Multimodal convergence is needed before inferring neuroaxonal injury in migraine.

Gallardo and colleagues studied patients with high-frequency migraine and found interesting results. They reported higher levels of serum neurofilament light (sNf-L) in these patients. They also observed changes in brain imaging, particularly in specific areas. However, these findings do not confirm a common injury process in the brain. The serum Nf-L levels are not specific to any one area. The imaging results are indirect and may not indicate direct neuroaxonal injury. Additionally, the findings were localized, and there were no significant cross-modal associations. The classification model used in the study had a small test set, leading to uncertainty. Therefore, the researchers recommend viewing these results as separate markers linked to high-frequency migraine. More research is needed to establish any connections between these markers and neuroaxonal injury in migraine patients. Understanding these factors could help improve future migraine treatments. Clinical relevance: This research highlights the need for caution when interpreting migraine-related brain changes.