Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case–Control Study

Background: The asymmetry of cortical veins in susceptibility weighted imaging (SWI) in MRI might be a biomarker for migraine auras and cortical spreading depression (CSD). The aim of this study was to assess in humans if SWI asymmetry can be found in patients who have migraine attacks without auras...

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Main Authors: Adrian Scutelnic, Tomas Klail, Diego Moor, Nedelina Slavova, Valentina Petroulia, Simon Jung, Mattia Branca, Urs Fischer, Franz Riederer, Roland Wiest, Christoph J. Schankin
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Neurology International
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Online Access:https://www.mdpi.com/2035-8377/17/7/104
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author Adrian Scutelnic
Tomas Klail
Diego Moor
Nedelina Slavova
Valentina Petroulia
Simon Jung
Mattia Branca
Urs Fischer
Franz Riederer
Roland Wiest
Christoph J. Schankin
author_facet Adrian Scutelnic
Tomas Klail
Diego Moor
Nedelina Slavova
Valentina Petroulia
Simon Jung
Mattia Branca
Urs Fischer
Franz Riederer
Roland Wiest
Christoph J. Schankin
author_sort Adrian Scutelnic
collection DOAJ
description Background: The asymmetry of cortical veins in susceptibility weighted imaging (SWI) in MRI might be a biomarker for migraine auras and cortical spreading depression (CSD). The aim of this study was to assess in humans if SWI asymmetry can be found in patients who have migraine attacks without auras. Methods: We included patients (<i>n</i> = 100 per group) from the emergency room setting when they (i) presented with an acute neurological deficit or headache; (ii) had a discharge diagnosis of a migraine aura, a migraine without an aura, or neither (controls without stroke or epilepsy); and (iii) had a brain MRI with SWI in the acute setting. Results: In the migraines with auras group, SWI asymmetry was found in 26% (95% CI 18–35) compared to patients with migraines without auras (3%, [95% CI 1–8], <i>p</i> < 0.001) and controls 7% [95% CI 3–14], <i>p</i> < 0.001). There was no difference between patients with migraines without auras and controls (<i>p</i> = 0.19). Conclusions: The distinct SWI changes in migraines with and without auras suggest that CSD might not be involved in the pathophysiology of migraines without auras.
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spelling doaj-art-44e556b1e30e457fb3933a6491fab9e32025-08-20T02:47:22ZengMDPI AGNeurology International2035-83772025-07-0117710410.3390/neurolint17070104Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case–Control StudyAdrian Scutelnic0Tomas Klail1Diego Moor2Nedelina Slavova3Valentina Petroulia4Simon Jung5Mattia Branca6Urs Fischer7Franz Riederer8Roland Wiest9Christoph J. Schankin10Department of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, SwitzerlandInstitute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, 3010 Bern, SwitzerlandDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, SwitzerlandDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, SwitzerlandInstitute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, 3010 Bern, SwitzerlandDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, SwitzerlandCTU Bern, University of Bern, 3012 Bern, SwitzerlandDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, SwitzerlandDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, SwitzerlandInstitute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, 3010 Bern, SwitzerlandDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, SwitzerlandBackground: The asymmetry of cortical veins in susceptibility weighted imaging (SWI) in MRI might be a biomarker for migraine auras and cortical spreading depression (CSD). The aim of this study was to assess in humans if SWI asymmetry can be found in patients who have migraine attacks without auras. Methods: We included patients (<i>n</i> = 100 per group) from the emergency room setting when they (i) presented with an acute neurological deficit or headache; (ii) had a discharge diagnosis of a migraine aura, a migraine without an aura, or neither (controls without stroke or epilepsy); and (iii) had a brain MRI with SWI in the acute setting. Results: In the migraines with auras group, SWI asymmetry was found in 26% (95% CI 18–35) compared to patients with migraines without auras (3%, [95% CI 1–8], <i>p</i> < 0.001) and controls 7% [95% CI 3–14], <i>p</i> < 0.001). There was no difference between patients with migraines without auras and controls (<i>p</i> = 0.19). Conclusions: The distinct SWI changes in migraines with and without auras suggest that CSD might not be involved in the pathophysiology of migraines without auras.https://www.mdpi.com/2035-8377/17/7/104migraineauracortical spreading depressionheadache
spellingShingle Adrian Scutelnic
Tomas Klail
Diego Moor
Nedelina Slavova
Valentina Petroulia
Simon Jung
Mattia Branca
Urs Fischer
Franz Riederer
Roland Wiest
Christoph J. Schankin
Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case–Control Study
Neurology International
migraine
aura
cortical spreading depression
headache
title Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case–Control Study
title_full Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case–Control Study
title_fullStr Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case–Control Study
title_full_unstemmed Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case–Control Study
title_short Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case–Control Study
title_sort susceptibility weighted imaging in migraines with and without aura a case control study
topic migraine
aura
cortical spreading depression
headache
url https://www.mdpi.com/2035-8377/17/7/104
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