Patterns of gray matter alterations in migraine and restless legs syndrome

Fu Chi Yang, Kun Hsien Chou, Pei Lin Lee, Jiu Haw Yin, Shao Yuan Chen, Hung Wen Kao, Yueh Feng Sung, Chung Hsing Chou, Chia Kuang Tsai, Chia Lin Tsai, Ching Po Lin, Jiunn Tay Lee*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Objectives: Migraine and restless legs syndrome (RLS) are often comorbid and share elements of pathology; however, their neuroanatomical underpinnings are poorly understood. This study aimed to identify patterns of gray matter volume (GMV) alteration specific to and common among patients with RLS, migraine, and comorbid migraine and RLS. Methods: High-resolution T1-weighted images were acquired from 116 subjects: 27 RLS patients, 22 migraine patients, 22 patients with comorbid migraine and RLS, and 45 healthy controls. Direct group comparisons and conjunction analysis were first used to localize the distinct and shared neural signatures of migraine and RLS. We also investigated whether the shared neural signature could be replicated in an additional comorbid migraine/RLS group. Results: Compared with healthy controls, migraine patients showed GMV changes in the lateral occipital cortex, cerebellum, frontal pole, and middle frontal gyrus (MFG), and RLS patients showed GMV changes in the thalamus, middle temporal gyrus, anterior cingulate cortex, insular cortex, and MFG. In migraine, compared with RLS, GMV differences were found in the precuneus, lateral occipital and occipital fusiform cortex, superior frontal and precentral gyri, and cerebellum. Conjunction analyses for these disorders showed altered GMV in the MFG, also found in patients with comorbid migraine and RLS. The GMV of the MFG also correlated with sleep quality in patients with comorbid migraine and RLS. Interpretation: Migraine and RLS are characterized by shared and distinctive neuroanatomical characteristics, with a specific role of the MFG. These findings may be related to shared pathophysiology of these two distinct disorders.

Original languageEnglish
Pages (from-to)57-67
Number of pages11
JournalAnnals of Clinical and Translational Neurology
Issue number1
StatePublished - Jan 2019


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