Investigation of the Blood-brain and Blood-dura Barrier Durin Migraine Attacks Using MRI

Study Overview
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Brief Summary
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Substudy 1 Blood-brain barrier breakdown has been proposed in migraine patients. Our hypothesis that we will test in this study is that the blood-brain barrier breaks down during migraine attacks but not out side attacks using MRI. Substudy 2 Altered cerebral resting-state functional connectivity networks have been reported in migraine patients outside migraine attacks. What happens during migraine attacks has never been investigated. The hypothesis we will test is that pain related networks are affected during spontaneous attacks using functional MRI. Substudy 3 Old studies report that cerebral blood flow (CBF) is altered in patients with migraine with aura, but not in those without aura. We hypothesize that CBF is altered regionally during attacks, which we will investigate in this study using arterial spin labeling (ASL). Substudy 4 Structural changes using voxel-based morphometry (VBM) of the brain have been suggested but never investigated during migraine attacks. Our hypothesis is that pain related structures show altered VBM during spontaneous migraine attacks.

Detailed Description
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Brain MRI during and outside migraine attacks. Up to 600 patients will be recruited, who will be given a phone number that they can call when they get migraine attacks. The study will continue until 20 patients with migraine with aura, 20 patients without aura, 20 patients with chronic migraine have completed the study.

Official Title
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Investigation of the Blood-brain and Blood-dura Barrier Durin Migraine Attacks Using MRI

Conditions
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Migraine With Aura, Migraine Without Aura, Chronic Migraine

Intervention / Treatment
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* Other: Brain MRI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of migraine with aura, migraine without aura, or chronic migraine according to the International Headache Society. written informed consent. use of anticonceptive method by women in childbearing age. Exclusion Criteria: tension type headache more than 5/month during last year. tension type headache on the experimental day. use of antimigraine medication or pain-killer on the experimental day before MRI. pregnant or breastfeeding women. contraindications against MRI. history or clinical sign of cardio- or cerebrovascular disease. untreated severe mental disorder or drug abuse. other diseases or disorders interpreted, by the examining doctor, to interfere with participation in the study. not accepting information about potential accidental finding during experiment.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Migraine with aura<br>Brain MRI | Other: Brain MRI<br>* Brain MRI with gadolinium contrast<br>|
| Migraine without aura<br>Brain MRI | Other: Brain MRI<br>* Brain MRI with gadolinium contrast<br>|
| Chronic migraine<br>Brain MRI | Other: Brain MRI<br>* Brain MRI with gadolinium contrast<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood-brain barrier alteration during migraine attacks |  | Up to 1 year | 
| Cerebral blood flow alteration during migraine attacks |  | Up to 1 year | 
| Resting-state functional brain connectivity alteration during migraine attacks |  | Up to 1 year | 
| Voxel-based morphometry alteration during migraine attacks |  | Up to 1 year |