Corneal confocal microscopy identifies corneal nerve fiber loss in patients with migraine

Guldiken Y. C., Petropoulos I. N., Malik A., Malik R. A., Yüksel R., Budak F., ...Daha Fazla

CEPHALALGIA, cilt.43, sa.5, 2023 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 43 Sayı: 5
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1177/03331024231170810
  • Dergi Adı: CEPHALALGIA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, Veterinary Science Database
  • Anahtar Kelimeler: biomarker, corneal confocal microscopy, Migraine, neurodegeneration
  • Kocaeli Üniversitesi Adresli: Evet

Özet

Background/HypothesisMigraine affects >1 billion people but its pathophysiology remains poorly understood. Alterations in the trigeminovascular system play an important role. We have compared corneal nerve morphology in patients with migraine to healthy controls. MethodsSixty patients with episodic (n = 32) or chronic (n = 28) migraine and 20 age-matched healthy control subjects were studied cross-sectionally. Their migraine characteristics and signs and symptoms of dry eyes were assessed. Manual and automated quantification of corneal nerves was undertaken by corneal confocal microscopy. ResultsIn patients with migraine compared to controls, manual corneal nerve fiber density (P < 0.001), branch density (P = 0.015) and length (P < 0.001); and automated corneal nerve fiber density (P < 0.001), branch density (P < 0.001), length (P < 0.001), total branch density (P < 0.001), nerve fiber area (P < 0.001), nerve fiber width (P = 0.045) and fractal dimension (P < 0.001) were lower. Automated corneal nerve fiber density was higher in patients with episodic migraine and aura (P = 0.010); and fractal dimension (P = 0.029) was lower in patients with more headache days in the last three months. Automated corneal nerve fiber density predicted a significant amount of the observed variance in pain intensity (adjusted r(2) = 0.14, partial r = -0.37, P = 0.004) in patients with migraine. ConclusionsCorneal confocal microscopy reveals corneal nerve loss in patients with migraine. It may serve as an objective imaging biomarker of neurodegeneration in migraine.