Increased iron deposition in nucleus accumbens associated with disease progression and chronicity in migraine

Xiaopei Xu; Mengting Zhou; Xiao Wu; Fangling Zhao; Xiao Luo; Kaicheng Li; Qingze Zeng; Jiahui He; Hongrong Cheng; Xiaojun Guan; Peiyu Huang; Minming Zhang; Kaiming Liu

doi:10.1186/s12916-023-02855-1

Increased iron deposition in nucleus accumbens associated with disease progression and chronicity in migraine

BMC Med. 2023 Apr 7;21(1):136. doi: 10.1186/s12916-023-02855-1.

Authors

Xiaopei Xu^#¹, Mengting Zhou^#², Xiao Wu^#¹, Fangling Zhao², Xiao Luo¹, Kaicheng Li¹, Qingze Zeng¹, Jiahui He², Hongrong Cheng², Xiaojun Guan¹, Peiyu Huang¹, Minming Zhang³, Kaiming Liu⁴

Affiliations

¹ Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China.
² Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China.
³ Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China. zhangminming@zju.edu.cn.
⁴ Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China. 2314411@zju.edu.cn.

^# Contributed equally.

Abstract

Background: Migraine is one of the world's most prevalent and disabling diseases. Despite huge advances in neuroimaging research, more valuable neuroimaging markers are still urgently needed to provide important insights into the brain mechanisms that underlie migraine symptoms. We therefore aim to investigate the regional iron deposition in subcortical nuclei of migraineurs as compared to controls and its association with migraine-related pathophysiological assessments.

Methods: A total of 200 migraineurs (56 chronic migraine [CM], 144 episodic migraine [EM]) and 41 matched controls were recruited. All subjects underwent MRI and clinical variables including frequency/duration of migraine, intensity of migraine, 6-item Headache Impact Test (HIT-6), Migraine Disability Assessment (MIDAS), and Pittsburgh Sleep Quality Index (PSQI) were recorded. Quantitative susceptibility mapping was employed to quantify the regional iron content in subcortical regions. Associations between clinical variables and regional iron deposition were studied as well.

Results: Increased iron deposition in the putamen, caudate, and nucleus accumbens (NAC) was observed in migraineurs more than controls. Meanwhile, patients with CM had a significantly higher volume of iron deposits compared to EM in multiple subcortical nuclei, especially in NAC. Volume of iron in NAC can be used to distinguish patients with CM from EM with a sensitivity of 85.45% and specificity of 71.53%. As the most valuable neuroimaging markers in all of the subcortical nuclei, higher iron deposition in NAC was significantly associated with disease progression, and higher HIT-6, MIDAS, and PSQI.

Conclusions: These findings provide evidence that iron deposition in NAC may be a biomarker for migraine chronicity and migraine-related dysfunctions, thus may help to understand the underlying vascular and neural mechanisms of migraine.

Trial registration: ClinicalTrials.gov, number NCT04939922.

Keywords: Chronicity; Disease burden; Iron deposition; Migraine; Neuroimaging biomarkers; Nucleus accumbens.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Brain
Disease Progression
Humans
Iron
Migraine Disorders* / diagnostic imaging
Nucleus Accumbens*

Substances

Iron

Associated data

ClinicalTrials.gov/NCT04939922