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The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2018

Open Access 01-12-2018 | Research article

Comparison of gray matter volume between migraine and “strict-criteria” tension-type headache

Authors: Wei-Ta Chen, Kun-Hsien Chou, Pei-Lin Lee, Fu-Jung Hsiao, David M. Niddam, Kuan-Lin Lai, Jong-Ling Fuh, Ching-Po Lin, Shuu-Jiun Wang

Published in: The Journal of Headache and Pain | Issue 1/2018

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Abstract

Background

Despite evidently distinct symptoms, tension-type headache (TTH) and migraine are highly comorbid and exhibit many similarities in clinical practice. The purpose of this study was to investigate whether both types of headaches are similar in brain morphology.

Methods

Consecutive patients with TTH and age- and sex-matched patients with migraine and healthy controls were enrolled for brain magnetic resonance imaging examination. Patients with TTH were excluded if they reported any headache features or associated symptoms of migraine. Changes in gray matter (GM) volume associated with headache diagnosis (TTH vs. migraine) and frequency (episodic vs. chronic) were examined using voxel-based morphometry. The correlation with headache profile and the discriminative ability between TTH and migraine were also investigated for these GM changes.

Results

In comparison with controls (n = 43), the patients with TTH (25 episodic and 24 chronic) exhibited a GM volume increase in the anterior cingulate cortex, supramarginal gyrus, temporal pole, lateral occipital cortex, and caudate. The patients with migraine (31 episodic and 25 chronic) conversely exhibited a GM volume decrease in the orbitofrontal cortex. These GM changes did not correlate with any headache profile. A voxel-wise 2 × 2 factorial analysis further revealed the substantial effects of headache types and frequency in the comparison of GM volume between TTH and migraine. Specifically, the migraine group (vs. TTH) had a GM decrease in the superior and middle frontal gyri, cerebellum, dorsal striatum, and precuneus. The chronic group (vs. episodic group) otherwise demonstrated a GM decrease in the bilateral insula and anterior cingulate cortex. In receiver operating characteristic analysis, the GM volumes of the left superior frontal gyrus and right cerebellum V combined had good discriminative ability for distinguishing TTH and migraine (area under the curve = 0.806).

Conclusions

TTH and migraine are separate headache disorders with different characteristics in relation to GM changes. The major morphological difference between the two types of headaches is the relative GM decrease of the prefrontal and cerebellar regions in migraine, which may reflect a higher allostatic load associated with this disabling headache.
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Metadata
Title
Comparison of gray matter volume between migraine and “strict-criteria” tension-type headache
Authors
Wei-Ta Chen
Kun-Hsien Chou
Pei-Lin Lee
Fu-Jung Hsiao
David M. Niddam
Kuan-Lin Lai
Jong-Ling Fuh
Ching-Po Lin
Shuu-Jiun Wang
Publication date
01-12-2018
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2018
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-018-0834-6

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