::INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES::

CODEN : IAJPBB
issn 2349-7750

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TITLE:

STUDY TO DETERMINE THE ANATOMICAL ALTERATIONS IN BRAIN STEM OF PATIENTS WITH MIGRAINE

AUTHORS:

Dr Sadia Aman, Dr Khurram Shabbir, Dr Bilal Hassan

ABSTRACT:

Background: Atypical modulation of brainstem pain may contribute to the changes in sensory processing typical of migraine. The aim of the study was to investigate whether migraine is associated with structural changes in the brainstem that correlate with this altered pain processing. Place and Duration: In the Neurology and Radiology department of Holy Family Hospital, Rawalpindi for one-year duration from June 2019 to June 2020. Methods: T1-weighted MRI images of 55 migraine patients and 58 healthy controls were used to: (1) create deformable mesh models of the brainstem that enable shape analysis; (2) calculate the volume of the midbrain, pons, medulla and upper pedicels of the cerebellum; (3) examine the correlations between regional brainstem volumes, cutaneous heat pain thresholds, and symptoms of allodynia. Results: People with migraines had smaller volumes of the midbrain (healthy controls = 61.28 mm3, SD = 5.89; migraine = 58.80 mm3, SD = 6.64; p = 0.038) and significant (pb 0.05) internal deformities ventral midbrain and bridges, and external deformities of the lateral spine and dorsolateral bridge in relation to healthy subjects. In people with migraine, a negative correlation was found between the severity of ASC-12 allodynia symptoms and the volume of the midbrain (r = −0.32; p = 0.019) and a positive correlation between the thresholds of thermal cutaneous pain with the core (r = 0.337; p = 0.012) and the volume of peduncle of the cerebellum (r = 0.435; p = 0.001). Conclusion: Migraine with more symptoms of allodynia has smaller volumes of the midbrain, and migraine with a lower threshold of thermal pain has a smaller core and pedicels of the cerebellum. The brainstem likely plays a role in altered sensory processing in migraine, and the structure of the brainstem may reflect the severity of allodynia and hypersensitivity to pain in migraine. Keywords: Migraine, Magnetic resonance imaging, Brainstem, Allodynia