75 Some researchers suggested that immunological changes associate with the presence of these lesions. In one study, migraine patients with white matter lesions on MRI displayed a significantly higher frequency of anti-neuronal antibodies than those without MRI alterations.76 Of note, serum immunoglobulin G (IgG) of migraine Adriamycin mw patients predominantly reacted with the cytoplasm of neurons and the molecular layer of cerebellum. Longitudinal studies provide valuable insights into the significance of white matter lesions that may compensate for the difficulty in obtaining histopathological correlates. An important study recently conducted

by Dinia and colleagues77 used MRI to prospectively evaluate longitudinal changes in the white selleck monoclonal humanized antibody matter

lesions in migraineurs with aura. The subjects were followed for a mean time of 33.2 months and were evaluated for cerebrovascular risk factors. White matter lesions were present in 63.4% of the patients on baseline scans. At follow up, 19.5% of the patients exhibited new lesions. A significant correlation existed between aura duration and the number of new white matter lesions, as well as between the number of migraine attacks with aura and new white matter lesions. These findings demonstrate that in migraine with aura, the number of white matter abnormalities may progress over time and suggest an association between aura features and the progression of lesions. Several other structural brain changes have been observed in migraine patients. High-resolution MR techniques showed

increased iron deposition in the PAG in migraineurs, suggestive of a disturbed central antinociceptive neuronal network.78 Larger population-based MCE公司 studies detected increased iron concentrations in the putamen, globus pallidus, and red nucleus of migraineurs aged less than 50 years, compared with controls.70,79 Higher risks in those with higher attack frequency or longer disease duration were found, consistent with a causal relationship between migraine and these abnormalities. Tepper and collaborators80 used MRI to evaluate iron deposition in basal ganglia and pain regulatory nuclei in neurologically HC subjects and in patients with various migraine subtypes and concluded that T2 imaging in the globus pallidus was able to distinguish between episodic and chronic migraine, suggesting that this technique may be appropriate to assess migraine frequency. These studies confirm the essential role played by several deep brain nuclei in migraine pathophysiology. In addition, the observed association between repeated migraine attacks and increased iron accumulation in deep nuclei involved in central pain processing raises the intriguing possibility that migraine has cumulative effects on brain structure and homeostasis.