Cortical Thickness Changes in Migraine Patients Treated with Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies: A Prospective Age- and Sex-Matched Controlled Study
<b>Background:</b> Migraine is associated with structural brain abnormalities, including cortical thickness changes. Anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) are a novel therapy for migraine prevention, but their effects on cortical structures are poorl...
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2025-05-01
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| author | Soohyun Cho |
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| description | <b>Background:</b> Migraine is associated with structural brain abnormalities, including cortical thickness changes. Anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) are a novel therapy for migraine prevention, but their effects on cortical structures are poorly understood. <b>Methods:</b> In this prospective age- and sex-matched controlled study, 30 migraine patients receiving either anti-CGRP mAbs (fremanezumab) (<i>n</i> = 15) or oral preventive medications (<i>n</i> = 15) underwent 3T MRI scans before and after treatment. Treatment response was defined as a ≥50% reduction in monthly headache days after 3 months. Cortical thickness was analyzed across 46 cortical regions, comparing patients treated with anti-CGRP mAbs to those receiving oral preventive treatment, as well as responders to non-responders within the anti-CGRP group. <b>Results:</b> Cortical thickness changes did not differ significantly between the anti-CGRP and oral treatment groups. However, among patients receiving anti-CGRP mAbs, responders showed significant decreases in cortical thickness compared to non-responders, particularly in the right caudal anterior cingulate (<i>p</i> = 0.026) and left rostral middle frontal cortex (<i>p</i> = 0.007). These cortical changes correlated with treatment response to anti-CGRP mAbs (β = −0.429, 95% CI [−0.777, −0.081], <i>p</i> = 0.016 in the right caudal anterior cingulate; β = −0.224, 95% CI [−0.390, −0.057], <i>p</i> = 0.008 in the left rostral middle frontal cortex). <b>Conclusions:</b> This exploratory study, based on a small sample size, suggests that cortical thickness changes may be associated with treatment response to anti-CGRP mAbs rather than with CGRP mAb treatment itself. Further studies with larger cohorts are needed to confirm these findings. |
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| spelling | doaj-art-5309ffd0e6e141ff87f9c3e652052f3d2025-08-20T03:14:42ZengMDPI AGBiomedicines2227-90592025-05-01135115010.3390/biomedicines13051150Cortical Thickness Changes in Migraine Patients Treated with Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies: A Prospective Age- and Sex-Matched Controlled StudySoohyun Cho0Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, 712, Dongil-ro, Uijeongbu 11749, Republic of Korea<b>Background:</b> Migraine is associated with structural brain abnormalities, including cortical thickness changes. Anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) are a novel therapy for migraine prevention, but their effects on cortical structures are poorly understood. <b>Methods:</b> In this prospective age- and sex-matched controlled study, 30 migraine patients receiving either anti-CGRP mAbs (fremanezumab) (<i>n</i> = 15) or oral preventive medications (<i>n</i> = 15) underwent 3T MRI scans before and after treatment. Treatment response was defined as a ≥50% reduction in monthly headache days after 3 months. Cortical thickness was analyzed across 46 cortical regions, comparing patients treated with anti-CGRP mAbs to those receiving oral preventive treatment, as well as responders to non-responders within the anti-CGRP group. <b>Results:</b> Cortical thickness changes did not differ significantly between the anti-CGRP and oral treatment groups. However, among patients receiving anti-CGRP mAbs, responders showed significant decreases in cortical thickness compared to non-responders, particularly in the right caudal anterior cingulate (<i>p</i> = 0.026) and left rostral middle frontal cortex (<i>p</i> = 0.007). These cortical changes correlated with treatment response to anti-CGRP mAbs (β = −0.429, 95% CI [−0.777, −0.081], <i>p</i> = 0.016 in the right caudal anterior cingulate; β = −0.224, 95% CI [−0.390, −0.057], <i>p</i> = 0.008 in the left rostral middle frontal cortex). <b>Conclusions:</b> This exploratory study, based on a small sample size, suggests that cortical thickness changes may be associated with treatment response to anti-CGRP mAbs rather than with CGRP mAb treatment itself. Further studies with larger cohorts are needed to confirm these findings.https://www.mdpi.com/2227-9059/13/5/1150migrainetreatmentcortical thicknessanti-calcitonin gene-related peptide monoclonal antibodyprospective study |
| spellingShingle | Soohyun Cho Cortical Thickness Changes in Migraine Patients Treated with Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies: A Prospective Age- and Sex-Matched Controlled Study Biomedicines migraine treatment cortical thickness anti-calcitonin gene-related peptide monoclonal antibody prospective study |
| title | Cortical Thickness Changes in Migraine Patients Treated with Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies: A Prospective Age- and Sex-Matched Controlled Study |
| title_full | Cortical Thickness Changes in Migraine Patients Treated with Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies: A Prospective Age- and Sex-Matched Controlled Study |
| title_fullStr | Cortical Thickness Changes in Migraine Patients Treated with Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies: A Prospective Age- and Sex-Matched Controlled Study |
| title_full_unstemmed | Cortical Thickness Changes in Migraine Patients Treated with Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies: A Prospective Age- and Sex-Matched Controlled Study |
| title_short | Cortical Thickness Changes in Migraine Patients Treated with Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies: A Prospective Age- and Sex-Matched Controlled Study |
| title_sort | cortical thickness changes in migraine patients treated with anti calcitonin gene related peptide monoclonal antibodies a prospective age and sex matched controlled study |
| topic | migraine treatment cortical thickness anti-calcitonin gene-related peptide monoclonal antibody prospective study |
| url | https://www.mdpi.com/2227-9059/13/5/1150 |
| work_keys_str_mv | AT soohyuncho corticalthicknesschangesinmigrainepatientstreatedwithanticalcitoningenerelatedpeptidemonoclonalantibodiesaprospectiveageandsexmatchedcontrolledstudy |