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Huang SY, Salomon M, Eikermann-Haerter K. Advanced brain MRI may help understand the link between migraine and multiple sclerosis. J Headache Pain 2023; 24:113. [PMID: 37596546 PMCID: PMC10439604 DOI: 10.1186/s10194-023-01645-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/04/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND There is a clinical association between migraine and multiple sclerosis. MAIN BODY Migraine and MS patients share similar demographics, with the highest incidence among young, female and otherwise healthy patients. The same hormonal constellations/changes trigger disease exacerbation in both entities. Migraine prevalence is increased in MS patients, which is further enhanced by disease-modifying treatment. Clinical data show that onset of migraine typically starts years before the clinical diagnosis of MS, suggesting that there is either a unidirectional relationship with migraine predisposing to MS, and/or a "shared factor" underlying both conditions. Brain imaging studies show white matter lesions in both MS and migraine patients. Neuroinflammatory mechanisms likely play a key role, at least as a shared downstream pathway. In this review article, we provide an overview of the literature about 1) the clinical association between migraine and MS as well as 2) brain MRI studies that help us better understand the mechanistic relationship between both diseases with implications on their underlying pathophysiology. CONCLUSION Studies suggest a migraine history predisposes patients to develop MS. Advanced brain MR imaging may shed light on shared and distinct features, while helping us better understand mechanisms underlying both disease entities.
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Affiliation(s)
- Susie Y Huang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Marc Salomon
- Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY, 10016, USA
| | - Katharina Eikermann-Haerter
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY, 10016, USA.
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2
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Noseda R. Cerebro-Cerebellar Networks in Migraine Symptoms and Headache. FRONTIERS IN PAIN RESEARCH 2022; 3:940923. [PMID: 35910262 PMCID: PMC9326053 DOI: 10.3389/fpain.2022.940923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
The cerebellum is associated with the biology of migraine in a variety of ways. Clinically, symptoms such as fatigue, motor weakness, vertigo, dizziness, difficulty concentrating and finding words, nausea, and visual disturbances are common in different types of migraine. The neural basis of these symptoms is complex, not completely known, and likely involve activation of both specific and shared circuits throughout the brain. Posterior circulation stroke, or neurosurgical removal of posterior fossa tumors, as well as anatomical tract tracing in animals, provided the first insights to theorize about cerebellar functions. Nowadays, with the addition of functional imaging, much progress has been done on cerebellar structure and function in health and disease, and, as a consequence, the theories refined. Accordingly, the cerebellum may be useful but not necessary for the execution of motor, sensory or cognitive tasks, but, rather, would participate as an efficiency facilitator of neurologic functions by improving speed and skill in performance of tasks produced by the cerebral area to which it is reciprocally connected. At the subcortical level, critical regions in these processes are the basal ganglia and thalamic nuclei. Altogether, a modulatory role of the cerebellum over multiple brain regions appears compelling, mainly by considering the complexity of its reciprocal connections to common neural networks involved in motor, vestibular, cognitive, affective, sensory, and autonomic processing—all functions affected at different phases and degrees across the migraine spectrum. Despite the many associations between cerebellum and migraine, it is not known whether this structure contributes to migraine initiation, symptoms generation or headache. Specific cerebellar dysfunction via genetically driven excitatory/inhibitory imbalances, oligemia and/or increased risk to white matter lesions has been proposed as a critical contributor to migraine pathogenesis. Therefore, given that neural projections and functions of many brainstem, midbrain and forebrain areas are shared between the cerebellum and migraine trigeminovascular pathways, this review will provide a synopsis on cerebellar structure and function, its role in trigeminal pain, and an updated overview of relevant clinical and preclinical literature on the potential role of cerebellar networks in migraine pathophysiology.
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Affiliation(s)
- Rodrigo Noseda
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- *Correspondence: Rodrigo Noseda
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3
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P2X7R/NLRP3 signaling pathway-mediated pyroptosis and neuroinflammation contributed to cognitive impairment in a mouse model of migraine. J Headache Pain 2022; 23:75. [PMID: 35780081 PMCID: PMC9250730 DOI: 10.1186/s10194-022-01442-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/10/2022] [Indexed: 01/15/2023] Open
Abstract
Migraine is the second most common form of headache disorder and the second leading cause of disability worldwide. Cognitive symptoms ranked second resulting in migraine-related disability, after pain. P2X7 receptor (P2X7R) was recently shown to be involved in hyperalgesia in migraine. However, the role of P2X7R in migraine-related cognitive impairment is still ill-defined. The aim of this study was to explore the molecular mechanisms underlying migraine-related cognitive impairment and the role of P2X7R in it. Here we used a well-established mouse model of migraine that triggered migraine attacks by application of inflammatory soup (IS) to the dura. Our results showed that repeated dural IS stimulation triggered upregulation of P2X7R, activation of NLRP3 inflammasome, release of proinflammatory cytokines (IL-1β and IL-18) and activation of pyroptotic cell death pathway. Gliosis (microgliosis and astrogliosis), neuronal loss and cognitive impairment also occurred in the IS-induced migraine model. No significant apoptosis or whiter matter damage was observed following IS-induced migraine attacks. These pathological changes occurred mainly in the cerebral cortex and to a less extent in the hippocampus, all of which can be prevented by pretreatment with a specific P2X7R antagonist Brilliant Blue G (BBG). Moreover, BBG can alleviate cognitive impairment following dural IS stimulation. These results identified P2X7R as a key contributor to migraine-related cognitive impairment and may represent a potential therapeutic target for mitigating cognitive impairment in migraine.
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4
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Can you have a migraine aura without knowing it? Curr Opin Neurol 2021; 34:350-355. [PMID: 33661163 DOI: 10.1097/wco.0000000000000924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This review covers several aspects our understanding of episodic manifestations and unusual symptoms that may be associated with migraine aura. RECENT FINDINGS The episodic manifestation of migraine aura is typically visual in nature, although five other types are currently recognized: sensory, speech and/or language, motor, brainstem, and retinal. Other transitory perceptions or experiences such as emotional, olfactory, or auditory have been reported as possible migraine auras. As underlined by the much higher reported prevalence of aura manifestation in individuals with professional knowledge of its possible manifestations, it appears that a number of migraine auras may remain unnoticed, unreported, or misdiagnosed. SUMMARY Aura manifestations may be more common, complex, symptom-rich and variable than previously thought. Clinicians should proactively ask questions beyond those addressing visual symptoms when examining individuals with a potential diagnosis of migraine with aura.
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Eikermann-Haerter K, Huang SY. White Matter Lesions in Migraine. THE AMERICAN JOURNAL OF PATHOLOGY 2021; 191:1955-1962. [PMID: 33636178 DOI: 10.1016/j.ajpath.2021.02.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/16/2021] [Accepted: 02/12/2021] [Indexed: 12/20/2022]
Abstract
Migraine, the third most common disease worldwide, is a well-known independent risk factor for subclinical focal deep white matter lesions (WMLs), even in young and otherwise healthy individuals with no cardiovascular risk factors. These WMLs are more commonly seen in migraine patients with transient neurologic symptoms preceding their headaches, the so-called aura, and those with a high attack frequency. The pathophysiology of migraine-related deep white matter hyperintensities remains poorly understood despite their prevalence. Characteristic differences in their distribution related to chronic small vessel ischemic disease compared with that of common periventricular WMLs in the elderly suggest a different underlying mechanism. Both ischemic and inflammatory mechanisms have been proposed, as there is increased cerebral vulnerability to ischemia in migraineurs, whereas there is also evidence of blood-brain barrier disruption with associated release of proinflammatory substances during migraine attacks. An enhanced susceptibility to spreading depolarization, the electrophysiological event underlying migraine, may be the mechanism that causes repetitive episodes of cerebral hypoperfusion and neuroinflammation during migraine attacks. WMLs can negatively affect both physical and cognitive function, underscoring the public health importance of migraine, and suggesting that migraine is an important contributor to neurologic deficits in the general population.
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Affiliation(s)
| | - Susie Y Huang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and the Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts
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Ke J, Yu Y, Zhang X, Su Y, Wang X, Hu S, Dai H, Hu C, Zhao H, Dai L. Functional Alterations in the Posterior Insula and Cerebellum in Migraine Without Aura: A Resting-State MRI Study. Front Behav Neurosci 2020; 14:567588. [PMID: 33132860 PMCID: PMC7573354 DOI: 10.3389/fnbeh.2020.567588] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/19/2020] [Indexed: 01/03/2023] Open
Abstract
Background: Hypothesis-driven functional connectivity (FC) analyses have revealed abnormal functional interaction of regions or networks involved in pain processing in episodic migraine patients. We aimed to investigate the resting-state FC patterns in episodic migraine by combining data-driven voxel-wise degree centrality (DC) calculation and seed-based FC analysis. Methods: Thirty-nine patients suffering from episodic migraine without aura and 35 healthy controls underwent clinical assessment and functional MRI. DC was analyzed voxel-wise and compared between groups, and FC of regions with DC differences were further examined using a seed-based approach. Results: Compared with the control group, the migraine group showed increased and decreased DC in the right posterior insula and left crus I, respectively. Seed-based FC analyses revealed that migraine patients demonstrated increased right posterior insula connections with the postcentral gyrus, supplementary motor area/paracentral lobule, fusiform gyrus and temporal pole. The left crus I showed decreased FC with regions of the default mode network (DMN), including the medial prefrontal cortex (mPFC), angular gyrus, medial and lateral temporal cortex in patients with migraine. Furthermore, pain intensity positively correlated with DC in the right amygdala/parahippocampal gyrus, and migraine frequency negatively correlated with FC between the left crus I and mPFC. Conclusion: Patients with episodic migraine without aura have increased FC with the right posterior insula and decreased FC within the DMN, which may underlie disturbed sensory integration and cognitive processing of pain. The left crus I-mPFC connectivity may be a useful biomarker for assessing migraine frequency.
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Affiliation(s)
- Jun Ke
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Yang Yu
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Xiaodong Zhang
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Yunyan Su
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Ximing Wang
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Su Hu
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Hui Dai
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Chunhong Hu
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Hongru Zhao
- Department of Neurology, the First Affiliated Hospital of Soochow University, Soochow, China
| | - Lingling Dai
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
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7
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Jia Z, Chen X, Tang W, Zhao D, Yu S. Atypical functional connectivity between the anterior cingulate cortex and other brain regions in a rat model of recurrent headache. Mol Pain 2019; 15:1744806919842483. [PMID: 30900511 PMCID: PMC6484243 DOI: 10.1177/1744806919842483] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We explored the atypical functional connectivity between the anterior cingulate cortex and other brain areas in rats subjected to repeated meningeal nociception. The rat model was established by infusing an inflammatory soup through supradural catheters in conscious rats. Rats were subdivided according to the frequency of the inflammatory soup infusions. Functional connectivity analysis seeded on the anterior cingulate cortex was performed on rats 21 days after inflammatory soup infusion. Glyceryl trinitrate was injected following baseline scanning in the low-frequency inflammatory soup group and magnetic resonance imaging data were acquired 1 h after the injection. The rats exhibited nociceptive behavior after high-frequency inflammatory soup infusion. The anterior cingulate cortex showed increased functional connectivity with the cerebellum in the inflammatory soup groups. The medulla showed increased functional connectivity with the anterior cingulate cortex in the ictal period in the low-frequency inflammatory soup rats. Several areas showed increased functional connectivity with the anterior cingulate cortex in the high-frequency inflammatory soup group, including the pontine tegmentum, midbrain, thalamus, corpus callosum, hippocampus, and retrosplenial, visual, sensory, and motor cortices. This study indicated that the medulla participates in the early stage of a migraine attack and may be associated with the initiation of migraine. Sensitization of the trigeminal nociceptive pathway might contribute to the cutaneous allodynia seen in chronic migraine. Brain areas important for memory function may be related to the chronification of migraine. Electrophysiological studies should examine those migraine-related areas and provide new targets for migraine treatment and prevention.
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Affiliation(s)
- Zhihua Jia
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Xiaoyan Chen
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Wenjing Tang
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Dengfa Zhao
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
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8
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Arkink EB, Palm-Meinders IH, Koppen H, Milles J, van Lew B, Launer LJ, Hofman PAM, Terwindt GM, van Buchem MA, Ferrari MD, Kruit MC. Microstructural white matter changes preceding white matter hyperintensities in migraine. Neurology 2019; 93:e688-e694. [PMID: 31296653 DOI: 10.1212/wnl.0000000000007940] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 03/21/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We used magnetization transfer imaging to assess white matter tissue integrity in migraine, to explore whether white matter microstructure was more diffusely affected beyond visible white matter hyperintensities (WMHs), and to explore whether focal invisible microstructural changes precede visible focal WMHs in migraineurs. METHODS We included 137 migraineurs (79 with aura, 58 without aura) and 74 controls from the Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis (CAMERA) study, a longitudinal population-based study on structural brain lesions in migraine patients, who were scanned at baseline and at a 9-year follow-up. To assess microstructural brain tissue integrity, baseline magnetization transfer ratio (MTR) values were calculated for whole brain white matter. Baseline MTR values were determined for areas of normal-appearing white matter (NAWM) that had progressed into MRI-detectable WMHs at follow-up and compared to MTR values of contralateral NAWM. RESULTS MTR values for whole brain white matter did not differ between migraineurs and controls. In migraineurs, but not in controls, NAWM that later progressed to WMHs at follow-up had lower mean MTR (mean [SD] 0.354 [0.009] vs 0.356 [0.008], p = 0.047) at baseline as compared to contralateral white matter. CONCLUSIONS We did not find evidence for widespread microstructural white matter changes in migraineurs compared to controls. However, our findings suggest that a gradual or stepwise process might be responsible for evolution of focal invisible microstructural changes into focal migraine-related visible WMHs.
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Affiliation(s)
- Enrico B Arkink
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Inge H Palm-Meinders
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Hille Koppen
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Julien Milles
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Baldur van Lew
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Lenore J Launer
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Paul A M Hofman
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Gisela M Terwindt
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Mark A van Buchem
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Michel D Ferrari
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands
| | - Mark C Kruit
- From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands.
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Russo A, Silvestro M, Tessitore A, Tedeschi G. Shedding light on migraine with aura: the clarifying role of advanced neuroimaging investigations. Expert Rev Neurother 2019; 19:739-750. [PMID: 31267785 DOI: 10.1080/14737175.2019.1638252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction: While migraine with aura is a complex neurological syndrome with a well-characterized clinical phenotype, its pathophysiology still has grey areas which could be partially clarified by microstructural and functional neuroimaging investigations. Areas covered: This article, summarizing the most significant findings from advanced neuroimaging studies, aims to achieve a unifying pathophysiological model of the migraine aura. A comprehensive review has been conducted of PubMed citations by entering the key word 'neuroimaging' combined with 'migraine with aura' AND/OR 'MRI.' Other keywords included 'grey matter' OR 'white matter', 'structural' OR 'functional'. Expert opinion: Converging evidence from advanced neuroimaging investigations underlined the critical role of the extrastriate visual cortex, and in particular the lingual gyrus, in the genesis of the aura phenomenon. However, the relationship between the aura and the headache phase of migraine attacks has not been completely clarified, to date, and underlying pathophysiological mechanisms need to be further elucidated.
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Affiliation(s)
- Antonio Russo
- a Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy.,b MRI Research Center SUN-FISM , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Marcello Silvestro
- a Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy.,b MRI Research Center SUN-FISM , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Alessandro Tessitore
- a Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy.,b MRI Research Center SUN-FISM , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Gioacchino Tedeschi
- a Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy.,c Institute for Diagnosis and Care ''Hermitage Capodimonte'' , Naples , Italy
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10
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Hadjikhani N, Vincent M. Neuroimaging clues of migraine aura. J Headache Pain 2019; 20:32. [PMID: 30943894 PMCID: PMC6734229 DOI: 10.1186/s10194-019-0983-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/14/2019] [Indexed: 12/12/2022] Open
Abstract
While migraine headaches can be provoked, or predicted by the presence of an aura or premonitory symptoms, the prediction or elicitation of the aura itself is more problematic. Therefore, imaging studies directly examining the aura phenomenon are sparse. There are however interictal imaging studies that can shed light on the pathophysiology of the migraine with aura (MWA) cascade. Here, we review findings pointing to the involvement of cortical spreading depression (CSD) and neuroinflammation in MWA. Whether asymptomatic CSD also happens in some migraine without aura is still under debate. In addition, new evidence points to glial activation in MWA, indicating the involvement of astrocytes in the neuroinflammatory cascade that follows CSD, as well as dural macrophages, supporting the involvement of the trigeminovascular system in migraine pain.
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Affiliation(s)
- Nouchine Hadjikhani
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, USA. .,Gillberg Neuropsychiatry Center, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
| | - Maurice Vincent
- Neuroscience Research, Eli Lilly and Company, Indianapolis, USA
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11
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Abstract
Background Although there is a great wealth of knowledge about the neurobiological processes underlying migraine and its accompanying symptoms, the mechanisms by which an attack starts remain elusive, and the disease remains undertreated. Although the vast majority of literature focuses on the involvement of the trigeminovascular systems and higher systems it innervates, such as thalamic and hypothalamic nuclei, several lines of evidence implicate the cerebellum in the pathophysiology of migraine. Aim In this review, we aim to summarize potential cerebellar involvement seen from different perspectives including the results from imaging studies, cerebellar connectivity to migraine-related brain structures, comorbidity with disorders implying cerebellar dysfunction, similarities in triggers precipitating both such disorders, and migraine and cerebellar expression of migraine-related genes and neuropeptides. We aim to inspire an increase in interest for future research on the subject. Conclusion It is hoped that future studies can provide an answer as to how the cerebellum may be involved and whether treatment options specifically targeting the cerebellum could provide alleviation of this disorder.
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Affiliation(s)
- Lieke Kros
- 1 Dominick P Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, NY, USA.,2 Department of Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Kamran Khodakhah
- 1 Dominick P Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, NY, USA
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12
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Szabó N, Faragó P, Király A, Veréb D, Csete G, Tóth E, Kocsis K, Kincses B, Tuka B, Párdutz Á, Szok D, Tajti J, Vécsei L, Kincses ZT. Evidence for Plastic Processes in Migraine with Aura: A Diffusion Weighted MRI Study. Front Neuroanat 2018; 11:138. [PMID: 29387002 PMCID: PMC5776127 DOI: 10.3389/fnana.2017.00138] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 12/26/2017] [Indexed: 01/03/2023] Open
Abstract
Background: Formerly white matter abnormalities in a mixed group of migraine patients with and without aura were shown. Here, we aimed to explore white matter alterations in a homogeneous group of migraineurs with aura and to delineate possible relationships between white matter changes and clinical variables. Methods: Eighteen patients with aura, 25 migraine patients without aura and 28 controls were scanned on a 1.5T MRI scanner. Diffusivity parameters of the white matter were estimated and compared between patients’ groups and controls using whole-brain tract-based spatial statistics. Results: Decreased radial diffusivity (p < 0.036) was found bilaterally in the parieto-occipital white matter, the corpus callosum, and the cingular white matter of migraine with aura (MwA) patients compared to controls. Migraine without aura (MwoA) patients showed no alteration compared to controls. MwA compared to MwoA showed increased fractional anisotropy (p < 0.048) in the left parieto-occipital white matter. In MwA a negative correlation was found between axial diffusivity and disease duration in the left superior longitudinal fascicle (left parieto-occipital region) and in the left corticospinal tract (p < 0.036) and with the number of the attacks in the right superior longitudinal fascicle (p < 0.048). Conclusion: We showed for the first time that there are white matter microstructural differences between these two subgroups of migraine and hence it is important to handle the two groups separately in further researches. We propose that degenerative and maladaptive plastic changes coexist in the disease and the diffusion profile is a result of these processes.
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Affiliation(s)
- Nikoletta Szabó
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Péter Faragó
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - András Király
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Dániel Veréb
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Gergő Csete
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Eszter Tóth
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Krisztián Kocsis
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Bálint Kincses
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | | | - Árpád Párdutz
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Délia Szok
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - János Tajti
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Zsigmond T Kincses
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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13
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Visual cortex and cerebellum hyperactivation during negative emotion picture stimuli in migraine patients. Sci Rep 2017; 7:41919. [PMID: 28181500 PMCID: PMC5299401 DOI: 10.1038/srep41919] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 01/03/2017] [Indexed: 01/03/2023] Open
Abstract
Migraines are a common and undertreated disease and often have psychiatric comorbidities; however, the abnormal mechanism of emotional processing in migraine patients has not been well clarified. This study sought to investigate the different brain functional activation to neutral, positive and negative emotional stimuli between migraine and healthy subjects. Twenty-six adults with migraines and 26 healthy adults, group-matched for sex and age, participated in this experiment. Although there were no significant differences between two groups during the viewing of positive affective pictures vs. neutral affective pictures, there were different activation patterns during the viewing of negative to neutral affective pictures in the two groups; the control group showed both increased and decreased activation patterns, while the migraine subjects showed only increased activation. Negative affective pictures elicited stronger activation than neutral affective pictures in migraineurs, which included the bilateral cerebellum anterior lobe/culmen, the bilateral lingual gyri, the bilateral precuneus and the left cuneus. Our data indicated that migraine patients were hypersensitive to negative stimuli, which might provide clues to aid in the understanding of the pathophysiology and psychiatric comorbidities of migraines.
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14
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Faragó P, Tuka B, Tóth E, Szabó N, Király A, Csete G, Szok D, Tajti J, Párdutz Á, Vécsei L, Kincses ZT. Interictal brain activity differs in migraine with and without aura: resting state fMRI study. J Headache Pain 2017; 18:8. [PMID: 28124204 PMCID: PMC5267588 DOI: 10.1186/s10194-016-0716-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/20/2016] [Indexed: 01/03/2023] Open
Abstract
Background Migraine is one of the most severe primary headache disorders. The nature of the headache and the associated symptoms during the attack suggest underlying functional alterations in the brain. In this study, we examined amplitude, the resting state fMRI fluctuation in migraineurs with and without aura (MWA, MWoA respectively) and healthy controls. Methods Resting state functional MRI images and T1 high-resolution images were acquired from all participants. For data analysis we compared the groups (MWA-Control, MWA-MWoA, MWoA-Control). The resting state networks were identified by MELODIC. The mean time courses of the networks were identified for each participant for all networks. The time-courses were decomposed into five frequency bands by discrete wavelet decomposition. The amplitude of the frequency-specific activity was compared between groups. Furthermore, the preprocessed resting state images were decomposed by wavelet analysis into five specific frequency bands voxel-wise. The voxel-wise amplitudes were compared between groups by non-parametric permutation test. Results In the MWA-Control comparison the discrete wavelet decomposition found alterations in the lateral visual network. Higher activity was measured in the MWA group in the highest frequency band (0.16–0.08 Hz). In case of the MWA-MWoA comparison all networks showed higher activity in the 0.08–0.04 Hz frequency range in MWA, and the lateral visual network in in higher frequencies. In MWoA-Control comparison only the default mode network revealed decreased activity in MWoA group in the 0.08–0.04 Hz band. The voxel-wise frequency specific analysis of the amplitudes found higher amplitudes in MWA as compared to MWoA in the in fronto-parietal regions, anterior cingulate cortex and cerebellum. Discussion The amplitude of the resting state fMRI activity fluctuation is higher in MWA than in MWoA. These results are in concordance with former studies, which found cortical hyperexcitability in MWA.
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Affiliation(s)
- Péter Faragó
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Bernadett Tuka
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Eszter Tóth
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Nikoletta Szabó
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - András Király
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Gergő Csete
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Délia Szok
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - János Tajti
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Árpád Párdutz
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Zsigmond Tamás Kincses
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary. .,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
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15
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On the interplay between chronic pain and age with regard to neurocognitive integrity: Two interacting conditions? Neurosci Biobehav Rev 2016; 69:174-92. [DOI: 10.1016/j.neubiorev.2016.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 06/04/2016] [Accepted: 07/11/2016] [Indexed: 01/25/2023]
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16
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Eising E, Huisman SMH, Mahfouz A, Vijfhuizen LS, Anttila V, Winsvold BS, Kurth T, Ikram MA, Freilinger T, Kaprio J, Boomsma DI, van Duijn CM, Järvelin MRR, Zwart JA, Quaye L, Strachan DP, Kubisch C, Dichgans M, Davey Smith G, Stefansson K, Palotie A, Chasman DI, Ferrari MD, Terwindt GM, de Vries B, Nyholt DR, Lelieveldt BPF, van den Maagdenberg AMJM, Reinders MJT. Gene co-expression analysis identifies brain regions and cell types involved in migraine pathophysiology: a GWAS-based study using the Allen Human Brain Atlas. Hum Genet 2016; 135:425-439. [PMID: 26899160 PMCID: PMC4796339 DOI: 10.1007/s00439-016-1638-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 01/16/2016] [Indexed: 01/03/2023]
Abstract
Migraine is a common disabling neurovascular brain disorder typically characterised by attacks of severe headache and associated with autonomic and neurological symptoms. Migraine is caused by an interplay of genetic and environmental factors. Genome-wide association studies (GWAS) have identified over a dozen genetic loci associated with migraine. Here, we integrated migraine GWAS data with high-resolution spatial gene expression data of normal adult brains from the Allen Human Brain Atlas to identify specific brain regions and molecular pathways that are possibly involved in migraine pathophysiology. To this end, we used two complementary methods. In GWAS data from 23,285 migraine cases and 95,425 controls, we first studied modules of co-expressed genes that were calculated based on human brain expression data for enrichment of genes that showed association with migraine. Enrichment of a migraine GWAS signal was found for five modules that suggest involvement in migraine pathophysiology of: (i) neurotransmission, protein catabolism and mitochondria in the cortex; (ii) transcription regulation in the cortex and cerebellum; and (iii) oligodendrocytes and mitochondria in subcortical areas. Second, we used the high-confidence genes from the migraine GWAS as a basis to construct local migraine-related co-expression gene networks. Signatures of all brain regions and pathways that were prominent in the first method also surfaced in the second method, thus providing support that these brain regions and pathways are indeed involved in migraine pathophysiology.
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Affiliation(s)
- Else Eising
- Department of Human Genetics, Leiden University Medical Center, 2333 ZC, Leiden, The Netherlands
| | - Sjoerd M H Huisman
- Delft Bioinformatics Lab, Department of Intelligent Systems, Delft University of Technology, 2628 CD, Delft, The Netherlands.,Division of Image Processing, Department of Radiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Ahmed Mahfouz
- Delft Bioinformatics Lab, Department of Intelligent Systems, Delft University of Technology, 2628 CD, Delft, The Netherlands.,Division of Image Processing, Department of Radiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Lisanne S Vijfhuizen
- Department of Human Genetics, Leiden University Medical Center, 2333 ZC, Leiden, The Netherlands
| | - Verneri Anttila
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - Bendik S Winsvold
- FORMI and Department of Neurology, Oslo University Hospital and University of Oslo, 0424, Oslo, Norway
| | - Tobias Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02215-1204, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Centre, 3015 CE, Rotterdam, The Netherlands.,Department of Radiology, Erasmus University Medical Centre, 3015 CE, Rotterdam, The Netherlands.,Department of Neurology, Erasmus University Medical Centre, 3015 CE, Rotterdam, The Netherlands
| | - Tobias Freilinger
- Department of Neurology and Epileptology and Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany.,Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximillians-Universität, 81377, Munich, Germany
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, 00014, Helsinki, Finland.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00290, Helsinki, Finland
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University, 1081 HV, Amsterdam, The Netherlands
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus University Medical Centre, 3015 CE, Rotterdam, The Netherlands
| | - Marjo-Riitta R Järvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, W2 1PG, UK.,Center for Life-Course Health Research and Northern Finland Cohort Center, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Biocenter Oulu, University of Oulu, Aapistie 5A, P.O. Box 5000, 90014, Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, Kajaanintie 50, 90029 OYS, P.O. Box 20, 90220, Oulu, Finland
| | - John-Anker Zwart
- FORMI and Department of Neurology, Oslo University Hospital and University of Oslo, 0424, Oslo, Norway
| | - Lydia Quaye
- Department of Twin Research and Genetic Epidemiology, King's College London, London, SE1 7EH, UK
| | - David P Strachan
- Population Health Research Institute, St George's, University of London, London, SW17 0RE, UK
| | - Christian Kubisch
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximillians-Universität, 81377, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), 81377, Munich, Germany
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit (IEU), School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK
| | - Kari Stefansson
- deCODE Genetics, 101, Reykjavik, Iceland.,School of Medicine, University of Iceland, 101, Reykjavik, Iceland
| | - Aarno Palotie
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00290, Helsinki, Finland
| | - Daniel I Chasman
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02215-1204, USA
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Boukje de Vries
- Department of Human Genetics, Leiden University Medical Center, 2333 ZC, Leiden, The Netherlands
| | - Dale R Nyholt
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Brisbane, QLD, 4059, Australia.,Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Boudewijn P F Lelieveldt
- Delft Bioinformatics Lab, Department of Intelligent Systems, Delft University of Technology, 2628 CD, Delft, The Netherlands.,Division of Image Processing, Department of Radiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Center, 2333 ZC, Leiden, The Netherlands. .,Department of Neurology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands.
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Department of Intelligent Systems, Delft University of Technology, 2628 CD, Delft, The Netherlands.
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Multicontrast MRI Quantification of Focal Inflammation and Degeneration in Multiple Sclerosis. BIOMED RESEARCH INTERNATIONAL 2015; 2015:569123. [PMID: 26295042 PMCID: PMC4532805 DOI: 10.1155/2015/569123] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 11/07/2014] [Accepted: 11/07/2014] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Local microstructural pathology in multiple sclerosis patients might influence their clinical performance. This study applied multicontrast MRI to quantify inflammation and neurodegeneration in MS lesions. We explored the impact of MRI-based lesion pathology in cognition and disability. METHODS 36 relapsing-remitting MS subjects and 18 healthy controls underwent neurological, cognitive, behavioural examinations and 3 T MRI including (i) fluid attenuated inversion recovery, double inversion recovery, and magnetization-prepared gradient echo for lesion count; (ii) T1, T2, and T2(*) relaxometry and magnetisation transfer imaging for lesion tissue characterization. Lesions were classified according to the extent of inflammation/neurodegeneration. A generalized linear model assessed the contribution of lesion groups to clinical performances. RESULTS Four lesion groups were identified and characterized by (1) absence of significant alterations, (2) prevalent inflammation, (3) concomitant inflammation and microdegeneration, and (4) prevalent tissue loss. Groups 1, 3, 4 correlated with general disability (Adj-R (2) = 0.6; P = 0.0005), executive function (Adj-R (2) = 0.5; P = 0.004), verbal memory (Adj-R (2) = 0.4; P = 0.02), and attention (Adj-R (2) = 0.5; P = 0.002). CONCLUSION Multicontrast MRI provides a new approach to infer in vivo histopathology of plaques. Our results support evidence that neurodegeneration is the major determinant of patients' disability and cognitive dysfunction.
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18
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Lin YC, Daducci A, Meskaldji DE, Thiran JP, Michel P, Meuli R, Krueger G, Menegaz G, Granziera C. Quantitative Analysis of Myelin and Axonal Remodeling in the Uninjured Motor Network After Stroke. Brain Connect 2014; 5:401-12. [PMID: 25296185 DOI: 10.1089/brain.2014.0245] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Contralesional brain connectivity plasticity was previously reported after stroke. This study aims at disentangling the biological mechanisms underlying connectivity plasticity in the uninjured motor network after an ischemic lesion. In particular, we measured generalized fractional anisotropy (GFA) and magnetization transfer ratio (MTR) to assess whether poststroke connectivity remodeling depends on axonal and/or myelin changes. Diffusion-spectrum imaging and magnetization transfer MRI at 3T were performed in 10 patients in acute phase, at 1 and 6 months after stroke, which was affecting motor cortical and/or subcortical areas. Ten age- and gender-matched healthy volunteers were scanned 1 month apart for longitudinal comparison. Clinical assessment was also performed in patients prior to magnetic resonance imaging (MRI). In the contralesional hemisphere, average measures and tract-based quantitative analysis of GFA and MTR were performed to assess axonal integrity and myelination along motor connections as well as their variations in time. Mean and tract-based measures of MTR and GFA showed significant changes in a number of contralesional motor connections, confirming both axonal and myelin plasticity in our cohort of patients. Moreover, density-derived features (peak height, standard deviation, and skewness) of GFA and MTR along the tracts showed additional correlation with clinical scores than mean values. These findings reveal the interplay between contralateral myelin and axonal remodeling after stroke.
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Affiliation(s)
- Ying-Chia Lin
- 1 Department of Computer Science, University of Verona , Verona, Italy
| | - Alessandro Daducci
- 2 STI/IEL/LTS5 , Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Djalel Eddine Meskaldji
- 3 Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland .,4 Department of Radiology and Medical Informatics, University of Geneva , Geneva, Switzerland
| | - Jean-Philippe Thiran
- 2 STI/IEL/LTS5 , Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Patrik Michel
- 5 Stroke Center, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne , Lausanne, Switzerland
| | - Reto Meuli
- 6 Department of Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne , Lausanne, Switzerland
| | - Gunnar Krueger
- 7 Healthcare Sector IM&WS S, Siemens Schweiz AG, Lausanne, Switzerland .,8 Advanced Clinical Imaging Technology Group, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Gloria Menegaz
- 1 Department of Computer Science, University of Verona , Verona, Italy
| | - Cristina Granziera
- 2 STI/IEL/LTS5 , Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland .,8 Advanced Clinical Imaging Technology Group, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland .,9 Laboratoire de Recherche en Neuroimagerie and Neuroimmunology Unit, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne , Lausanne, Switzerland
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19
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Zhao L, Liu J, Zhang F, Dong X, Peng Y, Qin W, Wu F, Li Y, Yuan K, von Deneen KM, Gong Q, Tang Z, Liang F. Effects of long-term acupuncture treatment on resting-state brain activity in migraine patients: a randomized controlled trial on active acupoints and inactive acupoints. PLoS One 2014; 9:e99538. [PMID: 24915066 PMCID: PMC4051855 DOI: 10.1371/journal.pone.0099538] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 05/14/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Acupuncture has been commonly used for preventing migraine attacks and relieving pain during a migraine, although there is limited knowledge on the physiological mechanism behind this method. The objectives of this study were to compare the differences in brain activities evoked by active acupoints and inactive acupoints and to investigate the possible correlation between clinical variables and brain responses. METHODS AND RESULTS A randomized controlled trial and resting-state functional magnetic resonance imaging (fMRI) were conducted. A total of eighty migraineurs without aura were enrolled to receive either active acupoint acupuncture or inactive acupoint acupuncture treatment for 8 weeks, and twenty patients in each group were randomly selected for the fMRI scan at the end of baseline and at the end of treatment. The neuroimaging data indicated that long-term active acupoint therapy elicited a more extensive and remarkable cerebral response compared with acupuncture at inactive acupoints. Most of the regions were involved in the pain matrix, lateral pain system, medial pain system, default mode network, and cognitive components of pain processing. Correlation analysis showed that the decrease in the visual analogue scale (VAS) was significantly related to the increased average Regional homogeneity (ReHo) values in the anterior cingulate cortex in the two groups. Moreover, the decrease in the VAS was associated with increased average ReHo values in the insula which could be detected in the active acupoint group. CONCLUSIONS Long-term active acupoint therapy and inactive acupoint therapy have different brain activities. We postulate that acupuncture at the active acupoint might have the potential effect of regulating some disease-affected key regions and the pain circuitry for migraine, and promote establishing psychophysical pain homeostasis. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-TRC-13003635.
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Affiliation(s)
- Ling Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jixin Liu
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- * E-mail: (FL), (JL)
| | - Fuwen Zhang
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xilin Dong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yulin Peng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wei Qin
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Fumei Wu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ying Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Karen M. von Deneen
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Qiyong Gong
- Department of Radiology, The Center for Medical Imaging, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Zili Tang
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- * E-mail: (FL), (JL)
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Bonnier G, Roche A, Romascano D, Simioni S, Meskaldji D, Rotzinger D, Lin YC, Menegaz G, Schluep M, Du Pasquier R, Sumpf TJ, Frahm J, Thiran JP, Krueger G, Granziera C. Advanced MRI unravels the nature of tissue alterations in early multiple sclerosis. Ann Clin Transl Neurol 2014; 1:423-32. [PMID: 25356412 PMCID: PMC4184670 DOI: 10.1002/acn3.68] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 03/27/2014] [Accepted: 04/28/2014] [Indexed: 01/16/2023] Open
Abstract
Introduction In patients with multiple sclerosis (MS), conventional magnetic resonance imaging (MRI) provides only limited insights into the nature of brain damage with modest clinic-radiological correlation. In this study, we applied recent advances in MRI techniques to study brain microstructural alterations in early relapsing-remitting MS (RRMS) patients with minor deficits. Further, we investigated the potential use of advanced MRI to predict functional performances in these patients. Methods Brain relaxometry (T1, T2, T2*) and magnetization transfer MRI were performed at 3T in 36 RRMS patients and 18 healthy controls (HC). Multicontrast analysis was used to assess for microstructural alterations in normal-appearing (NA) tissue and lesions. A generalized linear model was computed to predict clinical performance in patients using multicontrast MRI data, conventional MRI measures as well as demographic and behavioral data as covariates. Results Quantitative T2 and T2* relaxometry were significantly increased in temporal normal-appearing white matter (NAWM) of patients compared to HC, indicating subtle microedema (P = 0.03 and 0.004). Furthermore, significant T1 and magnetization transfer ratio (MTR) variations in lesions (mean T1 z-score: 4.42 and mean MTR z-score: −4.09) suggested substantial tissue loss. Combinations of multicontrast and conventional MRI data significantly predicted cognitive fatigue (P = 0.01, Adj-R2 = 0.4), attention (P = 0.0005, Adj-R2 = 0.6), and disability (P = 0.03, Adj-R2 = 0.4). Conclusion Advanced MRI techniques at 3T, unraveled the nature of brain tissue damage in early MS and substantially improved clinical–radiological correlations in patients with minor deficits, as compared to conventional measures of disease.
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Affiliation(s)
- Guillaume Bonnier
- Advanced Clinical Imaging Technology group, Siemens Healthcare IM BM PI Lausanne, Switzerland ; Neuro-immunology and Laboratoire de recherché en neuroimagérie, Neurology Division, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne, Switzerland ; LTS5, Ecole Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Alexis Roche
- Advanced Clinical Imaging Technology group, Siemens Healthcare IM BM PI Lausanne, Switzerland ; LTS5, Ecole Polytechnique Fédérale de Lausanne Lausanne, Switzerland ; Department of Radiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne, Switzerland
| | - David Romascano
- Advanced Clinical Imaging Technology group, Siemens Healthcare IM BM PI Lausanne, Switzerland ; LTS5, Ecole Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Samanta Simioni
- Neuro-immunology and Laboratoire de recherché en neuroimagérie, Neurology Division, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne, Switzerland
| | - Djalel Meskaldji
- LTS5, Ecole Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - David Rotzinger
- Department of Radiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne, Switzerland
| | - Ying-Chia Lin
- Department of Computer Science, University of Verona Verona, Italy
| | - Gloria Menegaz
- Department of Computer Science, University of Verona Verona, Italy
| | - Myriam Schluep
- Neuro-immunology and Laboratoire de recherché en neuroimagérie, Neurology Division, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne, Switzerland
| | - Renaud Du Pasquier
- Neuro-immunology and Laboratoire de recherché en neuroimagérie, Neurology Division, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne, Switzerland
| | - Tilman Johannes Sumpf
- Biomedizinische NMR Forschungs GmbH, Max Planck Institute for Biophysical Chemistry Goettingen, Germany
| | - Jens Frahm
- Biomedizinische NMR Forschungs GmbH, Max Planck Institute for Biophysical Chemistry Goettingen, Germany
| | | | - Gunnar Krueger
- Advanced Clinical Imaging Technology group, Siemens Healthcare IM BM PI Lausanne, Switzerland ; Healthcare Sector IM&WS S, Siemens Schweiz AG Renens, Switzerland
| | - Cristina Granziera
- Advanced Clinical Imaging Technology group, Siemens Healthcare IM BM PI Lausanne, Switzerland ; Neuro-immunology and Laboratoire de recherché en neuroimagérie, Neurology Division, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne, Switzerland ; LTS5, Ecole Polytechnique Fédérale de Lausanne Lausanne, Switzerland
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