Multimodal convergence is needed before inferring neuroaxonal injury in migraine.

Authors

Yuhao Zhang, Jian Jiang

Published in

The journal of headache and pain. Volume 27. Issue 1. Oct 06, 2026. Epub Oct 06, 2026.

Abstract

Gallardo and colleagues reported higher serum neurofilament light (sNf-L), greater susceptibility-weighted imaging signal in the left rostral anterior cingulate cortex, and lower fractional anisotropy in the right cuneus in patients with high-frequency migraine. Their prospective phenotyping and multimodal approach are valuable. However, these modality-specific findings do not necessarily indicate a shared neuroaxonal-injury process. Serum Nf-L is anatomically non-specific, susceptibility-weighted signal is an indirect marker of iron-related changes, and fractional anisotropy reflects several aspects of tissue architecture. In addition, the imaging findings were focal, cross-modal associations were not reported, and the classification model had a small held-out test set with a wide confidence interval. We therefore suggest describing the results as independent candidate markers associated with high-frequency migraine. Evidence of multimodal convergence would require replicated cross-modal relationships or related longitudinal changes. This distinction preserves the value of the study while avoiding a mechanistic interpretation that extends beyond the available data.Clinical trial number Not applicable.

PMID:
42839265
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.

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