Neuroimaging-based investigations on migraine pathophysiology recognize that migraine may clinically exist as either an episodic or chronic neurological disorder, of which headache is only one feature.

Pain processing in the central nervous system is complex and involves a synthesis of sensory-discriminative, emotional-affective and cognitive-evaluative components represented in a neural network termed the pain matrix. Further, migraine may be associated with aura referable to all lobes of the brain, in addition to autonomic symptoms. Therefore, neuroimaging biomarkers in migraine need to capture functional information elements across multiple neuroanatomic regions.

Neuroimaging research has driven major advances in the understanding of many important aspects of migraine pathophysiology, including generation, chronification, consequences and treatment.

Clinicians and researchers alike have long suspected that dynamic extra- and intracranial arterial changes are associated with migraine attacks.

Functional imaging techniques are able to capture dynamic, real-time data regarding cerebral blood flow, neuronal activity and metabolism.

The Mayo team is studying application of the following imaging techniques to study episodic and chronic migraine, both during attacks and in the attack-free state:

  • High-resolution magnetic resonance angiography (MRA)
  • Perfusion-weighted imaging (PWI)
  • Single-photon emission computerized tomography (SPECT)
  • Functional magnetic resonance imaging (fMRI)
  • Positron emission tomography (PET)
  • Diffusion-weighted imaging (DWI)
  • Blood-oxygen-level-dependent (BOLD) imaging
  • Resting state networks
  • Morphometric assessment

Major advances in the understanding of migraine pathophysiology have emerged from neuroimaging research.