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      Evidence for Plastic Processes in Migraine with Aura: A Diffusion Weighted MRI Study

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          Abstract

          Background: Formerly white matter abnormalities in a mixed group of migraine patients with and without aura were shown. Here, we aimed to explore white matter alterations in a homogeneous group of migraineurs with aura and to delineate possible relationships between white matter changes and clinical variables.

          Methods: Eighteen patients with aura, 25 migraine patients without aura and 28 controls were scanned on a 1.5T MRI scanner. Diffusivity parameters of the white matter were estimated and compared between patients’ groups and controls using whole-brain tract-based spatial statistics.

          Results: Decreased radial diffusivity ( p < 0.036) was found bilaterally in the parieto-occipital white matter, the corpus callosum, and the cingular white matter of migraine with aura (MwA) patients compared to controls. Migraine without aura (MwoA) patients showed no alteration compared to controls. MwA compared to MwoA showed increased fractional anisotropy ( p < 0.048) in the left parieto-occipital white matter. In MwA a negative correlation was found between axial diffusivity and disease duration in the left superior longitudinal fascicle (left parieto-occipital region) and in the left corticospinal tract ( p < 0.036) and with the number of the attacks in the right superior longitudinal fascicle ( p < 0.048).

          Conclusion: We showed for the first time that there are white matter microstructural differences between these two subgroups of migraine and hence it is important to handle the two groups separately in further researches. We propose that degenerative and maladaptive plastic changes coexist in the disease and the diffusion profile is a result of these processes.

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          Most cited references59

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          Training-induced brain structure changes in the elderly.

          It has been suggested that learning is associated with a transient and highly selective increase in brain gray matter in healthy young volunteers. It is not clear whether and to what extent the aging brain is still able to exhibit such structural plasticity. We built on our original study, now focusing on healthy senior citizens. We observed that elderly persons were able to learn three-ball cascade juggling, but with less proficiency compared with 20-year-old adolescents. Similar to the young group, gray-matter changes in the older brain related to skill acquisition were observed in area hMT/V5 (middle temporal area of the visual cortex). In addition, elderly volunteers who learned to juggle showed transient increases in gray matter in the hippocampus on the left side and in the nucleus accumbens bilaterally.
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            Water diffusion changes in Wallerian degeneration and their dependence on white matter architecture.

            This study investigates water diffusion changes in Wallerian degeneration. We measured indices derived from the diffusion tensor (DT) and T2-weighted signal intensities in the descending motor pathways of patients with small chronic lacunar infarcts of the posterior limb of the internal capsule on one side. We compared these measurements in the healthy and lesioned sides at different levels in the brainstem caudal to the primary lesion. We found that secondary white matter degeneration is revealed by a large reduction in diffusion anisotropy only in regions where fibers are arranged in isolated bundles of parallel fibers, such as in the cerebral peduncle. In regions where the degenerated pathway crosses other tracts, such as in the rostral pons, paradoxically there is almost no change in diffusion anisotropy, but a significant change in the measured orientation of fibers. The trace of the diffusion tensor is moderately increased in all affected regions. This allows one to differentiate secondary and primary fiber loss where the increase in trace is considerably higher. We show that DT-MRI is more sensitive than T2-weighted MRI in detecting Wallerian degeneration. Significant diffusion abnormalities are observed over the entire trajectory of the affected pathway in each patient. This finding suggests that mapping degenerated pathways noninvasively with DT-MRI is feasible. However, the interpretation of water diffusion data is complex and requires a priori information about anatomy and architecture of the pathway under investigation. In particular, our study shows that in regions where fibers cross, existing DT-MRI-based fiber tractography algorithms may lead to erroneous conclusion about brain connectivity.
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              Acquisition and voxelwise analysis of multi-subject diffusion data with tract-based spatial statistics.

              There is much interest in using magnetic resonance diffusion imaging to provide information on anatomical connectivity in the brain by measuring the diffusion of water in white matter tracts. Among the measures, the most commonly derived from diffusion data is fractional anisotropy (FA), which quantifies local tract directionality and integrity. Many multi-subject imaging studies are using FA images to localize brain changes related to development, degeneration and disease. In a recent paper, we presented a new approach, tract-based spatial statistics (TBSS), which aims to solve crucial issues of cross-subject data alignment, allowing localized cross-subject statistical analysis. This works by transforming the data from the centers of the tracts that are consistent across a study's subjects into a common space. In this protocol, we describe the MRI data acquisition and analysis protocols required for TBSS studies of localized change in brain connectivity across multiple subjects.
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                Author and article information

                Contributors
                Journal
                Front Neuroanat
                Front Neuroanat
                Front. Neuroanat.
                Frontiers in Neuroanatomy
                Frontiers Media S.A.
                1662-5129
                17 January 2018
                2017
                : 11
                : 138
                Affiliations
                [1] 1Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged , Szeged, Hungary
                [2] 2Central European Institute of Technology , Brno, Czechia
                [3] 3MTA-SZTE Neuroscience Research Group , Szeged, Hungary
                Author notes

                Edited by: Laurent Petit, Centre National de la Recherche Scientifique (CNRS), France

                Reviewed by: Filippo Brighina, Università degli Studi di Palermo, Italy; Antonio Russo, University of Campania Luigi Vanvitelli, Italy

                *Correspondence: Zsigmond T. Kincses kincses.zsigmond.tamas@ 123456med.u-szeged.hu Nikoletta Szabó, sznikol@ 123456yahoo.com
                Article
                10.3389/fnana.2017.00138
                5776127
                29387002
                1473928a-5819-4c82-a617-db92d3a06b3f
                Copyright © 2018 Szabó, Faragó, Király, Veréb, Csete, Tóth, Kocsis, Kincses, Tuka, Párdutz, Szok, Tajti, Vécsei and Kincses.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 10 September 2017
                : 26 December 2017
                Page count
                Figures: 3, Tables: 1, Equations: 0, References: 75, Pages: 7, Words: 0
                Categories
                Neuroanatomy
                Original Research

                Neurosciences
                dti,microstructure,neurodegeneration,plasticity,tbss,white matter
                Neurosciences
                dti, microstructure, neurodegeneration, plasticity, tbss, white matter

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