Accurate classification of chronic migraine via brain magnetic resonance imaging

Todd J Schwedt, Catherine D. Chong, Teresa Wu, Nathan Gaw, Yinlin Fu, Jing Li

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background The International Classification of Headache Disorders provides criteria for the diagnosis and subclassification of migraine. Since there is no objective gold standard by which to test these diagnostic criteria, the criteria are based on the consensus opinion of content experts. Accurate migraine classifiers consisting of brain structural measures could serve as an objective gold standard by which to test and revise diagnostic criteria. The objectives of this study were to utilize magnetic resonance imaging measures of brain structure for constructing classifiers: (1) that accurately identify individuals as having chronic vs episodic migraine vs being a healthy control; and (2) that test the currently used threshold of 15 headache days/month for differentiating chronic migraine from episodic migraine. Methods Study participants underwent magnetic resonance imaging for determination of regional cortical thickness, cortical surface area, and volume. Principal components analysis combined structural measurements into principal components accounting for 85% of variability in brain structure. Models consisting of these principal components were developed to achieve the classification objectives. Tenfold cross validation assessed classification accuracy within each of the 10 runs, with data from 90% of participants randomly selected for classifier development and data from the remaining 10% of participants used to test classification performance. Headache frequency thresholds ranging from 5-15 headache days/month were evaluated to determine the threshold allowing for the most accurate subclassification of individuals into lower and higher frequency subgroups. Results Participants were 66 migraineurs and 54 healthy controls, 75.8% female, with an average age of 36-+/-11 years. Average classifier accuracies were: (1) 68% for migraine (episodic-+-chronic) vs healthy controls; (2) 67.2% for episodic migraine vs healthy controls; (3) 86.3% for chronic migraine vs healthy controls; and (4) 84.2% for chronic migraine vs episodic migraine. The classifiers contained principal components consisting of several structural measures, commonly including the temporal pole, anterior cingulate cortex, superior temporal lobe, entorhinal cortex, medial orbital frontal gyrus, and pars triangularis. A threshold of 15 headache days/month allowed for the most accurate subclassification of migraineurs into lower frequency and higher frequency subgroups. Conclusions Classifiers consisting of cortical surface area, cortical thickness, and regional volumes were highly accurate for determining if individuals have chronic migraine. Furthermore, results provide objective support for the current use of 15 headache days/month as a threshold for dividing migraineurs into lower frequency (ie, episodic migraine) and higher frequency (ie, chronic migraine) subgroups.

Original languageEnglish (US)
Pages (from-to)762-777
Number of pages16
JournalHeadache
Volume55
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Migraine Disorders
Magnetic Resonance Imaging
Brain
Headache
Prefrontal Cortex
Routine Diagnostic Tests
Entorhinal Cortex
Headache Disorders
Gyrus Cinguli
Expert Testimony
Temporal Lobe
Principal Component Analysis

Keywords

  • cortical surface area
  • cortical thickness
  • diagnostic classifier
  • magnetic resonance imaging
  • migraine

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Accurate classification of chronic migraine via brain magnetic resonance imaging. / Schwedt, Todd J; Chong, Catherine D.; Wu, Teresa; Gaw, Nathan; Fu, Yinlin; Li, Jing.

In: Headache, Vol. 55, No. 6, 01.06.2015, p. 762-777.

Research output: Contribution to journalArticle

Schwedt, Todd J ; Chong, Catherine D. ; Wu, Teresa ; Gaw, Nathan ; Fu, Yinlin ; Li, Jing. / Accurate classification of chronic migraine via brain magnetic resonance imaging. In: Headache. 2015 ; Vol. 55, No. 6. pp. 762-777.
@article{be880346e1c943ff92729b587bf8ef27,
title = "Accurate classification of chronic migraine via brain magnetic resonance imaging",
abstract = "Background The International Classification of Headache Disorders provides criteria for the diagnosis and subclassification of migraine. Since there is no objective gold standard by which to test these diagnostic criteria, the criteria are based on the consensus opinion of content experts. Accurate migraine classifiers consisting of brain structural measures could serve as an objective gold standard by which to test and revise diagnostic criteria. The objectives of this study were to utilize magnetic resonance imaging measures of brain structure for constructing classifiers: (1) that accurately identify individuals as having chronic vs episodic migraine vs being a healthy control; and (2) that test the currently used threshold of 15 headache days/month for differentiating chronic migraine from episodic migraine. Methods Study participants underwent magnetic resonance imaging for determination of regional cortical thickness, cortical surface area, and volume. Principal components analysis combined structural measurements into principal components accounting for 85{\%} of variability in brain structure. Models consisting of these principal components were developed to achieve the classification objectives. Tenfold cross validation assessed classification accuracy within each of the 10 runs, with data from 90{\%} of participants randomly selected for classifier development and data from the remaining 10{\%} of participants used to test classification performance. Headache frequency thresholds ranging from 5-15 headache days/month were evaluated to determine the threshold allowing for the most accurate subclassification of individuals into lower and higher frequency subgroups. Results Participants were 66 migraineurs and 54 healthy controls, 75.8{\%} female, with an average age of 36-+/-11 years. Average classifier accuracies were: (1) 68{\%} for migraine (episodic-+-chronic) vs healthy controls; (2) 67.2{\%} for episodic migraine vs healthy controls; (3) 86.3{\%} for chronic migraine vs healthy controls; and (4) 84.2{\%} for chronic migraine vs episodic migraine. The classifiers contained principal components consisting of several structural measures, commonly including the temporal pole, anterior cingulate cortex, superior temporal lobe, entorhinal cortex, medial orbital frontal gyrus, and pars triangularis. A threshold of 15 headache days/month allowed for the most accurate subclassification of migraineurs into lower frequency and higher frequency subgroups. Conclusions Classifiers consisting of cortical surface area, cortical thickness, and regional volumes were highly accurate for determining if individuals have chronic migraine. Furthermore, results provide objective support for the current use of 15 headache days/month as a threshold for dividing migraineurs into lower frequency (ie, episodic migraine) and higher frequency (ie, chronic migraine) subgroups.",
keywords = "cortical surface area, cortical thickness, diagnostic classifier, magnetic resonance imaging, migraine",
author = "Schwedt, {Todd J} and Chong, {Catherine D.} and Teresa Wu and Nathan Gaw and Yinlin Fu and Jing Li",
year = "2015",
month = "6",
day = "1",
doi = "10.1111/head.12584",
language = "English (US)",
volume = "55",
pages = "762--777",
journal = "Headache",
issn = "0017-8748",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Accurate classification of chronic migraine via brain magnetic resonance imaging

AU - Schwedt, Todd J

AU - Chong, Catherine D.

AU - Wu, Teresa

AU - Gaw, Nathan

AU - Fu, Yinlin

AU - Li, Jing

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background The International Classification of Headache Disorders provides criteria for the diagnosis and subclassification of migraine. Since there is no objective gold standard by which to test these diagnostic criteria, the criteria are based on the consensus opinion of content experts. Accurate migraine classifiers consisting of brain structural measures could serve as an objective gold standard by which to test and revise diagnostic criteria. The objectives of this study were to utilize magnetic resonance imaging measures of brain structure for constructing classifiers: (1) that accurately identify individuals as having chronic vs episodic migraine vs being a healthy control; and (2) that test the currently used threshold of 15 headache days/month for differentiating chronic migraine from episodic migraine. Methods Study participants underwent magnetic resonance imaging for determination of regional cortical thickness, cortical surface area, and volume. Principal components analysis combined structural measurements into principal components accounting for 85% of variability in brain structure. Models consisting of these principal components were developed to achieve the classification objectives. Tenfold cross validation assessed classification accuracy within each of the 10 runs, with data from 90% of participants randomly selected for classifier development and data from the remaining 10% of participants used to test classification performance. Headache frequency thresholds ranging from 5-15 headache days/month were evaluated to determine the threshold allowing for the most accurate subclassification of individuals into lower and higher frequency subgroups. Results Participants were 66 migraineurs and 54 healthy controls, 75.8% female, with an average age of 36-+/-11 years. Average classifier accuracies were: (1) 68% for migraine (episodic-+-chronic) vs healthy controls; (2) 67.2% for episodic migraine vs healthy controls; (3) 86.3% for chronic migraine vs healthy controls; and (4) 84.2% for chronic migraine vs episodic migraine. The classifiers contained principal components consisting of several structural measures, commonly including the temporal pole, anterior cingulate cortex, superior temporal lobe, entorhinal cortex, medial orbital frontal gyrus, and pars triangularis. A threshold of 15 headache days/month allowed for the most accurate subclassification of migraineurs into lower frequency and higher frequency subgroups. Conclusions Classifiers consisting of cortical surface area, cortical thickness, and regional volumes were highly accurate for determining if individuals have chronic migraine. Furthermore, results provide objective support for the current use of 15 headache days/month as a threshold for dividing migraineurs into lower frequency (ie, episodic migraine) and higher frequency (ie, chronic migraine) subgroups.

AB - Background The International Classification of Headache Disorders provides criteria for the diagnosis and subclassification of migraine. Since there is no objective gold standard by which to test these diagnostic criteria, the criteria are based on the consensus opinion of content experts. Accurate migraine classifiers consisting of brain structural measures could serve as an objective gold standard by which to test and revise diagnostic criteria. The objectives of this study were to utilize magnetic resonance imaging measures of brain structure for constructing classifiers: (1) that accurately identify individuals as having chronic vs episodic migraine vs being a healthy control; and (2) that test the currently used threshold of 15 headache days/month for differentiating chronic migraine from episodic migraine. Methods Study participants underwent magnetic resonance imaging for determination of regional cortical thickness, cortical surface area, and volume. Principal components analysis combined structural measurements into principal components accounting for 85% of variability in brain structure. Models consisting of these principal components were developed to achieve the classification objectives. Tenfold cross validation assessed classification accuracy within each of the 10 runs, with data from 90% of participants randomly selected for classifier development and data from the remaining 10% of participants used to test classification performance. Headache frequency thresholds ranging from 5-15 headache days/month were evaluated to determine the threshold allowing for the most accurate subclassification of individuals into lower and higher frequency subgroups. Results Participants were 66 migraineurs and 54 healthy controls, 75.8% female, with an average age of 36-+/-11 years. Average classifier accuracies were: (1) 68% for migraine (episodic-+-chronic) vs healthy controls; (2) 67.2% for episodic migraine vs healthy controls; (3) 86.3% for chronic migraine vs healthy controls; and (4) 84.2% for chronic migraine vs episodic migraine. The classifiers contained principal components consisting of several structural measures, commonly including the temporal pole, anterior cingulate cortex, superior temporal lobe, entorhinal cortex, medial orbital frontal gyrus, and pars triangularis. A threshold of 15 headache days/month allowed for the most accurate subclassification of migraineurs into lower frequency and higher frequency subgroups. Conclusions Classifiers consisting of cortical surface area, cortical thickness, and regional volumes were highly accurate for determining if individuals have chronic migraine. Furthermore, results provide objective support for the current use of 15 headache days/month as a threshold for dividing migraineurs into lower frequency (ie, episodic migraine) and higher frequency (ie, chronic migraine) subgroups.

KW - cortical surface area

KW - cortical thickness

KW - diagnostic classifier

KW - magnetic resonance imaging

KW - migraine

UR - http://www.scopus.com/inward/record.url?scp=84931353980&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84931353980&partnerID=8YFLogxK

U2 - 10.1111/head.12584

DO - 10.1111/head.12584

M3 - Article

C2 - 26571886

AN - SCOPUS:84931353980

VL - 55

SP - 762

EP - 777

JO - Headache

JF - Headache

SN - 0017-8748

IS - 6

ER -