Susceptibility Weighted Imaging in Migraine 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 aura 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 aura....

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Published in:Neurology international Vol. 17; no. 7; p. 104
Main Authors: Scutelnic, Adrian, Klail, Tomas, Moor, Diego, Slavova, Nedelina, Petroulia, Valentina, Jung, Simon, Branca, Mattia, Fischer, Urs, Riederer, Franz, Wiest, Roland, Schankin, Christoph
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Language:English
Published: Basel MDPI AG 08.07.2025
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ISSN:2035-8377, 2035-8385, 2035-8377
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Abstract Background: The asymmetry of cortical veins in susceptibility weighted imaging (SWI) in MRI might be a biomarker for migraine aura 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 aura. Methods: We included patients (n = 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 migraine with aura group, SWI asymmetry was found in 26% (95% CI 18–35) compared to patients with migraine without aura (3%, [95% CI 1–8], p < 0.001) and controls 7% [95% CI 3–14], p < 0.001). There was no difference between patients with migraine without aura and controls (p = 0.19). Conclusions: The distinct SWI changes in migraine with and without aura suggest that CSD might not be involved in the pathophysiology of migraine without aura.
AbstractList Background: The asymmetry of cortical veins in susceptibility weighted imaging (SWI) in MRI might be a biomarker for migraine aura 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 aura. Methods: We included patients (n = 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 migraine with aura group, SWI asymmetry was found in 26% (95% CI 18–35) compared to patients with migraine without aura (3%, [95% CI 1–8], p < 0.001) and controls 7% [95% CI 3–14], p < 0.001). There was no difference between patients with migraine without aura and controls (p = 0.19). Conclusions: The distinct SWI changes in migraine with and without aura suggest that CSD might not be involved in the pathophysiology of migraine without aura.
Author Scutelnic, Adrian
Schankin, Christoph
Klail, Tomas
Slavova, Nedelina
Jung, Simon
Wiest, Roland
Branca, Mattia
Petroulia, Valentina
Fischer, Urs
Riederer, Franz
Moor, Diego
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SubjectTerms Asymmetry
Emergency medical care
Headaches
Hypotheses
Magnetic resonance imaging
Migraine
Veins & arteries
Title Susceptibility Weighted Imaging in Migraine with and Without Aura: A Case–Control Study
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