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.

Details

Title
Comparison of gray matter volume between migraine and “strict-criteria” tension-type headache
Author
Wei-Ta, Chen 1   VIAFID ORCID Logo  ; Chou, Kun-Hsien 2 ; Pei-Lin, Lee 3 ; Fu-Jung, Hsiao 4 ; Niddam, David M 5 ; Kuan-Lin, Lai 6 ; Jong-Ling Fuh 7 ; Lin, Ching-Po 8 ; Wang, Shuu-Jiun 1 

1  Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan; The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan 
2  Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan 
3  Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan 
4  Brain Research Center, National Yang-Ming University, Taipei, Taiwan 
5  Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan 
6  Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan; The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan 
7  Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan; The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan 
8  Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan 
Pages
1-11
Publication year
2018
Publication date
Jan 2018
Publisher
Springer Nature B.V.
ISSN
11292369
e-ISSN
11292377
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s10194-018-0834-6
ProQuest document ID
2220812366
Copyright
The Journal of Headache and Pain is a copyright of Springer, (2018). All Rights Reserved., © 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.