{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:56:58Z","timestamp":1787763418525,"version":"build-2784847793"},"reference-count":70,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective of this longitudinal study was to determine whether brain iron accumulation, measured using magnetic resonance imaging magnetic transverse relaxation rates (T2*), is associated with response to erenumab for the treatment of migraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants (n\u2009=\u200928) with migraine, diagnosed using international classification of headache disorders 3rd edition criteria, were eligible if they had six to 25 migraine days during a four-week headache diary run-in phase. Participants received two treatments with 140\u2009mg erenumab, one immediately following the pre-treatment run-in phase and a second treatment four weeks later. T2* data were collected immediately following the pre-treatment phase, and at two weeks and eight weeks following the first erenumab treatment. Patients were classified as erenumab responders if their migraine-day frequency at five-to-eight weeks post-initial treatment was reduced by at least 50% compared to the pre-treatment run-in phase. A longitudinal Sandwich estimator approach was used to compare longitudinal group differences (responders vs non-responders) in T2* values, associated with iron accumulation. Group visit effects were calculated with a significance threshold of p\u2009=\u20090.005 and cluster forming threshold of 250 voxels. T2* values of 19 healthy controls were used for a reference. The average of each significant region was compared between groups and visits with Bonferroni corrections for multiple comparisons with significance defined as p\u2009&lt;\u20090.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pre- and post-treatment longitudinal imaging data were available from 28 participants with migraine for a total of 79 quantitative T2* images. Average subject age was 42\u2009\u00b1\u200913 years (25 female, three male). Of the 28 subjects studied, 53.6% were erenumab responders. Comparing longitudinal T2* between erenumab responders vs non-responders yielded two comparisons which survived the significance threshold of p\u2009&lt;\u20090.05 after correction for multiple comparisons: the difference at eight weeks between the erenumab-responders and non-responders in the periaqueductal gray (mean\u2009\u00b1\u2009standard error; responders 43\u2009\u00b1\u20091\u2009ms vs non-responders 32.5\u2009\u00b1\u20091\u2009ms, p\u2009=\u20090.002) and the anterior cingulate cortex (mean\u2009\u00b1\u2009standard error; responders 50\u2009\u00b1\u20091\u2009ms vs non-responders 40\u2009\u00b1\u20091\u2009ms, p\u2009=\u20090.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Erenumab response is associated with higher T2* in the periaqueductal gray and anterior cingulate cortex, regions that participate in pain processing and modulation. T2* differences between erenumab responders vs non-responders, a measure of brain iron accumulation, are seen at eight weeks post-treatment. Less iron accumulation in the periaqueductal gray and anterior cingulate cortex might play a role in the therapeutic mechanisms of migraine reduction associated with erenumab.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024221144783","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T06:16:42Z","timestamp":1675923402000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Longitudinal differences in iron deposition in periaqueductal gray matter and anterior cingulate cortex are associated with response to erenumab in migraine"],"prefix":"10.1177","volume":"43","author":[{"given":"Simona","family":"Nikolova","sequence":"first","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9035-8748","authenticated-orcid":false,"given":"Catherine Daniela","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Phoenix, AZ, USA"},{"name":"Department of Physiology and Biomedical Engineering, Mayo Clinic, Phoenix, AZ, USA"},{"name":"ASU-Mayo Center for Innovative Imaging, Tempe, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9519-5370","authenticated-orcid":false,"given":"Gina M.","family":"Dumkrieger","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Georgia Tech, School of Industrial and Systems Engineering, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Wu","sequence":"additional","affiliation":[{"name":"ASU-Mayo Center for Innovative Imaging, Tempe, AZ, USA"},{"name":"School of Computing, Informatics, Decision Systems Engineering, Arizona State University, Tempe AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd J","family":"Schwedt","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Phoenix, AZ, USA"},{"name":"ASU-Mayo Center for Innovative Imaging, Tempe, AZ, 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