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A systematic review and meta-analysis of voxel-based morphometric studies of migraine

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Abstract

Objectives

To comprehensively summarize and meta-analyze the concurrence across voxel-based morphometric (VBM) neuroimaging studies of migraine.

Methods

Neuroimaging studies published from origin to August 1, 2021 were searched in six databases including PubMed, Web of Science, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chongqing VIP. Study selection, quality assessment, and data extraction were conducted by two independent researchers. Anisotropic effect size-signed differential map** (AES-SDM) and activation likelihood estimation (ALE) were used to perform the meta-analysis of available studies reporting whole-brain gray matter (GM) structural data in migraine patients. Clinical variables correlation analysis and migraine subgroup analysis were also conducted.

Results

40 articles were included after the strict screening, containing 1616 migraine patients and 1681 matched healthy subjects (HS) in total. Using the method of AES-SDM, migraine patients showed GM increase in the bilateral amygdala, the bilateral parahippocampus, the bilateral temporal poles, the bilateral superior temporal gyri, the left hippocampus, the right superior frontal gyrus, and the left middle temporal gyrus, as well as GM decrease in the left insula, the bilateral cerebellum (hemispheric lobule IX), the right dorsal medulla, the bilateral rolandic operculum, the right middle frontal gyrus, and the right inferior parietal gyrus. Using the method of ALE, migraine patients showed GM increase in the left parahippocampus and GM decrease in the left insula. The results of correlation analysis showed that many of these brain regions were associated with migraine headache frequency and migraine disease duration. Migraine patients in different subtypes (such as migraine without aura (MwoA), migraine with aura (MwA), episodic migraine (EM), chronic migraine (CM), vestibular migraine (VM), etc.), and in different periods (in the ictal and interictal periods) presented not entirely consistent GM alterations.

Conclusion

Migraine patients have GM alterations in multiple brain regions associated with sensation, affection, cognition, and descending modulation aspects of pain. These changes might be a consequence of repeated migraine attacks. Further studies are required to determine how these GM changes can be used to diagnose, monitor disease progression, or exploit potential therapeutic interventions for migraine patients.

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Data availability statement

The datasets analyzed in the current study are available from the corresponding authors upon reasonable request.

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Acknowledgements

The authors thank Yuke Teng and Lin Yang for their assistance and suggestions.

Funding

The study is supported by funds from National Science Fund for Distinguished Young Scholars (No. 82225050), National Natural Science Foundation of China (No. 81973958), Sichuan Province Scientific and Technological Innovation Team for Youths (No. 2019JDTD0011) and Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (No: ZYYCXTD-D-202003). The sponsors play no part in study design, data collection, management, and analysis.

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Author notes

  1. **nyue Zhang, Jun Zhou, and Mengyuan Guo have contributed equally to this work.

Authors and Affiliations

  1. The Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China

    **nyue Zhang, Jun Zhou, Shirui Cheng, Yilin Chen, Nannan Jiang, **nling Li, Shengjie Hu, Zilei Tian, Zhengjie Li & Fang Zeng

  2. Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China

    **nyue Zhang, Shirui Cheng, **nling Li, Shengjie Hu, Zilei Tian, Zhengjie Li & Fang Zeng

  3. Institute College of Integrative Medicine, Dalian Medical University, Dalian, Liaoning, China

    Mengyuan Guo

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  1. **nyue Zhang
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Contributions

ZL and FZ contributed to the study conception and design and conceived the data analysis strategy. XZ, MG, YC and XL acquired the data. XZ, JZ, MG and NJ collated and analyzed the data. XZ, JZ and MG drafted the manuscript. SC, SH, ZT, ZL and FZ discussed, read, and revised the manuscript. All authors approved the publication of this manuscript.

Corresponding authors

Correspondence to Zhengjie Li or Fang Zeng.

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The authors declare that they have no conflicts of interest.

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Zhang, X., Zhou, J., Guo, M. et al. A systematic review and meta-analysis of voxel-based morphometric studies of migraine. J Neurol 270, 152–170 (2023). https://doi.org/10.1007/s00415-022-11363-w

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  • DOI: https://doi.org/10.1007/s00415-022-11363-w

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