White matter lesions and clinical characteristics of migraine do not appear to have any effect on cortical thickness and volume of bilateral lobes in a cohort of female migraineurs, according to a study recently published in The Journal of Headache and Pain. Significant predictors included intracranial volume, which predicted cortical volume, and age, which predicted cortical volume and thickness.

This study included 161 right-handed women with migraine, 52 of whom had white matter lesions and 63 of whom had aura, as well as 40 healthy controls matched for age. No participants were on chronic prophylactic therapy despite all having recurrent headaches. there were no medical comorbidities, and no headache or aura were unilaterally side-locked. The same three 3D MRI scanners were used to scan all participants, with Freesurfer 5.3 used to perform cortical segmentation and reconstruction. The Freesurfer Desikan-Killiany-Tourville atlas was used as a basis for cortical parcellation. Segmented regions consisted of insula, occipital, temporal, parietal, and frontal lobes. Both hemispheres were included in volume and cortical thickness calculations because insular and lobar volumes/thicknesses did not vary between left and right.

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Among participants with migraine, those with white matter lesions were older compared with controls (P =.018) and lesion-free participants (P =.0003). Compared with lesion-free participants, those with white matter lesions also had longer duration of disease (P =.003), higher rate of aura (P =.0003), and greater incidence of migraine (P =.022). All 3 groups (those with and without lesions and controls) had statistically similar cortical volume and thickness of lobes, though volume and thickness in each lobe were negatively associated with age (P <.001). Regional volumes were positively associated with intracranial volume (P <.001). Interactions between group and age, group and intracranial volume, and age and intracranial volume were not significant, nor were migraine characteristics significant as cortical volume or thickness predictors. Age predicted cortical volume and thickness (P <.001), and intracranial volume predicted volume (P <.001).

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Limitations to this study included a cross-sectional study design, which limited the ability to detect smaller changes in cortical characteristics.

The study researchers concluded that “neither the lesions nor other clinical characteristics have a detectable effect on cortical thickness and volume of bilateral intracerebral lobes. Cortical thicknesses were equivalent within the range of ±0.1 mm. Only age and [intracranial volume] proved to be significant predictors; the former for both cortical thickness and volume, while the latter for cortical volume.”


Komáromy H, He M, Perlaki G, et al. Influence of hemispheric white matter lesions and migraine characteristics on cortical thickness and volume. J Headache Pain. 2019;20(1):4.