Table 3 PET/SPECT studies in migraine patients with (MA) and without (MO) aura to detect an inflammatory phenotype
MO/MA studies which reported on dural uptake | |||||||
Reference | Population (MA/MO) | Modality and Tracer | Assumptions of Technique | Delay after Migraine Onset | Comparisons | Results | Comments |
Hadjikhani et al. [14] 2020 Annals of neurology | MA with visual aura N = 11 HC N = 11 Chronic lower back pain N = 11 | PET/MRI w/ 11C-PBR28 | 11C-PBR28 ligand binds to mitochondrial receptor protein on many activated cell types during inflammation. | 8 days median (0-18 range) 1 patient ictal during scan | MA with visual aura (interictally) vs. HC vs. Chronic lower back pain | • Uptake increased in MA in parameningeal tissue (meninges and skull bone) overlying occipital cortex • Uptake correlated with total episodes of visual aura in the preceding 4 weeks • Uptake unrelated to total attacks in the preceding 4 weeks | • 11C-PBR28 does not distinguish among cell types activated during inflammation • Total attack duration and intensity was not considered |
Knotkova et al. [12] 2007 Pain Medicine and Pappagallo et al. [27] 1999 Neurology (Preliminary results) | MO (spontaneous) N = 2 | SPECT w/ 99-Tc human serum albumin | 99-Tc albumin to detect disrupted BBB | 1st scan: 3 and 12 h after migraine onset 2nd scan: 3 h after 1st scan 3rd scan: Interictal | MO (ictal) vs. MO (interictal) | • Increased extravasation on the second scan at 3 h in frontotemporal and frontal regions ipsilateral to headache | • Preliminary results • Case reports |
MO/MA studies which did not report on dural uptake | |||||||
Reference | Population (MA/MO) | Modality and tracer | Assumptions of technique | Delay after migraine onset | Comparisons | Results | Comments |
Albrecht et al. [13] 2019 Neurology | MA N = 13 HC N = 16 | PET/MRI w/ 11C-PBR28 | 11C-PBR28 ligand binds to mitochondrial receptor protein on many activated cell types during inflammation, including microglia. | 8.08 ± 5.03 days (mean ± SD) | MA (interictally) vs. HC | • Uptake increased in visual cortex, thalamus, primary and secondary somatosensory cortices, posterior insular cortex, primary motor cortex, auditory cortices, regions of prefrontal cortex, orbitofrontal cortex, putamen, area MT and V3A • Uptake correlated with frequency of migraine attacks in several cortical and subcortical areas | • 11C-PBR28 does not differentiate between cell types activated during inflammation |
Schankin et al. [28] 2016 Brain | Mx N = 6 (4 MO, 2 MA) (GTN induced migraine attacks without aura) HC N = 6 | PET/CT w/ 11C-DHE | 11C-DHE to detect DHE passage of the BBB | Baseline scan and scan at 3 h after GTN infusion | Mx (Ictal) vs. Mx (interictal) HC (baseline) vs. HC (post-GTN) | • For Mx, no difference between ictal and interictal uptake • For HCs, no difference between baseline and post-GTN uptake • For all participants, uptake in choroid plexus of the lateral and 4th ventricles, pituitary fossa, venous sinus and facial tissue, and no uptake in cortical areas, brainstem, or thalamus | • Whether DHE passes a disrupted BBB is unexamined • Sample size may not have allowed detection of minor changes in BBB permeability |
Sianard-Gainko et al. [29] 1993 Cephalalgia | MO N = 7 Cluster headache N = 30 | SPECT w/ Gallium 67 citrate | Gallium 67 binds to proteins in inflammatory exudates [30]. | NA | MO (interictal)Cluster headache (interictal, chronic and episodic in active period) | • High parasellar uptake in 5/7 MO patients • High parasellar uptake similar for MO and cluster headache | • Absence of quantitative data may have overestimated uptake • No HC group |