Neuroimaging Studies of Migraine Without Aura

Modern neuroimaging techniques suggest that migraine is no longer considered a “sine-matter” headache. Both microstructural investigation techniques, such as diffusion tensor imaging, and those examining the macrostructure of brain gray matter in terms of volume and thickness, have yielded significant data supporting structural alterations in the migraine-affected brain. This frequently occurs in accordance with the recurrence of the migraine cycle and throughout time. The brain regions predominantly impacted are those associated with multisensory integration and nociceptive processing. The thalamus, hypothalamus, and brainstem regions, including the pons, trigeminal nucleus, and periaqueductal gray, exhibit activation and deactivation patterns, along with alterations in functional connectivity, contingent upon the migraine cycle. During the interictal phase, functional magnetic resonance imaging revealed significant engagement of neurocognitive networks that fluctuate in response to pain during a migraine episode. A multimodal morphological and functional magnetic resonance imaging methodology for investigating the migraine-affected brain, alongside enhanced phenotypic stratification of the patient and their life stages, would facilitate a deeper comprehension of migraine pathology.