Normative structural MRI deviation factors summarize patient-level neuroanatomical heterogeneity across episodic and chronic migraine
- 1Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University
- 2The Second School of Medicine, Wenzhou Medical University
- 3Department of Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University
Abstract
Background Structural MRI findings in migraine are inconsistent across cohorts, suggesting that group contrasts may obscure patient-level heterogeneity. We tested whether individualized normative structural deviations could be summarized into interpretable patient-level factor-weight dimensions related to chronicity and clinical burden. Methods In this single-center cross-sectional study, 249 adults with ICHD-3 migraine (198 episodic, 51 chronic) and 57 local healthy controls underwent 3.0-T MRI. Released PCNtoolkit lifespan models were locally adapted with controls to estimate patient-level deviation z scores for 158 FreeSurfer features. Non-negative matrix factorization was applied to the absolute-deviation matrix; directional negative- and positive-deviation models were sensitivity analyses. Covariate-adjusted associations were FDR-corrected within prespecified families. Result The primary model identified two stable factor-weight dimensions. Factor 1 captured a subcortical-limbic-brainstem/global-volume deviation pattern and was associated with chronic migraine (OR per 1-SD, 1.50; q = 0.036), MIDAS (beta = 16.46; q = 0.007), and monthly headache days (beta = 9.41; q < 0.001). Factor 2 mainly reflected cortical-thickness deviations, showed a borderline inverse association with chronic migraine (OR = 0.68; q = 0.054), and was associated with high absolute-deviation burden (OR = 2.37; q < 0.001). HIT-6 showed no corrected factor-specific association. Removing cranial-size-sensitive features preserved factor structure and main Factor 1 associations. Conclusion Normative structural MRI deviations in migraine can be summarized into non-mutually exclusive deviation-burden factors with patient-level weights. Factor 1 showed the most consistent associations with chronic migraine, headache frequency, and MIDAS; these associations attenuated in restricted sensitivity analyses, and external validation is required before clinical application.
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BibTeX
@article{dai2026normative,
title = {{Normative structural MRI deviation factors summarize patient-level neuroanatomical heterogeneity across episodic and chronic migraine}},
author = {Chenyu Dai and Mengqian Ye and Xinhao Li and Zhewei Yan and Lechao Ye and YangJingJie Mao and Huimin Wang and Yan Li and Keyang Chen and Xiaozheng Liu and Beilei Hu and Yungang Cao and Fangwang Fu},
journal = {The Journal of Headache and Pain},
year = {2026},
month = jul,
doi = {10.1186/s10194-026-02464-2},
url = {https://doi.org/10.1186/s10194-026-02464-2},
note = {CC BY},
}
RIS
TY - JOUR
TI - Normative structural MRI deviation factors summarize patient-level neuroanatomical heterogeneity across episodic and chronic migraine
AU - Chenyu Dai
AU - Mengqian Ye
AU - Xinhao Li
AU - Zhewei Yan
AU - Lechao Ye
AU - YangJingJie Mao
AU - Huimin Wang
AU - Yan Li
AU - Keyang Chen
AU - Xiaozheng Liu
AU - Beilei Hu
AU - Yungang Cao
AU - Fangwang Fu
PY - 2026
DA - 2026/07/01
JO - The Journal of Headache and Pain
DO - 10.1186/s10194-026-02464-2
UR - https://doi.org/10.1186/s10194-026-02464-2
AB - Background Structural MRI findings in migraine are inconsistent across cohorts, suggesting that group contrasts may obscure patient-level heterogeneity. We tested whether individualized normative structural deviations could be summarized into interpretable patient-level factor-weight dimensions related to chronicity and clinical burden. Methods In this single-center cross-sectional study, 249 adults with ICHD-3 migraine (198 episodic, 51 chronic) and 57 local healthy controls underwent 3.0-T MRI. Released PCNtoolkit lifespan models were locally adapted with controls to estimate patient-level deviation z scores for 158 FreeSurfer features. Non-negative matrix factorization was applied to the absolute-deviation matrix; directional negative- and positive-deviation models were sensitivity analyses. Covariate-adjusted associations were FDR-corrected within prespecified families. Result The primary model identified two stable factor-weight dimensions. Factor 1 captured a subcortical-limbic-brainstem/global-volume deviation pattern and was associated with chronic migraine (OR per 1-SD, 1.50; q = 0.036), MIDAS (beta = 16.46; q = 0.007), and monthly headache days (beta = 9.41; q < 0.001). Factor 2 mainly reflected cortical-thickness deviations, showed a borderline inverse association with chronic migraine (OR = 0.68; q = 0.054), and was associated with high absolute-deviation burden (OR = 2.37; q < 0.001). HIT-6 showed no corrected factor-specific association. Removing cranial-size-sensitive features preserved factor structure and main Factor 1 associations. Conclusion Normative structural MRI deviations in migraine can be summarized into non-mutually exclusive deviation-burden factors with patient-level weights. Factor 1 showed the most consistent associations with chronic migraine, headache frequency, and MIDAS; these associations attenuated in restricted sensitivity analyses, and external validation is required before clinical application.
SN - 1129-2377
SN - 1129-2369
ER -