@article {973, title = {Structural brain changes in patients with persistent headache after COVID-19 resolution}, journal = {Journal of Neurology}, volume = {270}, year = {2023}, pages = {13-31}, abstract = {

Headache is among the most frequently reported symptoms after resolution of COVID-19. We assessed structural brain changes using T1- and diffusion-weighted MRI processed data from 167 subjects: 40 patients who recovered from COVID-19 but suffered from persistent headache without prior history of headache (COV), 41 healthy controls, 43 patients with episodic migraine and 43 patients with chronic migraine. To evaluate gray matter and white matter changes, morphometry parameters and diffusion tensor imaging-based measures were employed, respectively. COV patients showed significant lower cortical gray matter volume and cortical thickness than healthy subjects (p\thinspace\<\thinspace0.05, false discovery rate corrected) in the inferior frontal and the fusiform cortex. Lower fractional anisotropy and higher radial diffusivity (p\thinspace\<\thinspace0.05, family-wise error corrected) were observed in COV patients compared to controls, mainly in the corpus callosum and left hemisphere. COV patients showed higher cortical volume and thickness than migraine patients in the cingulate and frontal gyri, paracentral lobule and superior temporal sulcus, lower volume in subcortical regions and lower curvature in the precuneus and cuneus. Lower diffusion metric values in COV patients compared to migraine were identified prominently in the right hemisphere. COV patients present diverse changes in the white matter and gray matter structure. White matter changes seem to be associated with impairment of fiber bundles. Besides, the gray matter changes and other white matter modifications such as axonal integrity loss seemed subtle and less pronounced than those detected in migraine, showing that persistent headache after COVID-19 resolution could be an intermediate state between normality and migraine.

}, issn = {1432-1459}, doi = {10.1007/s00415-022-11398-z}, url = {https://doi.org/10.1007/s00415-022-11398-z}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and Guerrero, {\'A}ngel L. and Rodr{\'\i}guez, Margarita and Aja-Fern{\'a}ndez, Santiago and de Luis-Garc{\'\i}a, Rodrigo} } @article {980, title = {Viability of AMURA biomarkers from single-shell diffusion MRI in clinical studies}, journal = {Frontiers in Neuroscience}, volume = {17}, year = {2023}, pages = {1106350}, abstract = {

Diffusion Tensor Imaging (DTI) is the most employed method to assess white matter properties using quantitative parameters derived from diffusion MRI, but it presents known limitations that restrict the evaluation of complex structures. The objective of this study was to validate the reliability and robustness of complementary diffusion measures extracted with a novel approach, Apparent Measures Using Reduced Acquisitions (AMURA), with a typical diffusion MRI acquisition from a clinical context in comparison with DTI with application to clinical studies. Fifty healthy controls, 51 episodic migraine and 56 chronic migraine patients underwent single-shell diffusion MRI. Four DTI-based and eight AMURA-based parameters were compared between groups with tract-based spatial statistics to establish reference results. On the other hand, following a region-based analysis, the measures were assessed for multiple subsamples with diverse reduced sample sizes and their stability was evaluated with the coefficient of quartile variation. To assess the discrimination power of the diffusion measures, we repeated the statistical comparisons with a region-based analysis employing reduced sample sizes with diverse subsets, decreasing 10 subjects per group for consecutive reductions, and using 5,001 different random subsamples. For each sample size, the stability of the diffusion descriptors was evaluated with the coefficient of quartile variation. AMURA measures showed a greater number of statistically significant differences in the reference comparisons between episodic migraine patients and controls compared to DTI. In contrast, a higher number of differences was found with DTI parameters compared to AMURA in the comparisons between both migraine groups. Regarding the assessments reducing the sample size, the AMURA parameters showed a more stable behavior than DTI, showing a lower decrease for each reduced sample size or a higher number of regions with significant differences. However, most AMURA parameters showed lower stability in relation to higher coefficient of quartile variation values than the DTI descriptors, although two AMURA measures showed similar values to DTI. For the synthetic signals, there were AMURA measures with similar quantification to DTI, while other showed similar behavior. These findings suggest that AMURA presents favorable characteristics to identify differences of specific microstructural properties between clinical groups in regions with complex fiber architecture and lower dependency on the sample size or assessing technique than DTI.

}, issn = {1662-453X}, doi = {10.3389/fnins.2023.1106350}, url = {https://www.frontiersin.org/articles/10.3389/fnins.2023.1106350}, author = {Mart{\'\i}n-Mart{\'\i}n, Carmen and {\'A}lvaro Planchuelo-G{\'o}mez and Guerrero, {\'A}ngel L. and Garc{\'\i}a-Azor{\'\i}n, David and Trist{\'a}n-Vega, Antonio and de Luis-Garc{\'\i}a, Rodrigo and Aja-Fern{\'a}ndez, Santiago} } @conference {968, title = {Long-term grey matter structural changes in the transition from chronic migraine to episodic migraine}, booktitle = {8th Congress of the European Academy of Neurology}, year = {2022}, month = {2022}, abstract = {

Background and aims: The objective was to assess grey matter longitudinal changes in patients with chronic migraine (CM) who reverse to episodic migraine (EM) compared to those who do not reverse.

Methods: High-resolution 3D brain T1-weighted Magnetic Resonance Imaging data were obtained twice from migraine patients. The first acquisition was performed immediately after the first visit to the Headache Unit, before taking preventive treatments. The second timepoint was at least three years after the first acquisition. From the longitudinal pipeline of FreeSurfer (v6.0), the mean values of cortical thickness, surface area and grey matter volume of 68 cortical, 14 subcortical regions and the cerebellum were extracted. Longitudinal changes between patients with CM and those who reversed to EM were assessed with linear
mixed-effects models, setting p\<0.05 (false discovery rate corrected) as threshold for statistical significance.

Results: 22 patients were included, and 10 of them (45.5\%) reversed to EM. No statistically significant differences of age (42.0+-9.0 years) and sex (21 women, 95.5\%) were found between patient groups. Higher statistically significant values of the three parameters in patients who reversed to EM were found in the pericalcarine, parietal, orbitofrontal cortex, and amygdala (Table 1, Figure 1). In contrast, lower values were detected in the cingulum, caudal middle frontal cortex, cerebellum, caudate nucleus and pallidum (Figure 2). In the insula, higher thickness but lower area was appreciated in patients who reversed.

Conclusion: Patients with CM who reverse to EM present distinct patterns of increased and decreased morphometric parameters propagated in the orbital frontal cortex and the cingulum, respectively.

Disclosure: Nothing to disclose.

}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Marchante-Re{\'\i}llo, Ginebra and Sierra, {\'A}lvaro and Garc{\'\i}a-Azor{\'\i}n, David and Mart{\'\i}n-Mart{\'\i}n, Carmen and de Luis-Garc{\'\i}a, Rodrigo and Aja-Fern{\'a}ndez, Santiago and Moro, Ra{\'u}l and Rodr{\'\i}guez, Margarita and Gonz{\'a}lez-Osorio, Y{\'e}sica and {\'A}ngel L. Guerrero} } @conference {967, title = {Objective measurement of pain related to cardiac surgery: a study using algometry}, booktitle = {8th Congress of the European Academy of Neurology}, year = {2022}, month = {2022}, abstract = {

Background and aims: Algometry is a safe and objective technique to quantify pain, up to now used in headache research, but to a lesser extent to assess pain related to surgery. We aimed to analyze the demographic characteristics of pain related to cardiac surgery, assessed using static algometry.

Methods: Adult patients consecutively undergoing cardiac surgery were prospectively recruited. Pressure pain thresholds (PPT) were measured in both sides of sternum manubrium, body (five measures) and xiphoid process, preoperatively and on days 1, 3 and 7 postoperatively. Linear mixed-effects models were employed to assess the longitudinal changes and results were corrected for multiple comparisons following a false discovery rate procedure.

Results: We included 70 patients (41.4\% female) with a median age of 67.5 years (range 26-85). Regarding the baseline values, PPT were significantly lower in women and patients older than 65 years. After the surgery, there was a significant reduction of PPT in all assessed regions, which was partially compensated after seven days. Moreover, postoperatively, differences associated with age disappeared and those associated with sex were almost negligible. These differences related to age and sex increased after seven days of surgery, but this difference was lower in comparison with the baseline situation (Table 1, Figure 1). Postoperative pain perception was significantly higher (lower PPT) in both sexes.

Conclusion: Pain related to cardiac surgery can be measured with algometry, mainly during first postoperative days. Differences in pain sensitivity related to age and sex decrease after surgery.

Disclosure: No conflict of interest.

}, author = {Segura-M{\'e}ndez, B{\'a}rbara and {\'A}lvaro Planchuelo-G{\'o}mez and Sierra, {\'A}lvaro and Garc{\'\i}a-Azor{\'\i}n, David and Velasco-Garc{\'\i}a, E. and Fuentes-Mart{\'\i}n, {\'A}. and S{\'a}nchez, C. and V{\'a}zquez-Alarc{\'o}n de la Lastra, I. and {\'A}ngel L. Guerrero and Carrascal, Yolanda} } @conference {941, title = {Clinical course of migraine during the COVID-19 Lockdown}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {

Objective: Previous studies have demonstrated that migraine can worsen due to stress, changes in lifestyle habits or infections. We hypothesize that changes during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine.
Methods: Retrospective survey study collecting demographic data, clinical variables related to headache (frequency), migraine (subjective worsening, frequency, and intensity), lockdown, and symptoms of post-traumatic stress from migraine patients followed-up at three Headache Units between June-July 2020.
Results: 222 subjects were included. Among them, 201/222 (90.5\%) were women, aged 42.5 +- 12.0 (mean +- SD). Subjective improvement of migraine was reported in 31/222 participants (14.0\%), while worsening in 105/222 (47.3\%) and was associated with changes in migraine triggers such as stress related to going outdoors and intake of specific foods/drinks. Intensity of attacks increased in 67/222 patients (30.2\%), and it was associated with the subjective worsening, female sex, recent insomnia, and use of acute medication during a headache. An increase in monthly days with any headache was observed in 105/222 patients (47.3\%) and was related to symptoms of post-traumatic stress, older age and living with five or more people.

Conclusion: Approximately half the migraine patients reported worsening of their usual pain during the lockdown; worsening was related to changes in triggers and the emotional impact of the lockdown.

}, url = {https://journals.sagepub.com/doi/pdf/10.1177/03331024211034005}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David and Santos-Lasaosa, Sonia and P{\'e}rez-Navarro, Mar{\'\i}a P and Odriozola-Gonz{\'a}lez, Paula and Irurtia, Mar{\'\i}a Jes{\'u}s and Quintas, Sonia and Rodrigo de Luis-Garc{\'\i}a and Ana B Gago-Veiga} } @article {952, title = {Effects of the onabotulinumtoxinA follow-up delay in migraine course during the COVID-19 lockdown}, journal = {Neurological Sciences}, volume = {42}, year = {2021}, pages = {5087-5092}, issn = {1590-3478}, doi = {10.1007/s10072-021-05180-8}, url = {https://doi.org/10.1007/s10072-021-05180-8}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David and Santos-Lasaosa, Sonia and Navarro-P{\'e}rez, Mar{\'\i}a Pilar and Odriozola-Gonz{\'a}lez, Paula and Irurtia, Mar{\'\i}a Jes{\'u}s and Quintas, Sonia and de Luis-Garc{\'\i}a, Rodrigo and Ana B Gago-Veiga} } @article {944, title = {Evaluation of the Impact of the COVID-19 Lockdown in the Clinical Course of Migraine}, journal = {Pain Medicine}, volume = {22}, year = {2021}, month = {2021}, pages = {2079-2091}, abstract = {

Objective: Previous studies have demonstrated that emotional stress, changes in lifestyle habits and infections can worsen the clinical course of migraine. We hypothesize that changes in habits and medical care during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine.

Design: Retrospective survey study collecting online responses from migraine patients followed-up by neurologists at three tertiary hospitals between June and July 2020.

Methods: We used a web-based survey that included demographic data, clinical variables related with any headache (frequency) and migraine (subjective worsening, frequency, and intensity), lockdown, and symptoms of post-traumatic stress.

Results: The response rate of the survey was 239/324 (73.8\%). The final analysis included 222 subjects. Among them, 201/222 (90.5\%) were women, aged 42.5 +- 12.0 (mean+-SD). Subjective improvement of migraine during lockdown was reported in 31/222 participants (14.0\%), while worsening in 105/222 (47.3\%) and was associated with changes in migraine triggers such as stress related to going outdoors and intake of specific foods or drinks. Intensity of attacks increased in 67/222 patients (30.2\%), and it was associated with the subjective worsening, female sex, recent insomnia, and use of acute medication during a headache. An increase in monthly days with any headache was observed in 105/222 patients (47.3\%) and was related to symptoms of post-traumatic stress, older age and living with five or more people.

Conclusions: Approximately half the migraine patients reported worsening of their usual pain during the lockdown. Worse clinical course in migraine patients was related to changes in triggers and the emotional impact of the lockdown.

}, keywords = {COVID-19, Headache, Lockdown, Migraine, SARS-CoV-2}, issn = {1526-4637}, doi = {10.1093/pm/pnaa449}, url = {https://doi.org/10.1093/pm/pnaa449}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David and Santos-Lasaosa, Sonia and Navarro-P{\'e}rez, Mar{\'\i}a Pilar and Odriozola-Gonz{\'a}lez, Paula and Irurtia, Mar{\'\i}a Jes{\'u}s and Quintas, Sonia and Rodrigo de Luis-Garc{\'\i}a and Ana B Gago-Veiga} } @conference {940, title = {Evaluation of the burden of migraine on the partners lifestyle: a multicenter study}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {

Objective: Migraine is a highly disabling disease that affects the patient{\textquoteright}s life, but its consequences on the patient{\textquoteright}s partner have been barely studied. The objective was to analyze these effects on romantic relationship, relationship with their children, friendship and work; as well as to evaluate caregiver burden and the presence of anxiety and/or depression.
Methods: Cross-sectional observational study. An online survey was filled by partners of migraine patients from five Spanish Headache Units. Questions about the four assessed areas and two scales to evaluate anxiety, depression and caregiver burden (Hospital Anxiety and Depression Scale and Zarit scale) were included. The presence of anxiety and depression was compared to the Spanish prevalence (6.7\% in both cases).
Results: Out of 176 registered responses, 155 were accepted. The sample included 86.5\% of women, with mean age 44.2 +- 10.4 years. Effects on partners were found on love relationship and items concerning children and friendships, with a minor impact at work. Partners showed a significant moderate burden according to the Zarit scale (p = 12/155 = 0.077 [0.041-0.131]; p \< 0.001) and a higher anxiety rate than the 6.7\% national prevalence (p = 23/155 = 0.148 [0.096-0.214]; p \< 0.001), but similar depression rate.
Conclusion: We found an impact on the patient{\textquoteright}s partners on the studied areas. Migraine is a disease that implies caregiver burden in the patient{\textquoteright}s environment with possible effect on anxiety levels.

}, url = {https://journals.sagepub.com/doi/pdf/10.1177/03331024211034005}, author = {Fern{\'a}ndez-Bermejo, Eva M and {\'A}lvaro Planchuelo-G{\'o}mez and Quintas, Sonia and Gonzalez-Martinez, Alicia and Garc{\'\i}a-Azor{\'\i}n, David and Sierra, {\'A}lvaro and {\'A}ngel L. Guerrero and Santos-Lasaosa, Sonia and Navarro-P{\'e}rez, Mar{\'\i}a P and Gonz{\'a}lez-Garc{\'\i}a, Nuria and D{\'\i}az-de-Ter{\'a}n, Javier and Ana B Gago-Veiga} } @conference {937, title = {Gray matter cortical changes in patients with persistent headache after COVID-19 infection: an exploratory study}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {

Objective: To evaluate gray matter alterations in patients with persistent headache after COVID-19 resolution.
Methods: Exploratory case-control study. Highresolution 3D brain T1-weighted Magnetic Resonance Imaging data were acquired in patients with persistent
headache after COVID-19 infection and healthy controls (HC). FreeSurfer (version 6.0) was employed to segment the T1-weighted images and extract the mean values of the cortical curvature (CC) and thickness (CT), surface area (SA) and gray matter volume (GMV) of 68 cortical regions. GMV comparisons were adjusted for intracranial volume. Significant results were considered with p \< 0.05 (False Discovery Rate corrected).
Results: Ten patients with persistent headache after COVID-19 (mean age: 53.8 +- 7.8 years; nine women) and 10 HC balanced for age and sex (mean age: 53.1 +- 7.0 years; nine women) were included in the study. Significant higher mean SA and GMV values were found in patients with persistent headache compared to HC in the bilateral medial orbitofrontal cortex, left rostral middle frontal gyrus, and right pars opercularis and superior frontal gyrus. In the patients, significant higher GMV in the right caudal anterior cingulate gyrus and SA values in five temporal, frontal and parietal regions were observed. No CC or CT changes were found.
Conclusions: Persistent headache after COVID-19 infection is related to gray matter cortical changes defined by higher GMV and SA values mainly localized in frontal regions.

}, url = {https://journals.sagepub.com/doi/pdf/10.1177/03331024211034005}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Santiago Aja-Fern{\'a}ndez and Rodr{\'\i}guez, Margarita and Moro, Ra{\'u}l and Rodrigo de Luis-Garc{\'\i}a} } @conference {942, title = {Has onabotulinumtoxinA follow-up delay during COVID-19 lockdown affected the migraine course?}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {

Objective: During the COVID-19 pandemic face-to-face procedures have been postponed. We aim to evaluate the impact of onabotulinumtoxinA follow-up delay in migraine during COVID-19 pandemic.
Methods: Subjective worsening, intensity of migraine attacks and frequency of headache and migraine were retrospectively compared between patients with unmodified and interrupted onabotulinumtoxinA follow-up in Headache Units.
Results: We included 67 patients with chronic migraine or high-frequency episodic migraine under onabotulinumtoxinA treatment, 65 (97.0\%) female,
44.5 +- 12.1 years old. Treatment administration was voluntarily delayed in 14 (20.9\%) patients and nine (13.4\%) were unable to continue follow-up. Patients with uninterrupted follow-up during lockdown presented 8.4 and 8.1 less monthly days with headache (adjusted p = 0.011) and migraine attacks (adjusted p = 0.009) compared to patients whose follow-up was interrupted, respectively.
Conclusion: Involuntary delay of onabotulinumtoxinA follow-up in patients with migraine due to COVID-19 pandemic was associated with a higher frequency of headache and migraine attacks. Safe administration of onabotulinumtoxinA during lockdown should be promoted.

}, url = {https://journals.sagepub.com/doi/pdf/10.1177/03331024211034005}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David and Santos-Lasaosa, Sonia and Navarro-P{\'e}rez, Mar{\'\i}a P and Odriozola-Gonz{\'a}lez, Paula and Irurtia, Mar{\'\i}a Jes{\'u}s and Quintas, Sonia and Rodrigo de Luis-Garc{\'\i}a and Ana B Gago-Veiga} } @article {907, title = {Multimodal fusion analysis of structural connectivity and gray matter morphology in migraine}, journal = {Human Brain Mapping}, volume = {42}, year = {2021}, pages = {908-921}, abstract = {

No specific migraine biomarkers have been found in single-modality MRI studies. We aimed at establishing biomarkers for episodic and chronic migraine using diverse MRI modalities. We employed canonical correlation analysis and joint independent component analysis to find structural connectivity abnormalities that are related to gray matter morphometric alterations. The number of streamlines (trajectories of estimated fiber-tracts from tractography) was employed as structural connectivity measure, while cortical curvature, thickness, surface area, and volume were used as gray matter parameters. These parameters were compared between 56 chronic and 54 episodic migraine patients, and 50 healthy controls. Cortical curvature alterations were associated with abnormalities in the streamline count in episodic migraine patients compared to controls, with higher curvature values in the frontal and temporal poles being related to a higher streamline count. Lower streamline count was found in migraine compared to controls in connections between cortical regions within each of the four lobes. Higher streamline count was found in migraine in connections between subcortical regions, the insula, and the cingulate and orbitofrontal cortex, and between the insula and the temporal region. The connections between the caudate nucleus and the orbitofrontal cortex presented worse connectivity in chronic compared to episodic migraine. The hippocampus was involved in connections with higher and lower number of streamlines in chronic migraine. Strengthening of structural networks involving pain processing and subcortical regions coexists in migraine with weakening of cortical networks within each lobe. The multimodal analysis offers a new insight about the association between brain structure and connectivity.

}, keywords = {Brain, Magnetic Resonance Imaging, connectome, diffusion magnetic resonance imaging, migraine disorders}, doi = {https://doi.org/10.1002/hbm.25267}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/hbm.25267}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Santiago Aja-Fern{\'a}ndez and Rodr{\'\i}guez, Margarita and Rodrigo de Luis-Garc{\'\i}a} } @article {909, title = {Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study}, journal = {Scientific Reports}, volume = {11}, year = {2021}, pages = {3846}, abstract = {

To date, two randomized, controlled studies support the use of candesartan for migraine prophylaxis but with limited external validity. We aim to evaluate the effectiveness and tolerability of candesartan in clinical practice and to explore predictors of patient response. Retrospective cohort study including all patients with migraine who received candesartan between April 2008-February 2019. The primary endpoint was the number of monthly headache days during weeks 8{\textendash}12 of treatment compared to baseline. Additionally, we evaluated the frequency during weeks 20{\textendash}24. We analysed the percentage of patients with 50\% and 75\% response rates and the retention rates after three and 6\ months of treatment. 120/4121 patients were eligible, aged 45.9 [11.5]; 100 (83.3\%) female. Eighty-four patients (70\%) had chronic migraine and 53 (42.7\%) had medication-overuse headache. The median number of prior prophylactics was 3 (Inter-quartile range 2{\textendash}5). At baseline, patients had 20.5 {\textpm} 8.5 headache days per month, decreasing 4.3 {\textpm} 8.4\ days by 3\ months (weeks 12{\textendash}16) and by 4.7 {\textpm} 8.7\ days by 6\ months (paired Student{\textquoteright}s t-test, p \< 0.001). The percentage of patients with a 50\% response was 32.5\% at 3\ months and 31.7\% at 6\ months, while the retention rate was 85.0\% and 58.3\%. The number of prior treatments (Odds ratio 0.79, 95\% CI 0.64{\textendash}0.97) and the presence of daily headache (Odds ratio 0.39, 95\% CI 0.16{\textendash}0.97) were associated with a lower probability of response. Candesartan showed beneficial effects in the preventive treatment of migraine in clinical practice, including patients with chronic migraine, medication-overuse headache and resistance to prior prophylactics.

}, issn = {2045-2322}, doi = {10.1038/s41598-021-83508-2}, url = {https://doi.org/10.1038/s41598-021-83508-2}, author = {S{\'a}nchez-Rodr{\'\i}guez, Carmen and Sierra, {\'A}lvaro and {\'A}lvaro Planchuelo-G{\'o}mez and Mart{\'\i}nez-P{\'\i}as, Enrique and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David} } @conference {939, title = {Resting-state functional alterations in patients with persistent headache after COVID-19 infection: an exploratory study}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {

Objective: To evaluate resting-state functional alterations in patients with persistent headache after COVID-19 resolution.
Methods: Exploratory case-control study. Highresolution brain resting-state functional Magnetic Resonance Imaging data were acquired in patients with
persistent headache after COVID-19 infection and healthy controls (HC). CONN toolbox (version 17) was employed to assess the resting-state functional connectivity between 84 cortical and subcortical gray matter regions of interest. Significant results were considered with p \< 0.05 (Family Discovery Rate and seed-level corrected).
Results: Ten patients with persistent headache after COVID-19 (mean age: 53.8 +- 7.8 years; nine women) and 10 HC balanced for age and sex (mean age: 51.9 +- 6.6 years; nine women) were included in the study. Statistically significant higher functional connectivity was observed in the patients with persistent headache compared to HC in 10 connections. These connections were composed of an occipital region and another region that included the isthmus cingulate gyrus, a frontal or a parietal area. In the patients, significant lower functional connectivity was found in 12 connections between the cingulate and hippocampal gyri, parietal, temporal and frontal regions.
Conclusions: Patients with persistent headache after COVID-19 infection present strengthened functional connectivity with occipital regions and weakened functional connectivity between frontal, temporal and parietal regions.

}, url = {https://journals.sagepub.com/doi/pdf/10.1177/03331024211034005}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Santiago Aja-Fern{\'a}ndez and Rodr{\'\i}guez, Margarita and Moro, Ra{\'u}l and Rodrigo de Luis-Garc{\'\i}a} } @article {924, title = {Temporal distribution of emergency room visits in patients with migraine and other headaches}, journal = {Expert Review of Neurotherapeutics}, volume = {21}, year = {2021}, pages = {599-605}, abstract = {

Background: Headache is a leading reason for presentation to the emergency department (ED) with migraine being the most frequently headache. To ensure the adequate staffing of healthcare providers during peak times of headache visits, we analyzed the temporal distribution of emergency department visits in patients presenting with headache and/or migraine.

Research design and methods: The authors conducted an ecological study, including all consecutive visits to the ED for headache. Patients were classified according to the IHS Classification. We analyzed circadian, circaseptan and circannual patterns for number of visits, comparing migraine patients with other headache patients.

Results: There were 2132 ED visits for headache, including primary headache in 1367 (64.1\%) cases; migraine in 963 (45.2\%); secondary headache in 404 (18.9\%); and unspecified headache in 366 (17.1\%). The circadian pattern showed peaks around 11:00{\textendash}13:00 and 17:00{\textendash}19:00, with visits during the night shift 45\% less frequent (p \< 0.001). The circaseptan pattern showed a peak on Monday-Tuesday and a low point on Sunday (p \< 0.007). The circannual pattern peaked in March and decreased in June.

Conclusions: ED visits for headache showed specific circadian, circaseptan and circannual variations. No differences were found in these patterns when comparing migraine patients to other headache patients.

}, doi = {10.1080/14737175.2021.1906222}, url = {https://doi.org/10.1080/14737175.2021.1906222}, author = {Garc{\'\i}a-Azor{\'\i}n, David and Abelaira-Freire, Jaime and Rodriguez-Adrada, Esther and Gonz{\'a}lez-Garc{\'\i}a, Nuria and {\'A}lvaro Planchuelo-G{\'o}mez and {\'A}ngel L. Guerrero and Porta-Etessam, Jes{\'u}s and Mart{\'\i}n-S{\'a}nchez, Francisco J} } @conference {938, title = {White matter microstructural alterations in patients with persistent headache after COVID-19 infection: an exploratory study}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {

Objective: To evaluate white matter alterations in patients with persistent headache after COVID-19 resolution.
Methods: Exploratory case-control study. Highresolution brain diffusion Magnetic Resonance Imaging data were acquired in patients with persistent headache after COVID-19 infection and healthy controls (HC). Tract-Based Spatial Statistics was used to compare fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), radial diffusivity (RD) and the return-to-axial (RTAP), return-to-origin (RTOP) and return-to-plane probability (RTPP) between the groups. RTAP, RTOP and RTPP were obtained with a new approach called AMURA (https://www.lpi.tel.uva.es/AMURA). Significant results were considered with p \< 0.05 (Family-Wise Error corrected) and region size larger than 30 mm3.
Results: Ten patients with persistent headache after COVID-19 (mean age: 53.8 +- 7.8 years; nine women) and 10 HC balanced for age and sex (mean age: 53.1 +- 7.0 years; nine women) were included in the study. Significant higher AD and lower RTPP values were found in patients with persistent headache compared to HC in five regions from the corona radiata, and the external and internal capsule. In the patients, significant lower RTPP values were identified in six additional areas from the same tracts and the superior longitudinal fasciculus. No additional changes were found.
Conclusions: White matter axonal alterations are present in patients with persistent headache after COVID-19 infection.

}, url = {https://journals.sagepub.com/doi/pdf/10.1177/03331024211034005}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Santiago Aja-Fern{\'a}ndez and Rodr{\'\i}guez, Margarita and Moro, Ra{\'u}l and Rodrigo de Luis-Garc{\'\i}a} } @proceedings {856, title = {AMURA with standard single-shell acquisition can detect changes beyond the Diffusion Tensor: a migraine clinical study}, volume = {4549}, year = {2020}, month = {2020}, abstract = {AMURA (Apparent Measures Using Reduced Acquisitions) is an alternative formulation to drastically reduce the number of samples needed for the estimation of diffusion properties related to the Ensemble Average diffusion Propagator (EAP). Although these measures were initially intended for medium-to-high b-values, in this work we evaluate their performance in DTI-like acquisitions. Fifty healthy controls, 54 episodic migraine (EM) and 56 chronic migraine (CM) patients were compared, using a single-shell diffusion scheme at b=1000 s/mm2. We compare AMURA measures (return-to-origin, return-to-axis and return-to-plane probabilities) to traditional DTI measures. Differences between EM and controls were only detectable using the return-to-origin probability.}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Rodrigo de Luis-Garc{\'\i}a and Antonio Trist{\'a}n-Vega and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Santiago Aja-Fern{\'a}ndez} } @article {891, title = {Alternative Microstructural Measures to Complement Diffusion Tensor Imaging in Migraine Studies with Standard MRI Acquisition}, journal = {Brain Sciences}, volume = {10}, year = {2020}, month = {2020}, pages = {711}, abstract = {The white matter state in migraine has been investigated using diffusion tensor imaging (DTI) measures, but results using this technique are conflicting. To overcome DTI measures, we employed ensemble average diffusion propagator measures obtained with apparent measures using reduced acquisitions (AMURA). The AMURA measures were return-to-axis (RTAP), return-to-origin (RTOP) and return-to-plane probabilities (RTPP). Tract-based spatial statistics was used to compare fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity from DTI, and RTAP, RTOP and RTPP, between healthy controls, episodic migraine and chronic migraine patients. Fifty healthy controls, 54 patients with episodic migraine and 56 with chronic migraine were assessed. Significant differences were found between both types of migraine, with lower axial diffusivity values in 38 white matter regions and higher RTOP values in the middle cerebellar peduncle in patients with a chronic migraine (p \< 0.05 family-wise error corrected). Significantly lower RTPP values were found in episodic migraine patients compared to healthy controls in 24 white matter regions (p \< 0.05 family-wise error corrected), finding no significant differences using DTI measures. The white matter microstructure is altered in a migraine, and in chronic compared to episodic migraine. AMURA can provide additional results with respect to DTI to uncover white matter alterations in migraine.}, issn = {2076-3425}, doi = {10.3390/brainsci10100711}, url = {https://www.mdpi.com/2076-3425/10/10/711}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Rodrigo de Luis-Garc{\'\i}a and Rodr{\'\i}guez, Margarita and Santiago Aja-Fern{\'a}ndez} } @article {904, title = {Deep Phenotyping of Headache in Hospitalized COVID-19 Patients via Principal Component Analysis}, journal = {Frontiers in Neurology}, volume = {11}, year = {2020}, pages = {1751}, abstract = {

Objectives: Headache is a common symptom in systemic infections, and one of the symptoms of the novel coronavirus disease 2019 (COVID-19). The objective of this study was to characterize the phenotype of COVID-19 headache via machine learning.Methods: We performed a cross-sectional study nested in a retrospective cohort. Hospitalized patients with COVID-19 confirmed diagnosis who described headache were included in the study. Generalized Linear Models and Principal Component Analysis were employed to detect associations between intensity and self-reported disability caused by headache, quality and topography of headache, migraine features, COVID-19 symptoms, and results from laboratory tests.Results: One hundred and six patients were included in the study, with a mean age of 56.6 {\textpm} 11.2, including 68 (64.2\%) females. Higher intensity and/or disability caused by headache were associated with female sex, fever, abnormal platelet count and leukocytosis, as well as migraine symptoms such as aggravation by physical activity, pulsating pain, and simultaneous photophobia and phonophobia. Pain in the frontal area (83.0\% of the sample), pulsating quality, higher intensity of pain, and presence of nausea were related to lymphopenia. Pressing pain and lack of aggravation by routine physical activity were linked to low C-reactive protein and procalcitonin levels.Conclusion: Intensity and disability caused by headache attributed to COVID-19 are associated with the disease state and symptoms. Two distinct headache phenotypes were observed in relation with COVID-19 status. One phenotype seems to associate migraine symptoms with hematologic and inflammatory biomarkers of severe COVID-19; while another phenotype would link tension-type headache symptoms to milder COVID-19.

}, issn = {1664-2295}, doi = {10.3389/fneur.2020.583870}, url = {https://www.frontiersin.org/article/10.3389/fneur.2020.583870}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Trigo, Javier and Rodrigo de Luis-Garc{\'\i}a and {\'A}ngel L. Guerrero and Porta-Etessam, Jes{\'u}s and Garc{\'\i}a-Azor{\'\i}n, David} } @article {887, title = {Factors associated with the presence of headache in hospitalized COVID-19 patients and impact on prognosis: a retrospective cohort study}, journal = {The Journal of Headache and Pain}, volume = {21}, year = {2020}, month = {Jul}, pages = {94}, abstract = {Headache is one of the most frequent neurologic manifestations in COVID-19. We aimed to analyze which symptoms and laboratory abnormalities were associated with the presence of headache and to evaluate if patients with headache had a higher adjusted in-hospital risk of mortality.}, issn = {1129-2377}, doi = {10.1186/s10194-020-01165-8}, url = {https://doi.org/10.1186/s10194-020-01165-8}, author = {Trigo, Javier and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}lvaro Planchuelo-G{\'o}mez and Mart{\'\i}nez-P{\'\i}as, Enrique and Talavera, Blanca and Hern{\'a}ndez-P{\'e}rez, Isabel and Valle-Pe{\~n}acoba, Gonzalo and Sim{\'o}n-Campo, Paula and de Lera, Mercedes and Chavarr{\'\i}a-Miranda, Alba and L{\'o}pez-Sanz, Cristina and Guti{\'e}rrez-S{\'a}nchez, Mar{\'\i}a and Mart{\'\i}nez-Velasco, Elena and Pedraza, Mar{\'\i}a and Sierra, {\'A}lvaro and G{\'o}mez-Vicente, Beatriz and Juan F Arenillas and {\'A}ngel L. Guerrero} } @proceedings {857, title = {Fewer number of gradient directions in diffusion MRI can be counterbalanced with higher sample size: a migraine clinical study}, volume = {4550}, year = {2020}, month = {2020}, abstract = {The effect of changes in the acquisition parameters on Diffusion Tensor Imaging (DTI) has been studied, but for very specific situations. A whole-brain comparison of 54 episodic migraine (EM) and 56 chronic migraine (CM) patients, using diffusion schemes of 61, 40 and 21 gradient orientations, was performed. Statistical comparisons were repeated reducing the sample size until no significant differences were found. Higher number of regions with significant lower axial diffusivity in CM compared to EM were found using 61 gradient directions. With a larger sample size, results with 40 and 21 directions were equivalent to results acquired with 61 directions.}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Santiago Aja-Fern{\'a}ndez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Rodrigo de Luis-Garc{\'\i}a} } @article {892, title = {Gray Matter Structural Alterations in Chronic and Episodic Migraine: A Morphometric Magnetic Resonance Imaging Study}, journal = {Pain Medicine}, volume = {21}, year = {2020}, pages = {2997-3011}, abstract = {

This study evaluates different parameters describing the gray matter structure to analyze differences between healthy controls, patients with episodic migraine, and patients with chronic migraine.Cohort study.Spanish community.Fifty-two healthy controls, 57 episodic migraine patients, and 57 chronic migraine patients were included in the study and underwent T1-weighted magnetic resonance imaging acquisition.Eighty-four cortical and subcortical gray matter regions were extracted, and gray matter volume, cortical curvature, thickness, and surface area values were computed (where applicable). Correlation analysis between clinical features and structural parameters was performed.Statistically significant differences were found between all three groups, generally consisting of increases in cortical curvature and decreases in gray matter volume, cortical thickness, and surface area in migraineurs with respect to healthy controls. Furthermore, differences were also found between chronic and episodic migraine. Significant correlations were found between duration of migraine history and several structural parameters.Migraine is associated with structural alterations in widespread gray matter regions of the brain. Moreover, the results suggest that the pattern of differences between healthy controls and episodic migraine patients is qualitatively different from that occurring between episodic and chronic migraine patients.

}, issn = {1526-2375}, doi = {10.1093/pm/pnaa271}, url = {https://doi.org/10.1093/pm/pnaa271}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Rodr{\'\i}guez, Margarita and Santiago Aja-Fern{\'a}ndez and Rodrigo de Luis-Garc{\'\i}a} } @article {888, title = {Phenotypic characterization of acute headache attributed to SARS-CoV-2: An ICHD-3 validation study on 106 hospitalized patients}, journal = {Cephalalgia}, volume = {40}, year = {2020}, month = {2020}, pages = {1432-1442}, abstract = {Introduction: Headache is a common symptom of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this study, we aimed to characterize the phenotype of headache attributed to SARS-CoV-2 infection and to test the International Classification of Headache Disorders (ICHD-3) phenotypic criteria for migraine and tension-type headache. Methods: The study design was a cross-sectional study nested in a cohort. We screened all consecutive patients that were hospitalized and had a positive SARS-CoV-2 test. We included patients that described headache if the headache was not better explained by another ICHD-3 diagnosis. Patients were interviewed by two neurologists. Results: We screened 580 patients and included 130 (mean age 56 years, 64\% female). Headache was the first symptom of the infection in 26\% of patients and appeared within 24 hours in 62\% of patients. The headache was bilateral in 85\%, frontal in 83\%, and with pressing quality in 75\% of patients. Mean intensity was 7.1, being severe in 64\%. Hypersensitivity to stimuli occurred in 57\% of patients. ICHD-3 criteria for headache attributed to systemic viral infection were fulfilled by 94\% of patients; phenotypic criteria for migraine were fulfilled by 25\% of patients, and tension-type headache criteria by 54\% of patients. Conclusion: Headache attributed to SARS-CoV-2 infection in hospitalized patients has severe intensity, frontal predominance and oppressive quality. It occurs early in the course of the disease. Most patients fulfilled ICHD-3 criteria for headache attributed to systemic viral infection; however, the phenotype might resemble migraine in a quarter of cases and tension-type headache in half of the patients.}, issn = {0333-1024}, doi = {10.1177/0333102420965146}, url = {https://doi.org/10.1177/0333102420965146}, author = {Trigo L{\'o}pez, Javier and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Iglesias, Cristina and Due{\~n}as-Guti{\'e}rrez, Carlos and {\'A}ngel L. Guerrero} } @article {903, title = {Response prediction for chronic migraine preventive treatment by gray matter morphometry in magnetic resonance imaging: a pilot study}, journal = {Revista de Neurologia}, volume = {71}, year = {2020}, pages = {399-406}, doi = {10.33588/rn.7111.2020488}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Santiago Aja-Fern{\'a}ndez and Ant{\'o}n-Juarros, Saray and Rodrigo de Luis-Garc{\'\i}a} } @article {826, title = {Structural connectivity alterations in chronic and episodic migraine: A diffusion magnetic resonance imaging connectomics study}, journal = {Cephalalgia}, volume = {40}, year = {2020}, pages = {367-383}, abstract = {

OBJECTIVE:

To identify possible structural connectivity alterations in patients with episodic and chronic migraine using magnetic resonance imaging data.

METHODS:

Fifty-four episodic migraine, 56 chronic migraine patients and 50 controls underwent T1-weighted and diffusion-weighted magnetic resonance imaging acquisitions. Number of streamlines (trajectories of estimated fiber-tracts), mean fractional anisotropy, axial diffusivity and radial diffusivity were the connectome measures. Correlation analysis between connectome measures and duration and frequency of migraine was performed.

RESULTS:

Higher and lower number of streamlines were found in connections involving regions like the superior frontal gyrus when comparing episodic and chronic migraineurs with controls (p \< .05 false discovery rate). Between the left caudal anterior cingulate and right superior frontal gyri, more streamlines were found in chronic compared to episodic migraine. Higher and lower fractional anisotropy, axial diffusivity, and radial diffusivity were found between migraine groups and controls in connections involving regions like the hippocampus. Lower radial diffusivity and axial diffusivity were found in chronic compared to episodic migraine in connections involving regions like the putamen. In chronic migraine, duration of migraine was positively correlated with fractional anisotropy and axial diffusivity.

CONCLUSIONS:

Structural strengthening of connections involving subcortical regions associated with pain processing and weakening in connections involving cortical regions associated with hyperexcitability may coexist in migraine

}, keywords = {Magnetic resonance imaging (MRI), Migraine, chronic migraine, connectomics, diffusion-weighted imaging, tractography}, doi = {10.1177/0333102419885392}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Santiago Aja-Fern{\'a}ndez and Rodr{\'\i}guez, Margarita and Rodrigo de Luis-Garc{\'\i}a} } @article {837, title = {White matter changes in chronic and episodic migraine: a diffusion tensor imaging study}, journal = {The Journal of Headache and Pain}, volume = {21}, year = {2020}, pages = {1}, chapter = {1}, abstract = {

BACKGROUND:

White matter alterations have been observed in patients with migraine. However, no microstructural white matter alterations have been found particularly in episodic or chronic migraine patients, and there is limited research focused on the comparison between these two groups of migraine patients.

METHODS:

Fifty-one healthy controls, 55 episodic migraine patients and 57 chronic migraine patients were recruited and underwent brain T1-weighted and diffusion-weighted MRI acquisition. Using Tract-Based Spatial Statistics (TBSS), fractional anisotropy, mean diffusivity, radial diffusivity and axial diffusivity were compared between the different groups. On the one hand, all migraine patients were compared against healthy controls. On the other hand, patients from each migraine group were compared between them and also against healthy controls. Correlation analysis between clinical features (duration of migraine in years, time from onset of chronic migraine in months, where applicable, and headache and migraine frequency, where applicable) and Diffusion Tensor Imaging measures was performed.

RESULTS:

Fifty healthy controls, 54 episodic migraine and 56 chronic migraine patients were finally included in the analysis. Significant decreased axial diffusivity (p \< .05 false discovery rate and by number of contrasts corrected) was found in chronic migraine compared to episodic migraine in 38 white matter regions from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas. Significant positive correlation was found between time from onset of chronic migraine and mean fractional anisotropy in the bilateral external capsule, and negative correlation between time from onset of chronic migraine and mean radial diffusivity in the bilateral external capsule.

CONCLUSIONS:

These findings suggest global white matter structural differences between episodic migraine and chronic migraine. Patients with chronic migraine could present axonal integrity impairment in the first months of chronic migraine with respect to episodic migraine patients. White matter changes after the onset of chronic migraine might reflect a set of maladaptive plastic changes.

}, keywords = {Diffusion tensor imaging, Magnetic resonance imaging (MRI), Migraine, Tract-based spatial statistics, chronic migraine}, doi = {10.1186/s10194-019-1071-3}, url = {https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1071-3}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Santiago Aja-Fern{\'a}ndez and Rodr{\'\i}guez, Margarita and Rodrigo de Luis-Garc{\'\i}a} } @conference {821, title = {White Matter Alterations in Chronic Migraine: A Diffusion Tensor Imaging and Structural Connectivity Study}, booktitle = {19th International Headache Congress International Headache Society}, year = {2019}, month = {2019}, publisher = {Cephalalgia}, organization = {Cephalalgia}, address = {Dublin, Ireland}, abstract = {

Objective: White matter alterations have been observed in patients with migraine. However, no microstructural white matter alterations have been found particularly in Episodic Migraine (EM) with respect to Chronic Migraine (CM) patients. In this study, we investigated whether there are significant differences between EM and CM, and between these groups and healthy controls, using diffusion Magnetic Resonance Imaging (dMRI) data.
Methods: We acquired high-resolution 3D brain T1-weighted and dMRI from 51 Healthy Controls (HC), 55 EM patients and 57 CM patients. Using Tract-Based Spatial Statistics, we compared Fractional Anisotropy (FA), Mean Diffusivity (MD), Radial Diffusivity (RD) and Axial Diffusivity (AD) between the different groups. We also obtained structural connectome matrices for each subject employing both dMRI and T1-weighted acquisitions. Number of streamlines, mean FA and mean AD for each white matter connection were compared between the three groups.
Results: Significant decreased AD (p \<.05 Family Wise Error corrected and volume \>30 mm3) were found in CM compared to EM in 38 white matter regions. Significant differences in the number of streamlines were found in 18 connections from the connectome when comparing migraine patients with healthy controls (p \<.05 False Discovery Rate corrected); significant differences were also found between CM and EM in one of these connections. Furthermore, significant differences in FA and AD were found in three and four connections from the connectome respectively (p \<.05 False Discovery Rate corrected); significant differences were also found between CM and EM in two of AD connections.
Conclusion: Our findings suggest global white matter structural differences between EM and CM, and structural connectivity alterations in migraine patients with respect to healthy controls, and in CM compared to EM.
Disclosure of Interest: None Declared.

}, doi = {https://doi.org/10.1177/0333102419859835}, url = {https://journals.sagepub.com/doi/full/10.1177/0333102419859835}, author = {{\'A}lvaro Planchuelo-G{\'o}mez and Garc{\'\i}a-Azor{\'\i}n, David and {\'A}ngel L. Guerrero and Santiago Aja-Fern{\'a}ndez and Rodr{\'\i}guez, Margarita and Rodrigo de Luis-Garc{\'\i}a} } @article {de2014white, title = {White matter abnormalities in chronic migraine patients are located in anterior corpus callosum: study using a new automatic tractography selection method}, journal = {EUROPEAN JOURNAL OF NEUROLOGY}, volume = {21}, year = {2014}, pages = {51{\textendash}51}, publisher = {WILEY-BLACKWELL 111 RIVER ST, HOBOKEN 07030-5774, NJ USA}, author = {De la Cruz, C and {\'A}ngel L. Guerrero and Penas, ML and Daniel Argibay-Qui{\~n}ones and Jose M Sierra and Santiago Aja-Fern{\'a}ndez and Rodrigo de Luis-Garc{\'\i}a} }