Retrospective Investigation of Brainstem Volume and Craniovertebral Junction Morphometry in Migraine Patients

Abstract

Aim: Migraine, a complex, multifactorial neurovascular brain disorder, might cause several functional and morphometric changes in the brain. Despite many studies, a consensus has not emerged on its pathophysiology, and it is not fully elucidated so far. Recently, changing brain structures in migraine with aura has been attracting the attention of the scientific periphery. The brainstem is a critical region in the pathogenesis of migraine. Another transition point is the craniovertebral junction. Regional pathologies might trigger off the pathogenesis of neurodegenerative and neurological diseases by affecting hydrodynamics. Moreover, there is insufficient data on the relationship between migraine and the craniovertebral junction. The present study aimed to make the volumetric analysis of brainstem volume in migraine with and without aura, perform some angular and linear measurements of the craniovertebral junction, and evaluate the effects of these parameters in migraine patients. Material and Methods: The study retrospectively analyzed the brain Magnetic Resonance Images of 108 migraine patients (aged 18 to 65). Their brainstem volumes were measured using volBrain (online brain MRI volumetry system). Also, the angular and linear parameters of craniovertebral junctions were derived from the images. The obtained data were transferred to the SPSS 22 package program and analyzed. Results: The mean brainstem volume was 17.21±2.79 cm3 in the migraine with aura group, 17.33±2.48 cm3 in the migraine without aura, and 19.27±2.76 cm3 in the control group. There was no statistically significant difference between migraine with and without aura groups (p>0.05). There was a statistically significant difference between the control and both migraine groups (p<0.05). Furthermore, the clivus-canal angle was significantly different between the control and patient groups. Conclusion: The study found that the brainstem volume was lower in the migraine groups (with and without aura) than in the control group. Also, the different clivus-canal angles between the control and patient groups show that this issue should be more comprehensively studied.