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Thickening in the somatosensory cortex of patients with migraine

From Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA (A.F.M.D., C.G., J.S., N.H.); and Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA (N.H.). Dr. DaSilva is currently with the P.A.I.N. Group, Brain Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA.

Address correspondence and reprint requests to Dr. Nouchine Hadjikhani, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Bldg. 36, First St., Room 417, Charlestown, MA 02129 nouchine{at}nmr.mgh.harvard.edu

Objective: To examine morphologic changes in the somatosensory cortex (SSC) of patients with migraine.

Methods: Cortical thickness of the SSC of patients with migraine was measured in vivo and compared with age- and sex-matched healthy subjects. The cohort was composed of 24 patients with migraine, subdivided into 12 patients who had migraine with aura, 12 patients who had migraine without aura, and 12 controls. Group and individual analyses were performed in the SSC and shown as average maps of significant changes in cortical thickness.

Results: Migraineurs had on average thicker SSCs than the control group. The most significant thickness changes were noticed in the caudal SSC, where the trigeminal area, including head and face, is somatotopically represented.

Conclusions: Our findings indicate the presence of interictal structural changes in the somatosensory cortex (SSC) of migraineurs. The SSC plays a crucial role in the noxious and nonnoxious somatosensory processing. Thickening in the SSC is in line with diffusional abnormalities observed in the subcortical trigeminal somatosensory pathway of the same migraine cohort in a previous study. Repetitive migraine attacks may lead to, or be the result of, neuroplastic changes in cortical and subcortical structures of the trigeminal somatosensory system.

Abbreviations: CS = central sulcus; DTI = diffusion tensor imaging; FA = fractional anisotropy; GPoC = gyrus postcentralis; GprC = gyrus precentralis; HC = healthy control; IRB = institutional review board; MP-RAGE = magnetization-prepared rapid acquisitions with gradient echoes; MWA = migraine with aura; MWoA = migraine without aura; ROI = region of interest; SMC = sensorimotor cortex; SPoC = sulcus postcentralis; SSC = somatosensory cortex.

Supported by NIH grant 5P01 NS 35611-09 (N.H., A.F.M.D., J.S.), the Swiss Heart Foundation (C.G.), and the Dean's award of Harvard School of Dental Medicine (A.F.M.D.).

Disclosure: The authors report no conflicts of interest.

Received February 12, 2007. Accepted in final form June 3, 2007.