Discussion
neuroinflammation, central pain, migraine-related functional disability, pain, CM, headache-related disability, migraine
MIGRAINE, DISEASE, IRON DEPOSITION
Our study demonstrated that migraineurs had increased iron deposition in Pu, Ca, and NAC than healthy controls. Meanwhile, patients with CM had a significantly higher volume of iron deposits in multiple subcortical brain nuclei including Pu, Ca, NAC, SNc, PBP, and HN compared to EM. Volume of iron in NAC can be used to distinguish patients with migraine from controls with a sensitivity of 72.9% and specificity of 86.8, and CM from EM with a sensitivity of 85.45% and specificity of 71.53%. Moreover, greater iron deposition in NAC was significantly associated with greater migraine burden, as measured by longer disease duration, higher frequency of attacks, more migraine days per month, and higher scores in HIT-6, MIDAS, and PSQI.Although increased iron deposition of subcortical nuclei has been reported in migraine patients, there is a lack of comprehensive subcortical nucleus and systematic comparison. Welch et al. [Repetitive episodes of neuroinflammation and hyperoxia lead to iron redistribution and iron unbalance in migraine patients [Our correlation analysis showed that greater iron deposition in NAC was significantly associated with greater migraine burden, as measured by longer disease duration, higher frequency of attacks, and more migraine days per month, suggesting a relationship between recurring attacks and accumulation of iron [If increased iron concentrations in NAC would play a role in the migraine chronicity, this might theoretically reflect a defective central pain processing system related to dysfunctions in several domains. NAC is located at the junction of the basal nucleus and the marginal system. The outer part of the septum and the inner and lower part of the caudate nucleus are connected to the pre-olfactory nucleus, and the ventral side is the ventral pale sphere and olfactory nodules. NAC plays important role in reward and punishment mechanisms, but studies on NAC and migraine are limited. The current study found that increased iron deposits in NAC were also associated with a higher level of migraine-related functional disability, as measured by HIT-6 and MIDAS, which are both widely accepted measures to assess headache-related disability and its impact on quality of life. As a key node of neural circuits projecting to multiple pain structures and mediating motivated behaviors [In addition, increased regional iron deposits of NAC were associated with worse sleep quality in migraineurs. Migraineurs usually have worse sleep quality than non-migraineurs [