Volumetric MRI analysis of the pineal gland and brain ventricles in patients with migraine

Abstract

Aim:  Previous studies have reported reduced melatonin levels and elevated cerebrospinal fluid (CSF) pressure in patients with migraine. However, the volumetric characteristics of the pineal gland, which is the primary source of melatonin, and the brain ventricles, which serve as CSF reservoirs, have not been sufficiently investigated. This study analyzed the volumes of the pineal gland and brain ventricles in migraine patients.

Materials and Methods:  The study included 21 migraine patients and 22 age- and sex-matched healthy controls. Brain volumetric analyses were performed using high-resolution magnetic resonance imaging (MRI). Pineal gland volumes were manually segmented and measured using ITK-SNAP software, while ventricular volumes were automatically computed using volBrain software. All volumetric measurements were expressed in cubic centimeters (cm³).

Results: The groups were comparable in terms of age (p=0.730), gender (p=0.420), and body mass index (p=0.082). Pineal gland volume was significantly reduced in the migraine group. An ANCOVA controlling for total intracranial volume confirmed this significant reduction (F(1, 39) = 34.95, p<0.001, partial η² = 0.473). Likewise, ventricular volumes were significantly smaller in migraine patients (p<0.001).

Conclusion: These findings indicate that the reduction in pineal gland volume in migraine patients occurs independently of overall brain size, pointing to a specific structural change relevant to the underlying pathology of the disease.