9, and the control patients had normal brain scans with no lesions.8 Results showed significantly reduced gray matter density in the brains of the migraineurs, particularly in the cortex of the frontal and temporal lobes bilaterally. The decreased gray matter density was strongly associated with age, disease duration, and T2-visible lesion load. Rocca et al also found increased PAG matter density in the brains of the migraineurs. Kim and colleagues sought to generalize Rocca et al’s findings concerning gray matter changes in the brains of migraineurs who had T2-visible white matter lesions to migraine patients

as a whole.4 Kim et al www.selleckchem.com/products/pexidartinib-plx3397.html used voxel-based morphometry to contrast the gray matter volume of 20 patients with EM and 33 healthy controls. The patients with EM had significant reductions in gray matter volume in several regions of the brain: bilateral insula, bilateral motor/premotor cortex, bilateral prefrontal cortex, left dorsal anterior cingulate Dabrafenib manufacturer cortex, right dorsal posterior cingulate cortex, right inferior and superior parietal cortex, orbitofrontal cortex, and visual cortex. Progressive decreases in gray matter volume were noted with increasing migraine attack duration and increasing attack frequency, suggesting that repeated migraine

attacks may produce atrophic changes in the pain-processing regions of the brain. Increased iron deposition SSR128129E is another structural change detected in the brains of migraineurs (Fig. 1).5 Using high-resolution MRI, Welch et al examined the PAG matter, red nucleus, and substantia nigra of patients with EM (n = 17), patients with chronic daily headache (CDH; n = 17), and control subjects (n = 17), comparing the amount of tissue iron present as determined by

mapping transverse relaxation rates R2, R2*, and R2′.5 The PAG matter exhibited increased tissue iron levels in the patients with CDH and EM compared with control subjects, and the accumulation of iron correlated positively with the duration of illness (Fig. 1). No differences in iron concentrations were detected between migraine with and without aura. These investigators also speculated that the increased R2′ values in the EM and CDH groups indicated impaired iron homeostasis related to neuronal damage or dysfunction caused by repeated headache attacks. A 2008 population study further corroborated and extended Welch et al’s findings.9 Kruit and colleagues demonstrated that iron deposition was significantly increased in the red nucleus, putamen, and globus pallidus of migraine patients younger than age 50 years compared with control subjects.