analysis. Pain Med 15:154–165CrossRefPubMed
23.
Schwedt TJ, Schlaggar BL, Mar S, Nolan T, Coalson RS, Nardos B, Benzinger T, Larson-Prior LJ (2013) Atypical resting-state functional connectivity of affective pain regions in chronic migraine. Headache 53:737–751CrossRefPubMedPubMedCentral
24.
Ito K, Kudo M, Sasaki M, Saito A, Yamashita F, Harada T, Yokosawa S, Uwano I, Kameda H, Terayama Y (2016) Detection of changes in the periaqueductal gray matter of patients with episodic migraine using quantitative diffusion kurtosis imaging: preliminary findings. Neuroradiology 58:115–120CrossRefPubMed
25.
26.
Welch KM, Cao Y, Aurora S, Wiggins G, Vikingstad EM (1998) MRI of the occipital cortex, red nucleus, and substantia nigra during visual aura of migraine. Neurology 51:1465–1469CrossRefPubMed
27.
Lisanti CJ, Asbach P, Bradley WG Jr (2005) The ependymal “Dot-Dash” sign: an MR imaging finding of early multiple sclerosis. AJNR Am J Neuroradiol 26:2033–2036PubMed
28.
Benkovic SA, Connor JR (1993) Ferritin, transferrin, and iron in selected regions of the adult and aged rat brain. J Comp Neurol 338:97–113CrossRefPubMed
29.
Morris CM, Candy JM, Bloxham CA, Edwardson JA (1992) Distribution of transferrin receptors in relation to cytochrome oxidase activity in the human spinal cord, lower brainstem and cerebellum. J Neurol Sci 111:158–172CrossRefPubMed
30.
Morris CM, Candy JM, Omar S, Bloxham CA, Edwardson JA (1994) Transferrin receptors in the parkinsonian midbrain. Neuropathol Appl Neurobiol 20:468–472CrossRefPubMed
Metadata
Title
Nonspecific periaqueductal gray lesions on T2WI in episodic migraine
Authors
Zhiye Chen
Xiaoyan Chen
Mengqi Liu
Shuangfeng Liu
Lin Ma
Shengyuan Yu
Publication date
01-12-2016
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2015
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-016-0695-9

Other articles of this Issue 1/2015

The Journal of Headache and Pain 1/2015 Go to the issue

Research article

Headaches attributed to airplane travel: a Danish survey

Consensus article

European headache federation consensus on technical investigation for primary headache disorders

Research article

Non-invasive Vagus Nerve Stimulation (nVNS) as mini-prophylaxis for menstrual/menstrually related migraine: an open-label study

Research article

Altered functional connectivity of the marginal division in migraine: a resting-state fMRI study

Research article

Real-life data in 115 chronic migraine patients treated with Onabotulinumtoxin A during more than one year

Research article

Nigrostriatal dopaminergic depletion increases static orofacial allodynia