Persistent post-traumatic headache vs. migraine

an MRI study demonstrating differences in brain structure

Todd J Schwedt, Catherine D. Chong, Jacob Peplinski, Katherine Ross, Visar Berisha

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The majority of individuals with post-traumatic headache have symptoms that are indistinguishable from migraine. The overlap in symptoms amongst these individuals raises the question as to whether post-traumatic headache has a unique pathophysiology or if head trauma triggers migraine. The objective of this study was to compare brain structure in individuals with persistent post-traumatic headache (i.e. headache lasting at least 3 months following a traumatic brain injury) attributed to mild traumatic brain injury to that of individuals with migraine. Methods: Twenty-eight individuals with persistent post-traumatic headache attributed to mild traumatic brain injury and 28 individuals with migraine underwent brain magnetic resonance imaging on a 3 T scanner. Regional volumes, cortical thickness, surface area and curvature measurements were calculated from T1-weighted sequences and compared between subject groups using ANCOVA. MRI data from 28 healthy control subjects were used to interpret the differences in brain structure between migraine and persistent post-traumatic headache. Results: Differences in regional volumes, cortical thickness, surface area and brain curvature were identified when comparing the group of individuals with persistent post-traumatic headache to the group with migraine. Structure was different between groups for regions within the right lateral orbitofrontal lobe, left caudal middle frontal lobe, left superior frontal lobe, left precuneus and right supramarginal gyrus (p < .05). Considering these regions only, there were differences between individuals with persistent post-traumatic headache and healthy controls within the right lateral orbitofrontal lobe, right supramarginal gyrus, and left superior frontal lobe and no differences when comparing the migraine cohort to healthy controls. Conclusions: In conclusion, persistent post-traumatic headache and migraine are associated with differences in brain structure, perhaps suggesting differences in their underlying pathophysiology. Additional studies are needed to further delineate similarities and differences in brain structure and function that are associated with post-traumatic headache and migraine and to determine their specificity for each of the headache types.

Original languageEnglish (US)
Article number87
JournalJournal of Headache and Pain
Volume18
Issue number1
DOIs
StatePublished - Dec 1 2017

Fingerprint

Post-Traumatic Headache
Migraine Disorders
Brain
Parietal Lobe
Frontal Lobe
Brain Concussion
Headache
Craniocerebral Trauma
Individuality
Healthy Volunteers
Magnetic Resonance Imaging

Keywords

  • Brain curvature
  • Brain structure
  • Brain surface area
  • Brain volume
  • Cortical thickness
  • Magnetic resonance imaging
  • Migraine
  • Post-traumatic headache
  • Traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Persistent post-traumatic headache vs. migraine : an MRI study demonstrating differences in brain structure. / Schwedt, Todd J; Chong, Catherine D.; Peplinski, Jacob; Ross, Katherine; Berisha, Visar.

In: Journal of Headache and Pain, Vol. 18, No. 1, 87, 01.12.2017.

Research output: Contribution to journalArticle

Schwedt, Todd J ; Chong, Catherine D. ; Peplinski, Jacob ; Ross, Katherine ; Berisha, Visar. / Persistent post-traumatic headache vs. migraine : an MRI study demonstrating differences in brain structure. In: Journal of Headache and Pain. 2017 ; Vol. 18, No. 1.
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abstract = "Background: The majority of individuals with post-traumatic headache have symptoms that are indistinguishable from migraine. The overlap in symptoms amongst these individuals raises the question as to whether post-traumatic headache has a unique pathophysiology or if head trauma triggers migraine. The objective of this study was to compare brain structure in individuals with persistent post-traumatic headache (i.e. headache lasting at least 3 months following a traumatic brain injury) attributed to mild traumatic brain injury to that of individuals with migraine. Methods: Twenty-eight individuals with persistent post-traumatic headache attributed to mild traumatic brain injury and 28 individuals with migraine underwent brain magnetic resonance imaging on a 3 T scanner. Regional volumes, cortical thickness, surface area and curvature measurements were calculated from T1-weighted sequences and compared between subject groups using ANCOVA. MRI data from 28 healthy control subjects were used to interpret the differences in brain structure between migraine and persistent post-traumatic headache. Results: Differences in regional volumes, cortical thickness, surface area and brain curvature were identified when comparing the group of individuals with persistent post-traumatic headache to the group with migraine. Structure was different between groups for regions within the right lateral orbitofrontal lobe, left caudal middle frontal lobe, left superior frontal lobe, left precuneus and right supramarginal gyrus (p < .05). Considering these regions only, there were differences between individuals with persistent post-traumatic headache and healthy controls within the right lateral orbitofrontal lobe, right supramarginal gyrus, and left superior frontal lobe and no differences when comparing the migraine cohort to healthy controls. Conclusions: In conclusion, persistent post-traumatic headache and migraine are associated with differences in brain structure, perhaps suggesting differences in their underlying pathophysiology. Additional studies are needed to further delineate similarities and differences in brain structure and function that are associated with post-traumatic headache and migraine and to determine their specificity for each of the headache types.",
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