Volumetric analysis assessment of cranial magnetic resonance imaging in pediatric patients with migraine

Background Voxel-based volumetric morphometry offers an objective method for assessing structural brain changes in neurological disorders. Objective To compare the volumes of specific brain regions in pediatric migraine patients and healthy controls using voxel-based morphometry via 3D Slicer software. Materials and Methods This retrospective study included 33 pediatric migraine patients and 22 age-matched healthy controls who underwent cranial magnetic resonance imaging (MRI) between January 2020 and July 2024. MRI images were analyzed using semi-automated segmentation in the open-source 3D Slicer platform. Brain volumes were calculated for selected anatomical regions, and comparisons were performed according to age (0–11, 12–17 years) and sex. Results In female migraine patients, volumes of the anterior cingulate cortex, cerebrum, and white matter were significantly lower, whereas amygdala and brainstem volumes were higher than in controls (P-value < 0.05). Among males, the globus pallidus and amygdala volumes were significantly higher in the migraine group (P-value < 0.05). In the 0–11 age subgroup, migraine patients had significantly smaller caudate nucleus volumes, while controls had lower volumes in the parietal lobe, cerebellum, brainstem (P-value < 0.05). In the 12–17 age subgroup, the migraine group had significantly reduced volumes in the anterior cingulate cortex, cerebrum, and white matter, whereas the control group had smaller parietal lobe, thalamus, and amygdala volumes (P-value < 0.05). Conclusion This is the first voxel-based volumetric analysis of pediatric migraine using 3D Slicer. Statistically significant age- and sex-related differences in brain volumes were observed across multiple regions, suggesting potential migraine-related structural alterations in the brain.