Table 1 Human experimental studies of BBB integrity in migraine
From: Brain barriers and their potential role in migraine pathophysiology
Study | Method | Study population | Outcomes | Limitations |
|---|---|---|---|---|
Amin et al., 2017 [10] | Gadolinium-based-DCE-MRI at rest and during spontaneous migraine attacks. Permeability assessed in five different brain regions located in the anterior, middle, and posterior cerebral area, brain stem and posterior pons. | 19 MO | No changes in BBB permeability on attack versus headache-free days. No changes in BBB permeability between pain and non-pain side. | Power of study caused a detection limit of 35% Permeability assessed using a 604 Da extremely hydrophilic molecule Median time of onset of attack to scan was 6.5 h. |
Hougaard et al. 2017 [11] | Gadolinium-based-DCE-MRI at rest and during spontaneous migraine attacks. Permeability assessed in five different brain regions located in the anterior, middle, and posterior cerebral area, brain stem and posterior pons. | 19 MA | No changes in BBB permeability on attack versus headache-free days. No changes in BBB permeability between pain and non-pain side. No difference in affected or non-affected hemispheres. | Power of study caused a detection limit of 11% Permeability assessed using a 604 Da extremely hydrophilic molecule. Median time of onset of attack to scan was 7.6 h and no patients were scanned during aura symptoms. |
Kim et al., 2019 [12] | Gadolinium-based-DCE-MRI was performed on migraine patients outside of attacks and compared with scans of healthy controls | 21 MA 14 MO 21 Healthy controls | No difference in gadolinium BBB permeability between patients and controls. Lower fractional plasma volume in left amygdala in migraine patients | Permeability assessed using a 604 Da extremely hydrophilic molecule Age of control group was not matched with migraine group Changes in amygdala cannot be directly correlated to changes in BBB integrity |
Schankin et al., 2016 [13] | PET-scan and the radioligand 11C-dihydroergotamine at rest and during GTN-induced migraine attacks. | 2 MA 4 MO 6 Heathy controls | No binding of the radioligand to brain parenchyma at rest or during GTN-induced attacks in migraineurs or healthy controls. | Limited spatial resolution of PET Permeability assessed with 11C-DHE with a molecular size of 583.7 g/mol. GTN-induced headache instead of spontaneous |