The Germans Trias i Pujol Hospital in Badalona (Barcelonès Nord) has discovered that a simple non-invasive test, a transcranial ultrasound, detects brain alterations in patients with chronic migraine.
The finding could contribute to improving the diagnosis of chronic migraine, one of the most prevalent and disabling diseases in the world that the WHO considers to be the main cause of disability between 15 and 49 years of age.
As explained by the neurologist Lola Vilas from Can Ruti, migraine is considered chronic when it is suffered at least 15 or more days a month for a minimum of three months and, although part of the pathophysiology of migraine is unknown, doctors know that is generated in different brain structures, including the nuclei of the brainstem, which is called periaqueductal gray matter. This is made up of a set of neurons that, when not altered, allow the modulation of pain and other sensory stimuli, according to Vilas.
The neurologist has specified that the precise diagnosis of migraine, especially the chronic one, is difficult since patients can suffer a non-specific headache that can lead to misdiagnosis. For this reason, finding migraine biomarkers would help improve knowledge of the disease, establish the diagnosis, and predict its progression and response to therapy.
In this sense, transcranial ultrasound, a non-invasive, innocuous and easy-to-do technique, can play an important role, according to a study prepared by the Department of Neurosciences at the Germans Trias Hospital, which has described for the first time the presence of structural changes in the periaqueductal gray matter in patients with chronic migraine.
These alterations, according to the neurologists, who have published their research in the journal ‘The Journal of Headache and Pain’, could be detected with the ultrasound test in the same hospital consultation.
The study, carried out over two years, included more than a hundred people who underwent this ultrasound, more than half of whom had chronic and episodic migraine. Thus they found that, compared to healthy volunteers and those with episodic migraine, those who suffered from it chronically presented ultrasound differences in the periaqueductal gray matter.
Vilas has highlighted that this is the first study that has evaluated the presence of brain alterations in patients with migraine using transcranial ultrasound and “it has proven to be useful in the diagnosis of other neurological diseases, since it allows the visualization of deep brain structures”.
“Therefore, extending and generalizing this test could become a biomarker for the chronicity of migraine,” indicated the neurologist. “New tools are needed to reduce the delay in the diagnosis of migraine, to facilitate the initiation of treatment in more incipient phases, and to detect predictors of response to treatments”, added Laura Dorado, also a neurologist at Can Ruti, for whom transcranial ultrasonography can be useful in diagnosing and prognosticating migraine.
