Increased Brain Iron Deposition in Episodic Migraine: A Pilot Voxel-based Quantitative Susceptibility Mapping

Introduction: Although iron deposition has been identified as a significant migraine trigger, the key structures in episodic migraine (EM) remain unknown. Objective: The aim of this study is to investigate cerebral iron deposition in EM using an advanced voxel-based quantitative susceptibility mapping (QSM). Methods: A multi-echo gradient echo sequence MR was performed in 15 episodic migraine patients (EMs) and 27 normal control subjects (NCs). The reconstructed quantitative susceptibility mapping images and voxel-based analysis were performed over the entire brain. The susceptibility value of all brain regions with altered iron deposition was extracted, and the correlations between susceptibility value and clinical variables (including HAMA, HAMD, MoCA, VAS, MIDAS score, diseased duration, and headache frequency) were calculated. Results: EM patients presented increased susceptibility value in the left putamen and bilateral substantia nigra (SN) compared with NC. There was no correlation between susceptibility value and the clinical variables. Conclusion: Increased brain iron deposition in the extrapyramidal system may be a biomarker for migraine, and abnormal iron metabolism may be involved in the extrapyramidal mechanism. The QSM technique would be an optimal and simple tool for clinical practice and research in iron measurement.