Multimodal serum and MRI signatures of neuroaxonal injury in high-frequency migraine.

IF 8.7 1区医学 Q1 CLINICAL NEUROLOGY

Journal of Headache and Pain Pub Date : 2026-05-14 DOI:10.1186/s10194-026-02392-1

Víctor J Gallardo, Edoardo Caronna, Joana Rosell-Mirmi, Laila Asskour, Deborah Pareto, Marta Torres-Ferrús, Alicia Alpuente, Eulàlia Giné-Ciprés, Nara Ikumi, Àlex Rovira, Patricia Pozo-Rosich

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引用次数: 0

Abstract

Background: It remains unclear whether high-frequency migraine is associated with objective markers of possible neuroaxonal injury and potential expression of neurodegenerative hallmarks. We compared serum and MRI biomarkers in high-frequency migraine versus healthy controls (HC) and tested whether baseline profiles predict 6-month response to erenumab.

Methods: Adults with migraine (≥ 10 monthly headache days) and age- and sex-matched healthy controls (HC) were prospectively recruited at a tertiary center in Spain (2020-2021). Serum neurofilament light (sNf-L) was measured, and susceptibility-weighted MRI (SWI; iron-related signal) and diffusion MRI (fractional anisotropy, FA) were acquired within 7 days of blood sampling; headache status on the scan day was recorded via an eDiary. Migraine participants received erenumab 140 mg monthly for 24 weeks; response was defined as a ≥ 50% reduction in monthly headache days. Mixed-effects models adjusted for demographic and clinical covariates, with modality-wise FDR correction.

Results: We included 134 participants (68 migraine, 66 HC); median migraine duration was 25.0 years. sNf-L was higher in migraine (β[SE] = 0.139[0.052]; adj.P = 0.028). In the MRI subcohort (n = 102), left rostral ACC SWI signal was higher (0.863[0.275]; adj.P = 0.027) and right cuneus FA lower (- 0.202[0.061]; adj.P = 0.017). A multivariable model including clinical and biomarker variables identified depressive symptoms as the strongest predictor, while elevated sNf-L and reduced FA in the right cuneus remained independent biomarkers distinguishing migraine from HC (Accuracy [95% CI]: 0.739 [0.516-0.898]). None of these biomarkers predicted erenumab response after 6 months.

Conclusions: High-frequency migraine was associated with higher sNf-L and focal SWI/FA differences versus HC, consistent with possible neuroaxonal involvement, but these measures did not predict erenumab response at 6 months.

Trial registration: EudraCT 2019-002224-32 (Registration Date: 2019-11-12).

查看原文本刊更多论文

高频偏头痛患者神经轴突损伤的多模态血清和MRI特征。

背景：目前尚不清楚高频偏头痛是否与可能的神经轴突损伤和神经退行性标志的潜在表达相关。我们比较了高频偏头痛患者与健康对照组（HC）的血清和MRI生物标志物，并测试了基线特征是否能预测6个月对erenumab的反应。方法：在西班牙的一个三级中心（2020-2021）前瞻性招募患有偏头痛（每月头痛天数≥10天）的成年人和年龄和性别匹配的健康对照（HC）。测量血清神经丝光（sNf-L），并在采血后7天内获得敏感性加权MRI （SWI；铁相关信号）和弥散性MRI（分数各向异性，FA）；通过记录仪记录扫描当天的头痛状况。偏头痛患者每月服用伊瑞那布140毫克，持续24周；缓解定义为每月头痛天数减少≥50%。混合效应模型对人口统计学和临床协变量进行了调整，并对模式进行了FDR校正。结果：我们纳入了134名参与者（偏头痛68名，HC 66名）；偏头痛持续时间中位数为25.0年。偏头痛患者sNf-L较高（β[SE] = 0.139[0.052]; adj.P = 0.028）。MRI亚队列（n = 102）中，左吻侧ACC SWI信号较高（0.863[0.275];adj.P = 0.027），右楔叶FA信号较低（- 0.202[0.061];adj.P = 0.017）。包括临床和生物标志物变量在内的多变量模型确定抑郁症状是最强的预测因子，而右侧锥体中sNf-L升高和FA减少仍然是区分偏头痛和HC的独立生物标志物（准确度[95% CI]: 0.739[0.516-0.898]）。这些生物标志物都不能预测6个月后的erenumab反应。结论：与HC相比，高频偏头痛与更高的sNf-L和局灶性SWI/FA差异相关，这与可能的神经轴突受损伤一致，但这些测量并不能预测6个月时的erenumab反应。试验注册：edract 2019-002224-32（注册日期：2019-11-12）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Headache and Pain 医学-临床神经学

CiteScore

11.80

自引率

13.50%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data. With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.