Clinical care may impact gray matter volume in migraine patients

(HealthDay)—Patients with migraine without prior clinical care have reduced gray matter volume (GMV) in the right dorsal medial prefrontal cortex (dMPFC) compared to those with prior care, according to a study published online Oct. 23 in The Journal of Headache and Pain.

Shana A.B. Burrowes, Ph.D., from the Boston University School of Medicine, and colleagues examined differences in GMV for migraine patients with and without prior clinical care for migraine, as determined by diagnosis by a medical practitioner or prescription of migraine-specific medication. Baseline magnetic resonance imaging and psychosocial symptom questionnaires were used from a longitudinal randomized controlled trial. Data were included for 117 patients: 23 without prior care and 94 with prior medical care, and for 36 healthy controls.

The researchers found that relative to patients who had prior care, patients without prior care had reduced GMV in the right dMPFC. Compared with healthy controls, both patient groups had reduced GMV. There was no difference observed between the patient groups for headache clinical variables. Increasing scores on stress and depression questionnaires (Perceived Stress Score and Patient Health Questionnaire) were associated with increased GMV in the dMPFC, regardless of medical care status.

"Our results provide further evidence that episodic migraine patients who are not receiving care may have an added burden associated with this lack of care even though clinically they may present the same," the authors write. "Given these findings it is clear that efforts to improve access to migraine treatment need to be expanded."

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