How About Glymphatic System Function in Patients With Migraine?

Background: There have been no studies evaluating the glymphatic system function in patients with migraine. In this study, we evaluated the alterations in glymphatic system function in patients with migraine compared to healthy controls using a diffusion tensor imaging (DTI) analysis along the perivascular space (DTI-ALPS) method. We also investigated the differences in glymphatic system function between migraine patients with and without aura using the ALPS method.Methods: We prospectively enrolled patients with migraine and healthy controls. All brain magnetic resonance imaging (MRI), including DTI, in participants, patients with migraine, and healthy controls were obtained using the same MRI scanner. We calculated the ALPS index and compared the differences in the ALPS index between patients with migraine and healthy controls, and between migraine patients with and without aura. In addition, we conducted a correlation analysis between glymphatic system function and the clinical characteristics of migraine.Results: We enrolled 92 patients with migraine and 80 healthy controls. There were no significant differences in the ALPS index between patients with migraine and healthy controls (1.655 vs. 1.713, p = 0.233), and between migraine patients with and without aura (1.690 vs. 1.645, p = 0.601). There were no significant correlations between the ALPS index and clinical characteristics of migraine, including age (r = -0.070, p = 0.507), age of onset (r = 0.066, p = 0.552), disease duration (r = -0.115, p = 0.306), attack frequency (r = -0.049, p = 0.668), and headache intensity (r = -0.003, p = 0.976).Conclusions: There was no glymphatic system dysfunction in patients with migraine. In addition, there were no differences in glymphatic system function between migraine patients with and without aura. We also demonstrated the feasibility of the ALPS method, which can be used for further research on various neurological diseases.