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Weisend JE, Carlson AP, Shuttleworth CW. Spreading Depolarization Induces a Transient Potentiation of Excitatory Synaptic Transmission. Neuroscience 2024; 551:323-332. [PMID: 38821241 DOI: 10.1016/j.neuroscience.2024.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024]
Abstract
Spreading depolarization (SD) is a slowly propagating wave of prolonged activation followed by a period of synaptic suppression. Some prior reports have shown potentiation of synaptic transmission after recovery from synaptic suppression and noted similarities with the phenomenon of long-term potentiation (LTP). Since SD is increasingly recognized as participating in diverse neurological disorders, it is of interest to determine whether SD indeed leads to a generalized and sustained long-term strengthening of synaptic connections. We performed a characterization of SD-induced potentiation, and tested whether distinctive features of SD, including adenosine accumulation and swelling, contribute to reports of SD-induced plasticity. Field excitatory postsynaptic potentials (fEPSPs) were recorded in the hippocampal CA1 subregion of murine brain slices, and SD elicited using focal microinjection of KCl. A single SD was sufficient to induce a consistent potentiation of slope and amplitude of fEPSPs. Both AMPA- and NMDA-receptor mediated components were enhanced. Potentiation peaked ∼20 min after SD recovery and was sustained for ∼30 min. However, fEPSP amplitude and slope decayed over an extended 2-hour recording period and was estimated to reach baseline after ∼3 h. Potentiation was saturated after a single SD and adenosine A1 receptor activation did not mask additional potentiation. Induction of LTP with theta-burst stimulation was not altered by prior induction of SD and molecular mediators known to block LTP induction did not block SD-induced potentiation. Together, these results indicate an intermediate duration potentiation that is distinct from hippocampal LTP and may have implications for circuit function for 1-2 h following SD.
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Affiliation(s)
- Jordan E Weisend
- Department of Neurosciences, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Andrew P Carlson
- Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - C William Shuttleworth
- Department of Neurosciences, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.
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2
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May A. Beyond aura: Understanding migraine as a cycling pan-sensory threshold disease. Headache 2024; 64:715-717. [PMID: 38779974 DOI: 10.1111/head.14736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Arne May
- Department of Systems Neuroscience, University Medical Center Hamburg Eppendorf, Hamburg, Germany
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3
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Zou X, He J, Zhou M, Zhao F, Tian X, Xu X, Hong W, Wang F, Chen J, Qin C, Xia J, Xie Y, Xiao Y, Liu K, Guo L. Photophobia and Visual Triggers in Vestibular Migraine. Neurol Ther 2024:10.1007/s40120-024-00631-8. [PMID: 38819614 DOI: 10.1007/s40120-024-00631-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION Vestibular migraine (VM) is a prevalent vestibular disorder characterized by episodic vertigo. However, the relationship between photophobia and visual triggers in VM remains unexplored. We investigated the correlation of photophobia during the VM attack with interictal photosensitivity and visually triggering dizziness in patients with VM. METHODS We enrolled patients diagnosed with VM, with or without photophobia, across seven specialized vertigo and headache clinics in China. Healthy individuals were also included as a control group. Using a cross-sectional survey design, we collected data related to light intensity and dizziness frequency triggered by flicker, glare, and eyestrain using the Headache Triggers Sensitivity and Avoidance Questionnaire. RESULTS A total of 366 patients were recruited. The photosensitivity and frequency of dizziness induced by flicker, glare, and eyestrain observed in patients with VM and photophobia were significantly elevated compared with those in patients without photophobia and control participants (P < 0.001). A significant positive correlation was observed between photosensitivity levels and dizziness frequency triggered by flicker, glare, and eyestrain in patients with VM and photophobia (P < 0.001). CONCLUSIONS This study unequivocally established a positive association of ictal photophobia with interictal photosensitivity and visually triggering dizziness, strongly advocating the need for further research on exposure-based therapies for managing VM. CLINICAL TRIALS REGISTRATION ClinicalTrial.gov Identifier, NCT04939922, retrospectively registered, 14th June 2021.
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Affiliation(s)
- Xiaodong Zou
- Department of Neurology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
- Key Laboratory of Cancer Prevention and Therapy Combining Traditional Chinese and Western Medicine of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Jiahui He
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Mengting Zhou
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Fangling Zhao
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Xiulin Tian
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Xiaopei Xu
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Wenwu Hong
- Department of Neurology, Tiantai People's Hospital of Zhejiang Province, Tiantai, 317200, Zhejiang, China
| | - Faming Wang
- Department of Neurology, Tiantai People's Hospital of Zhejiang Province, Tiantai, 317200, Zhejiang, China
| | - Juanyan Chen
- Department of Neurology, Dongyang People's Hospital, Dongyang, 322103, Zhejiang, China
| | - Chenghui Qin
- Department of Neurology, Affiliated Hospital of Shaoxing University, Shaoxing, 312099, Zhejiang, China
| | - Jinjin Xia
- Department of Neurology, Changxing People's Hospital of Zhejiang Province, Changxing, 313199, Zhejiang, China
| | - Yuying Xie
- Department of Neurology, Shanghang County Hospital, Shanghang, 364299, Fujian, China
| | - Yujin Xiao
- Department of Neurology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, 314033, Zhejiang, China
| | - Kaiming Liu
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
| | - Liang Guo
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China.
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Son H, Zhang Y, Shannonhouse J, Gomez R, Kim YS. PACAP38/mast-cell-specific receptor axis mediates repetitive stress-induced headache in mice. J Headache Pain 2024; 25:87. [PMID: 38802819 PMCID: PMC11131290 DOI: 10.1186/s10194-024-01786-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Pain, an evolutionarily conserved warning system, lets us recognize threats and motivates us to adapt to those threats. Headache pain from migraine affects approximately 15% of the global population. However, the identity of any putative threat that migraine or headache warns us to avoid is unknown because migraine pathogenesis is poorly understood. Here, we show that a stress-induced increase in pituitary adenylate cyclase-activating polypeptide-38 (PACAP38), known as an initiator of allosteric load inducing unbalanced homeostasis, causes headache-like behaviour in male mice via mas-related G protein-coupled receptor B2 (MrgprB2) in mast cells. METHODS The repetitive stress model and dural injection of PACAP38 were performed to induce headache behaviours. We assessed headache behaviours using the facial von Frey test and the grimace scale in wild-type and MrgprB2-deficient mice. We further examined the activities of trigeminal ganglion neurons using in vivo Pirt-GCaMP Ca2+ imaging of intact trigeminal ganglion (TG). RESULTS Repetitive stress and dural injection of PACAP38 induced MrgprB2-dependent headache behaviours. Blood levels of PACAP38 were increased after repetitive stress. PACAP38/MrgprB2-induced mast cell degranulation sensitizes the trigeminovascular system in dura mater. Moreover, using in vivo intact TG Pirt-GCaMP Ca2+ imaging, we show that stress or/and elevation of PACAP38 sensitized the TG neurons via MrgprB2. MrgprB2-deficient mice showed no sensitization of TG neurons or mast cell activation. We found that repetitive stress and dural injection of PACAP38 induced headache behaviour through TNF-a and TRPV1 pathways. CONCLUSIONS Our findings highlight the PACAP38-MrgprB2 pathway as a new target for the treatment of stress-related migraine headache. Furthermore, our results pertaining to stress interoception via the MrgprB2/PACAP38 axis suggests that migraine headache warns us of stress-induced homeostatic imbalance.
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Affiliation(s)
- Hyeonwi Son
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Yan Zhang
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center, San Antonio, TX, USA
| | - John Shannonhouse
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Ruben Gomez
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Yu Shin Kim
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center, San Antonio, TX, USA.
- Programs in Integrated Biomedical Sciences, Biomedical Engineering, Radiological Sciences, Translational Sciences, University of Texas Health Science Center, San Antonio, TX, USA.
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van den Hoek TC, van de Ruit M, Terwindt GM, Tolner EA. EEG Changes in Migraine-Can EEG Help to Monitor Attack Susceptibility? Brain Sci 2024; 14:508. [PMID: 38790486 PMCID: PMC11119734 DOI: 10.3390/brainsci14050508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/26/2024] Open
Abstract
Migraine is a highly prevalent brain condition with paroxysmal changes in brain excitability believed to contribute to the initiation of an attack. The attacks and their unpredictability have a major impact on the lives of patients. Clinical management is hampered by a lack of reliable predictors for upcoming attacks, which may help in understanding pathophysiological mechanisms to identify new treatment targets that may be positioned between the acute and preventive possibilities that are currently available. So far, a large range of studies using conventional hospital-based EEG recordings have provided contradictory results, with indications of both cortical hyper- as well as hypo-excitability. These heterogeneous findings may largely be because most studies were cross-sectional in design, providing only a snapshot in time of a patient's brain state without capturing day-to-day fluctuations. The scope of this narrative review is to (i) reflect on current knowledge on EEG changes in the context of migraine, the attack cycle, and underlying pathophysiology; (ii) consider the effects of migraine treatment on EEG features; (iii) outline challenges and opportunities in using EEG for monitoring attack susceptibility; and (iv) discuss future applications of EEG in home-based settings.
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Affiliation(s)
- Thomas C. van den Hoek
- Department of Neurology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands (M.v.d.R.); (G.M.T.)
| | - Mark van de Ruit
- Department of Neurology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands (M.v.d.R.); (G.M.T.)
- Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Gisela M. Terwindt
- Department of Neurology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands (M.v.d.R.); (G.M.T.)
| | - Else A. Tolner
- Department of Neurology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands (M.v.d.R.); (G.M.T.)
- Department of Human Genetics, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
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6
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Breitwieser GE, Cippitelli A, Wang Y, Pelletier O, Dershem R, Wei J, Toll L, Fakhoury B, Brunori G, Metpally R, Carey DJ, Robishaw J. Rare GPR37L1 Variants Reveal Potential Association between GPR37L1 and Disorders of Anxiety and Migraine. J Neurosci 2024; 44:e1226232024. [PMID: 38569927 PMCID: PMC11089846 DOI: 10.1523/jneurosci.1226-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
GPR37L1 is an orphan receptor that couples through heterotrimeric G-proteins to regulate physiological functions. Since its role in humans is not fully defined, we used an unbiased computational approach to assess the clinical significance of rare G-protein-coupled receptor 37-like 1 (GPR37L1) genetic variants found among 51,289 whole-exome sequences from the DiscovEHR cohort. Rare GPR37L1 coding variants were binned according to predicted pathogenicity and analyzed by sequence kernel association testing to reveal significant associations with disease diagnostic codes for epilepsy and migraine, among others. Since associations do not prove causality, rare GPR37L1 variants were functionally analyzed in SK-N-MC cells to evaluate potential signaling differences and pathogenicity. Notably, receptor variants exhibited varying abilities to reduce cAMP levels, activate mitogen-activated protein kinase (MAPK) signaling, and/or upregulate receptor expression in response to the agonist prosaptide (TX14(A)), as compared with the wild-type receptor. In addition to signaling changes, knock-out (KO) of GPR37L1 or expression of certain rare variants altered cellular cholesterol levels, which were also acutely regulated by administration of the agonist TX14(A) via activation of the MAPK pathway. Finally, to simulate the impact of rare nonsense variants found in the large patient cohort, a KO mouse line lacking Gpr37l1 was generated. Although KO animals did not recapitulate an acute migraine phenotype, the loss of this receptor produced sex-specific changes in anxiety-related disorders often seen in chronic migraineurs. Collectively, these observations define the existence of rare GPR37L1 variants associated with neuropsychiatric conditions in the human population and identify the signaling changes contributing to pathological processes.
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Affiliation(s)
- Gerda E Breitwieser
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Andrea Cippitelli
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Yingcai Wang
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Oliver Pelletier
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Ridge Dershem
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Jianning Wei
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Lawrence Toll
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Bianca Fakhoury
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Gloria Brunori
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | | | - David J Carey
- Geisinger, Weis Center for Research, Danville, Pennsylvania
| | - Janet Robishaw
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
- College of Veterinary Medicine, University of Florida, Gainesville, Florida
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7
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Lim M, Kim DJ, Nascimento TD, DaSilva AF. High-definition tDCS over primary motor cortex modulates brain signal variability and functional connectivity in episodic migraine. Clin Neurophysiol 2024; 161:101-111. [PMID: 38460220 DOI: 10.1016/j.clinph.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/08/2024] [Accepted: 02/10/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE This study investigated how high-definition transcranial direct current stimulation (HD-tDCS) over the primary motor cortex (M1) affects brain signal variability and functional connectivity in the trigeminal pain pathway, and their association with changes in migraine attacks. METHODS Twenty-five episodic migraine patients were randomized for ten daily sessions of active or sham M1 HD-tDCS. Resting-state blood-oxygenation-level-dependent (BOLD) signal variability and seed-based functional connectivity were assessed pre- and post-treatment. A mediation analysis was performed to test whether BOLD signal variability mediates the relationship between treatment group and moderate-to-severe headache days. RESULTS The active M1 HD-tDCS group showed reduced BOLD variability in the spinal trigeminal nucleus (SpV) and thalamus, but increased variability in the rostral anterior cingulate cortex (rACC) compared to the sham group. Connectivity decreased between medial pulvinar-temporal pole, medial dorsal-precuneus, and the ventral posterior medial nucleus-SpV, but increased between the rACC-amygdala, and the periaqueductal gray-parahippocampal gyrus. Changes in medial pulvinar variability mediated the reduction in moderate-to-severe headache days at one-month post-treatment. CONCLUSIONS M1 HD-tDCS alters BOLD signal variability and connectivity in the trigeminal somatosensory and modulatory pain system, potentially alleviating migraine headache attacks. SIGNIFICANCE M1 HD-tDCS realigns brain signal variability and connectivity in migraineurs closer to healthy control levels.
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Affiliation(s)
- Manyoel Lim
- Food Processing Research Group, Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Republic of Korea; Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - Dajung J Kim
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - Thiago D Nascimento
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - Alexandre F DaSilva
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA; Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109, USA.
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8
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Menyhárt Á, Bálint AR, Kozák P, Bari F, Farkas E. Nimodipine accelerates the restoration of functional hyperemia during spreading oligemia. J Neurochem 2024; 168:888-898. [PMID: 36810711 DOI: 10.1111/jnc.15792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/14/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023]
Abstract
Spreading depolarization (SD) is assumed to be the pathophysiological correlate of migraine aura, leading to spreading depression of activity and a long-lasting vasoconstriction known as spreading oligemia. Furthermore, cerebrovascular reactivity is reversibly impaired after SD. Here, we explored the progressive restoration of impaired neurovascular coupling to somatosensory activation during spreading oligemia. Also, we evaluated whether nimodipine treatment accelerated the recovery of impaired neurovascular coupling after SD. Male, 4-9-month-old C57BL/6 mice (n = 11) were anesthetized with isoflurane (1%-1.5%), and SD was triggered with KCl through a burr hole made at the caudal parietal bone. EEG and cerebral blood flow (CBF) were recorded minimally invasively with a silver ball electrode and transcranial laser-Doppler flowmetry, rostral to SD elicitation. The L-type voltage-gated Ca2+ channel blocker nimodipine was administered i.p. (10 mg/kg). Whisker stimulation-related evoked potentials (EVPs) and functional hyperemia were assessed under isoflurane (0.1%)-medetomidine (0.1 mg/kg i.p.) anesthesia before, and repeatedly after SD, at 15-min intervals for 75 minutes. Nimodipine accelerated the recovery of CBF from spreading oligemia (time to full recovery, 52 ± 13 vs. 70 ± 8 min, nimodipine vs. control) and exhibited a tendency to shorten the duration of the SD-related EGG depression duration. The amplitudes of EVP and functional hyperemia were markedly reduced after SD, and progressively recovered over an hour post-SD. Nimodipine exerted no impact on EVP amplitude but consistently increased the absolute level of functional hyperemia from 20 min post-CSD (93 ± 11% vs. 66 ± 13%, nimodipine vs. control). A linear, positive correlation between EVP and functional hyperemia amplitude was skewed by nimodipine. In conclusion, nimodipine facilitated CBF restoration from spreading oligemia and the recovery of functional hyperemia post-SD, which were linked to a tendency of an accelerated return of spontaneous neural activity after SD. The use of nimodipine in migraine prophylaxis is suggested to be re-visited.
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Affiliation(s)
- Ákos Menyhárt
- Hungarian Centre of Excellence for Molecular Medicine-University of Szeged, Cerebral Blood Flow and Metabolism Research Group, Szeged, Hungary
- Department of Cell Biology and Molecular Medicine, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Armand Rafael Bálint
- Department of Cell Biology and Molecular Medicine, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
- Department of Medical Physics and Informatics, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Péter Kozák
- Department of Cell Biology and Molecular Medicine, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Ferenc Bari
- Department of Medical Physics and Informatics, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Eszter Farkas
- Hungarian Centre of Excellence for Molecular Medicine-University of Szeged, Cerebral Blood Flow and Metabolism Research Group, Szeged, Hungary
- Department of Cell Biology and Molecular Medicine, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
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9
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Singh S, Kopruszinski CM, Watanabe M, Dodick DW, Navratilova E, Porreca F. Female-selective mechanisms promoting migraine. J Headache Pain 2024; 25:63. [PMID: 38658853 PMCID: PMC11040950 DOI: 10.1186/s10194-024-01771-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
Sexual dimorphism has been revealed for many neurological disorders including chronic pain. Prelicinal studies and post-mortem analyses from male and female human donors reveal sexual dimorphism of nociceptors at transcript, protein and functional levels suggesting different mechanisms that may promote pain in men and women. Migraine is a common female-prevalent neurological disorder that is characterized by painful and debilitating headache. Prolactin is a neurohormone that circulates at higher levels in females and that has been implicated clinically in migraine. Prolactin sensitizes sensory neurons from female mice, non-human primates and humans revealing a female-selective pain mechanism that is conserved evolutionarily and likely translationally relevant. Prolactin produces female-selective migraine-like pain behaviors in rodents and enhances the release of calcitonin gene-related peptide (CGRP), a neurotransmitter that is causal in promoting migraine in many patients. CGRP, like prolactin, produces female-selective migraine-like pain behaviors. Consistent with these observations, publicly available clinical data indicate that small molecule CGRP-receptor antagonists are preferentially effective in treatment of acute migraine therapy in women. Collectively, these observations support the conclusion of qualitative sex differences promoting migraine pain providing the opportunity to tailor therapies based on patient sex for improved outcomes. Additionally, patient sex should be considered in design of clinical trials for migraine as well as for pain and reassessment of past trials may be warranted.
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Affiliation(s)
- Shagun Singh
- Banner - University Medicine Sunrise Primary Care, Tucson, AZ, 85750, USA
| | - Caroline M Kopruszinski
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, 85724, USA
| | - Moe Watanabe
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, 85724, USA
| | - David W Dodick
- Department of Neurology, Mayo Clinic, Phoenix, AZ, USA
- Atria Academy of Science and Medicine, New York, NY, USA
| | - Edita Navratilova
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, 85724, USA
- Department of Neurology, Mayo Clinic, Phoenix, AZ, USA
| | - Frank Porreca
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, 85724, USA.
- Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.
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10
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Fila M, Przyslo L, Derwich M, Pawlowska E, Blasiak J. Potential of focal cortical dysplasia in migraine pathogenesis. Cereb Cortex 2024; 34:bhae158. [PMID: 38615241 DOI: 10.1093/cercor/bhae158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/15/2024] Open
Abstract
Focal cortical dysplasias are abnormalities of the cerebral cortex associated with an elevated risk of neurological disturbances. Cortical spreading depolarization/depression is a correlate of migraine aura/headache and a trigger of migraine pain mechanisms. However, cortical spreading depolarization/depression is associated with cortical structural changes, which can be classified as transient focal cortical dysplasias. Migraine is reported to be associated with changes in various brain structures, including malformations and lesions in the cortex. Such malformations may be related to focal cortical dysplasias, which may play a role in migraine pathogenesis. Results obtained so far suggest that focal cortical dysplasias may belong to the causes and consequences of migraine. Certain focal cortical dysplasias may lower the threshold of cortical excitability and facilitate the action of migraine triggers. Migraine prevalence in epileptic patients is higher than in the general population, and focal cortical dysplasias are an established element of epilepsy pathogenesis. In this narrative/hypothesis review, we present mainly information on cortical structural changes in migraine, but studies on structural alterations in deep white matter and other brain regions are also presented. We develop the hypothesis that focal cortical dysplasias may be causally associated with migraine and link pathogeneses of migraine and epilepsy.
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Affiliation(s)
- Michal Fila
- Department of Developmental Neurology and Epileptology, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Łódzkie, Poland
| | - Lukasz Przyslo
- Department of Developmental Neurology and Epileptology, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Łódzkie, Poland
| | - Marcin Derwich
- Department of Developmental Dentistry, Medical University of Lodz, Pomorska 251, 90-647 Lodz, Łódzkie, Poland
| | - Ezbieta Pawlowska
- Department of Developmental Dentistry, Medical University of Lodz, Pomorska 251, 90-647 Lodz, Łódzkie, Poland
| | - Janusz Blasiak
- Faculty of Medicine, Collegium Medicum, Mazovian Academy in Plock, Plac Generała Dabrowskiego 2, 09-420 Plock, Mazowieckie, Poland
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11
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Joshi S, Williamson J, Moosa S, Kapur J. Progesterone Receptor Activation Regulates Sensory Sensitivity and Migraine Susceptibility. THE JOURNAL OF PAIN 2024; 25:642-658. [PMID: 37777034 DOI: 10.1016/j.jpain.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/20/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023]
Abstract
Women develop chronic pain during their reproductive years more often than men, and estrogen and progesterone regulate this susceptibility. We tested whether brain progesterone receptor (PR) signaling regulates pain susceptibility. During the estrous cycle, animals were more sensitive to mechanical stimulus during the estrus stage than in the diestrus stage, suggesting a role for reproductive hormones, estrogen, and progesterone. Progesterone treatment of ovariectomized and estrogen-primed mice caused a delayed reduction in the mechanical threshold. Segesterone, a specific agonist of PRs replicated this effect, whereas, the segesterone-induced reduction in mechanical threshold was blocked in the mice lacking PRs in the nervous system. Segesterone treatment also did not alter mechanical threshold in adult male and juvenile female mice. PR activation increased the cold sensitivity but did not affect the heat and light sensitivity. We evaluated whether PR activation altered experimental migraine. Segesterone and nitroglycerin when administered sequentially, reduced the pain threshold but not when given separately. PRs were expressed in several components of the migraine ascending pain pathway, and their deletion blocked the painful effects of nitroglycerin. PR activation also increased the number of active neurons in the components of the migraine ascending pain pathway. These studies have uncovered a pain-regulating function of PRs. Targeting PRs may provide a novel therapeutic avenue to treat chronic pain and migraine in women. PERSPECTIVE: This article provides evidence for the role of progesterone receptors in regulating pain sensitivity and migraine susceptibility in females. Progesterone receptors may be a therapeutic target to treat chronic pain conditions more prevalent in women than men.
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Affiliation(s)
- Suchitra Joshi
- Department of Neurology, University of Virginia, Charlottesville, Virginia
| | - John Williamson
- Department of Neurology, University of Virginia, Charlottesville, Virginia
| | - Shayan Moosa
- Department of Neurosurgery, University of Virginia, Charlottesville, Virginia
| | - Jaideep Kapur
- Department of Neurology, University of Virginia, Charlottesville, Virginia; Department of Neuroscience, University of Virginia, Charlottesville, Virginia; UVA Brain Institute, University of Virginia, Charlottesville, Virginia
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12
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Pietrobon D, Conti F. Astrocytic Na +, K + ATPases in physiology and pathophysiology. Cell Calcium 2024; 118:102851. [PMID: 38308916 DOI: 10.1016/j.ceca.2024.102851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
The Na+, K+ ATPases play a fundamental role in the homeostatic functions of astrocytes. After a brief historic prologue and discussion of the subunit composition and localization of the astrocytic Na+, K+ ATPases, the review focuses on the role of the astrocytic Na+, K+ pumps in extracellular K+ and glutamate homeostasis, intracellular Na+ and Ca2+ homeostasis and signaling, regulation of synaptic transmission and neurometabolic coupling between astrocytes and neurons. Loss-of-function mutations in the gene encoding the astrocytic α2 Na+, K+ ATPase cause a rare monogenic form of migraine with aura (familial hemiplegic migraine type 2). On the other hand, the α2 Na+, K+ ATPase is upregulated in spinal cord and brain samples from amyotrophic lateral sclerosis and Alzheimer disease patients, respectively. In the last part, the review focuses on i) the migraine relevant phenotypes shown by familial hemiplegic migraine type 2 knock-in mice with 50 % reduced expression of the astrocytic α2 Na+, K+ ATPase and the insights into the pathophysiology of migraine obtained from these genetic mouse models, and ii) the evidence that upregulation of the astrocytic α2 Na+, K+ ATPase in mouse models of amyotrophic lateral sclerosis and Alzheimer disease promotes neuroinflammation and contributes to progressive neurodegeneration.
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Affiliation(s)
- Daniela Pietrobon
- Department of Biomedical Sciences and Padova Neuroscience Center (PNC), University of Padova, Padova 35131, Italy.
| | - Fiorenzo Conti
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy; Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy.
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13
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Hay DL. A future treatment horizon for migraine? Lancet Neurol 2024; 23:226-227. [PMID: 38365364 DOI: 10.1016/s1474-4422(24)00032-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/18/2024]
Affiliation(s)
- Debbie L Hay
- Department of Pharmacology & Toxicology, University of Otago, Dunedin 9054, New Zealand.
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14
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Zhao H, Zhang S, Wang Y, Zhang C, Gong Z, Zhang M, Dai W, Ran Y, Shi W, Dang Y, Liu A, Zhang Z, Yeh CH, Dong Z, Yu S. A pilot study on a patient with refractory headache: Personalized deep brain stimulation through stereoelectroencephalography. iScience 2024; 27:108847. [PMID: 38313047 PMCID: PMC10837616 DOI: 10.1016/j.isci.2024.108847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/23/2023] [Accepted: 01/03/2024] [Indexed: 02/06/2024] Open
Abstract
The integration of stereoelectroencephalography with therapeutic deep brain stimulation (DBS) holds immense promise as a viable approach for precise treatment of refractory disorders, yet it has not been explored in the domain of headache or pain management. Here, we implanted 14 electrodes in a patient with refractory migraine and integrated clinical assessment and electrophysiological data to investigate personalized targets for refractory headache treatment. Using statistical analyses and cross-validated machine-learning models, we identified high-frequency oscillations in the right nucleus accumbens as a critical headache-related biomarker. Through a systematic bipolar stimulation approach and blinded sham-controlled survey, combined with real-time electrophysiological data, we successfully identified the left dorsal anterior cingulate cortex as the optimal target for the best potential treatment. In this pilot study, the concept of the herein-proposed data-driven approach to optimizing precise and personalized treatment strategies for DBS may create a new frontier in the field of refractory headache and even pain disorders.
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Affiliation(s)
- Hulin Zhao
- Department of Neurosurgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Shuhua Zhang
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Yining Wang
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Chuting Zhang
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Zihua Gong
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Mingjie Zhang
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Wei Dai
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Ye Ran
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Wenbin Shi
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Key Laboratory of Brain Health Intelligent Evaluation and Intervention, Beijing Institute of Technology, Ministry of Education, Beijing 100081, China
| | - Yuanyuan Dang
- Department of Neurosurgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Aijun Liu
- Department of Neurosurgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhengbo Zhang
- Center for Artificial Intelligence in Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Chien-Hung Yeh
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Key Laboratory of Brain Health Intelligent Evaluation and Intervention, Beijing Institute of Technology, Ministry of Education, Beijing 100081, China
| | - Zhao Dong
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
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15
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Suryavanshi P, Sawant-Pokam P, Clair S, Brennan KC. Increased presynaptic excitability in a migraine with aura mutation. Brain 2024; 147:680-697. [PMID: 37831655 PMCID: PMC10834252 DOI: 10.1093/brain/awad326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 10/15/2023] Open
Abstract
Migraine is a common and disabling neurological disorder. The headache and sensory amplifications of migraine are attributed to hyperexcitable sensory circuits, but a detailed understanding remains elusive. A mutation in casein kinase 1 delta (CK1δ) was identified in non-hemiplegic familial migraine with aura and advanced sleep phase syndrome. Mice carrying the CK1δT44A mutation were more susceptible to spreading depolarization (the phenomenon that underlies migraine aura), but mechanisms underlying this migraine-relevant phenotype were not known. We used a combination of whole-cell electrophysiology and multiphoton imaging, in vivo and in brain slices, to compare CK1δT44A mice (adult males) to their wild-type littermates. We found that despite comparable synaptic activity at rest, CK1δT44A neurons were more excitable upon repetitive stimulation than wild-type, with a reduction in presynaptic adaptation at excitatory but not inhibitory synapses. The mechanism of this adaptation deficit was a calcium-dependent enhancement of the size of the readily releasable pool of synaptic vesicles, and a resultant increase in glutamate release, in CK1δT44A compared to wild-type synapses. Consistent with this mechanism, CK1δT44A neurons showed an increase in the cumulative amplitude of excitatory post-synaptic currents, and a higher excitation-to-inhibition ratio during sustained activity compared to wild-type. At a local circuit level, action potential bursts elicited in CK1δT44A neurons triggered an increase in recurrent excitation compared to wild-type, and at a network level, CK1δT44A mice showed a longer duration of 'up state' activity, which is dependent on recurrent excitation. Finally, we demonstrated that the spreading depolarization susceptibility of CK1δT44A mice could be returned to wild-type levels with the same intervention (reduced extracellular calcium) that normalized presynaptic adaptation. Taken together, these findings show a stimulus-dependent presynaptic gain of function at glutamatergic synapses in a genetic model of migraine, that accounts for the increased spreading depolarization susceptibility and may also explain the sensory amplifications that are associated with the disease.
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Affiliation(s)
- Pratyush Suryavanshi
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
- Interdepartmental Neuroscience Program, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
- Department of Pediatrics, University of Iowa, Iowa City, IA 52242, USA
| | - Punam Sawant-Pokam
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Sarah Clair
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - K C Brennan
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
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16
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van den Hoek TC, Perenboom MJL, Terwindt GM, Tolner EA, van de Ruit M. Bi-sinusoidal light stimulation reveals an enhanced response power and reduced phase coherence at the visual cortex in migraine. Front Neurol 2024; 14:1274059. [PMID: 38348113 PMCID: PMC10860712 DOI: 10.3389/fneur.2023.1274059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/14/2023] [Indexed: 02/15/2024] Open
Abstract
Introduction Migraine is associated with enhanced visual sensitivity during and outside attacks. Processing of visual information is a highly non-linear process involving complex interactions across (sub)cortical networks. In this exploratory study, we combined electroencephalography with bi-sinusoidal light stimulation to assess non-linear features of visual processing in participants with migraine. Methods Twenty participants with migraine (10 with aura, 10 without aura) and ten non-headache controls were measured (outside attacks). Participants received bi-sinusoidal 13 + 23 Hz red light visual stimulation. Electroencephalography spectral power and multi-spectral phase coherence were compared between groups at the driving stimulation frequencies together with multiples and combinations of these frequencies (harmonic and intermodulation frequencies) caused by non-linearities. Results Only at the driving frequency of 13 Hz higher spectral power was found in migraine with aura participants compared with those with migraine without aura and controls. Differences in phase coherence were present for 2nd, 4th, and 5th-order non-linearities in those with migraine (migraine with and without aura) compared with controls. Bi-sinusoidal light stimulation revealed evident non-linearities in the brain's electroencephalography response up to the 5th order with reduced phase coherence for higher order interactions in interictal participants with migraine. Discussion Insight into interictal non-linear visual processing may help understand brain dynamics underlying migraine attack susceptibility. Future research is needed to determine the clinical value of the results.
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Affiliation(s)
| | | | - Gisela M. Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, Netherlands
| | - Else A. Tolner
- Department of Neurology, Leiden University Medical Center, Leiden, Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Mark van de Ruit
- Department of Neurology, Leiden University Medical Center, Leiden, Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
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17
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Neugebauer V, Ponomarev I. Alcohol withdrawal and pain: Peripheral mechanisms join central circuits. Neuron 2024; 112:1-3. [PMID: 38176389 DOI: 10.1016/j.neuron.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024]
Abstract
Negative affective aspects of alcohol withdrawal and pain involve converging brain circuits. In this issue of Neuron, Son et al.1 identify a peripheral mechanism of an alcohol-withdrawal-induced headache-like condition, which is centered on mast-cell-specific receptor MrgprB2 activated by corticotropin-releasing factor (CRF) in dura mater to drive nociception.
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Affiliation(s)
- Volker Neugebauer
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center (TTUHSC), Lubbock, TX, USA; Center of Excellence for Translational Neuroscience and Therapeutics, Texas Tech University Health Sciences Center (TTUHSC), Lubbock, TX, USA; Garrison Institute on Aging, Texas Tech University Health Sciences Center (TTUHSC), Lubbock, TX, USA.
| | - Igor Ponomarev
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center (TTUHSC), Lubbock, TX, USA; Center of Excellence for Translational Neuroscience and Therapeutics, Texas Tech University Health Sciences Center (TTUHSC), Lubbock, TX, USA
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18
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Son H, Zhang Y, Shannonhouse J, Ishida H, Gomez R, Kim YS. Mast-cell-specific receptor mediates alcohol-withdrawal-associated headache in male mice. Neuron 2024; 112:113-123.e4. [PMID: 37909038 PMCID: PMC10843090 DOI: 10.1016/j.neuron.2023.09.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/13/2023] [Accepted: 09/26/2023] [Indexed: 11/02/2023]
Abstract
Rehabilitation from alcohol addiction or abuse is hampered by withdrawal symptoms including severe headaches, which often lead to rehabilitation failure. There is no appropriate therapeutic option available for alcohol-withdrawal-induced headaches. Here, we show the role of the mast-cell-specific receptor MrgprB2 in the development of alcohol-withdrawal-induced headache. Withdrawing alcohol from alcohol-acclimated mice induces headache behaviors, including facial allodynia, facial pain expressions, and reduced movement, which are symptoms often observed in humans. Those behaviors were absent in MrgprB2-deficient mice during alcohol withdrawal. We observed in vivo spontaneous activation and hypersensitization of trigeminal ganglia (TG) neurons in alcohol-withdrawal WT mice, but not in alcohol-withdrawal MrgprB2-deficient mice. Increased mast cell degranulation by alcohol withdrawal in dura mater was dependent on the presence of MrgprB2. The results indicate that alcohol withdrawal causes headache via MrgprB2 of mast cells in dura mater, suggesting that MrgprB2 is a potential target for treating alcohol-withdrawal-related headaches.
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Affiliation(s)
- Hyeonwi Son
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Yan Zhang
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - John Shannonhouse
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hirotake Ishida
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ruben Gomez
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Yu Shin Kim
- Department of Oral & Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Programs in Integrated Biomedical Sciences, Translational Sciences, Biomedical Engineering, Radiological Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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19
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Shibata M. In Search of More Leaps to Realize the Precision Medicine of Migraine. Int J Mol Sci 2023; 24:17375. [PMID: 38139204 PMCID: PMC10744148 DOI: 10.3390/ijms242417375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Migraine, clinically characterized by recurrent headache attacks of moderate-to-severe intensity, is the second most disabling disease in terms of years lived with disability [...].
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Affiliation(s)
- Mamoru Shibata
- Department of Neurology, Tokyo Dental College Ichikawa General Hospital, Chiba 272-8513, Japan
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20
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Qiu D, Ge Z, Mei Y, Wang W, Xiong Z, Li X, Yuan Z, Zhang P, Zhang M, Liu X, Zhang Y, Yu X, Tang H, Wang Y. Mapping brain functional networks topological characteristics in new daily persistent headache: a magnetoencephalography study. J Headache Pain 2023; 24:161. [PMID: 38053071 DOI: 10.1186/s10194-023-01695-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND The brain functional network topology in new daily persistent headache (NDPH) is not well understood. In this study, we aim to assess the cortical functional network topological characteristics of NDPH using non-invasive neural signal recordings. METHODS Resting-state magnetoencephalography (MEG) was used to measure power fluctuations in neuronal oscillations from distributed cortical parcels in 35 patients with NDPH and 40 healthy controls (HCs). Their structural data were collected by 3T MRI. Functional connectivity (FC) of neural networks from 1 to 80 Hz frequency ranges was analyzed with topographic patterns and calculated network topological parameters with graph theory. RESULTS In the delta (1-4 Hz) and beta (13-30 Hz) bands, the lateral occipital cortex and superior frontal gyrus FC were increased in NDPH groups compared to HCs. Graph theory analysis revealed that the NDPH had significantly increased global efficiency in the delta band and decreased nodal clustering coefficient (left medial orbitofrontal cortex) in the theta (4-8 Hz) band. The clinical characteristics had a significant correlation with network topological parameters. Age at onset of patients showed a positive correlation with global efficiency in the delta band. The degree of depression of patients showed a negative correlation with the nodal clustering coefficient (left medial orbitofrontal cortex) in the theta band. CONCLUSION The FC and topology of NDPH in brain networks may be altered, potentially leading to cortical hyperexcitability. Moreover, medial orbitofrontal cortex is involved in the pathophysiological mechanism of depression in patients with NDPH. Increased FC observed in the lateral occipital cortex and superior frontal gyrus during resting-state MEG could serve as one of the imaging characteristics associated with NDPH.
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Affiliation(s)
- Dong Qiu
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Zhaoli Ge
- Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong, China
| | - Yanliang Mei
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Wei Wang
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Zhonghua Xiong
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xiaoshuang Li
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Ziyu Yuan
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Peng Zhang
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Mantian Zhang
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xin Liu
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Yaqing Zhang
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xueying Yu
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Hefei Tang
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Yonggang Wang
- Department of Neurology, Headache Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
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21
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Liu H, Zheng R, Zhang Y, Zhang B, Hou H, Cheng J, Han S. Two distinct neuroanatomical subtypes of migraine without aura revealed by heterogeneity through discriminative analysis. Brain Imaging Behav 2023; 17:715-724. [PMID: 37776418 DOI: 10.1007/s11682-023-00802-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/02/2023]
Abstract
The neurobiological heterogeneity in migraine is poorly studied, resulting in conflicting neuroimaging findings. This study used a newly proposed method based on gray matter volumes (GMVs) to investigate objective neuroanatomical subtypes of migraine. Structural MRI and clinical measures of 31 migraine patients without aura and 33 matched healthy controls (HCs) were explored. Firstly, we investigated whether migraine patients exhibited higher interindividual variability than HCs in terms of GMVs. Then, heterogeneity through discriminative analysis (HYDRA) was applied to categorize migraine patients into distinct subtypes by regional volumetric measures of GMVs. Voxel-wise volume and clinical characteristics among different subtypes were also explored. Migraine patients without aura exhibited higher interindividual GMVs variability. Two distinct and reproducible neuroanatomical subtypes of migraine were revealed. These two subtypes exhibited opposite neuroanatomical aberrances compared to HCs. Subtype 1 showed widespread decreased GMVs, while Subtype 2 showed increased GMVs in limited regions. The total intracranial volume was significantly positively correlated with cognitive function in Subtype 2. Subtype 1 showed significantly longer illness duration and less cognitive scores compared to Subtype 2. The present study shows that migraine patients without aura have high structural heterogeneity and uncovers two distinct and robust neuroanatomical subtypes, which provide a possible explanation for conflicting neuroimaging findings.
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Affiliation(s)
- Hao Liu
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, 1 Jianshe Dong Rd, Zhengzhou, 450000, Henan, China
| | - Ruiping Zheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, 1 Jianshe Dong Rd, Zhengzhou, 450000, Henan, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, 1 Jianshe Dong Rd, Zhengzhou, 450000, Henan, China
| | - Beibei Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, 1 Jianshe Dong Rd, Zhengzhou, 450000, Henan, China
| | - Haiman Hou
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, 1 Jianshe Dong Rd, Zhengzhou, 450000, Henan, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, 1 Jianshe Dong Rd, Zhengzhou, 450000, Henan, China.
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22
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Pinto SN, Lerner A, Phung D, Barisano G, Chou B, Xu W, Sheikh-Bahaei N. Arterial Spin Labeling in Migraine: A Review of Migraine Categories and Mimics. J Cent Nerv Syst Dis 2023. [DOI: 10.1177/11795735231160032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Migraine is a complex headache characterized by changes in functional connectivity and cerebral perfusion. The perfusion changes represent a valuable domain for targeted drug therapy. Arterial spin labeling is a noncontrast imaging technique of quantifying cerebral perfusion changes in the migraine setting. In this narrative review, we will discuss the pathophysiology of the different categories of migraine, as defined by the International Classification of Headache Disorders-3 and describe a category-based approach to delineating perfusion changes in migraine on arterial spin labeling images. We will also discuss the use of arterial spin labeling to differentiate migraine from stroke and/or seizures in the adult and pediatric populations. Our systematic approach will help improve the understanding of the complicated vascular changes that occur during migraines and identify potential areas of future research.
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Affiliation(s)
- Soniya N Pinto
- Department of Diagnostic Imaging, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - Alexander Lerner
- University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Daniel Phung
- University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Giuseppe Barisano
- University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Brendon Chou
- University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Wilson Xu
- University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Nasim Sheikh-Bahaei
- University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
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Dai W, Qiu E, Lin X, Zhang S, Zhang M, Han X, Jia Z, Su H, Bian X, Zang X, Li M, Zhang Q, Ran Y, Gong Z, Wang X, Wang R, Tian L, Dong Z, Yu S. Abnormal Thalamo-Cortical Interactions in Overlapping Communities of Migraine: An Edge Functional Connectivity Study. Ann Neurol 2023; 94:1168-1181. [PMID: 37635687 DOI: 10.1002/ana.26783] [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: 06/07/2023] [Revised: 08/24/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Migraine has been demonstrated to exhibit abnormal functional connectivity of large-scale brain networks, which is closely associated with its pathophysiology and has not yet been explored by edge functional connectivity. We used an edge-centric approach combined with motif analysis to evaluate higher-order communication patterns of brain networks in migraine. METHODS We investigated edge-centric metrics in 108 interictal migraine patients and 71 healthy controls. We parcellated the brain into networks using independent component analysis. We applied edge graph construction, k-means clustering, community overlap detection, graph-theory-based evaluations, and clinical correlation analysis. We conducted motif analysis to explore the interactions among regions, and a classification model to test the specificity of edge-centric results. RESULTS The normalized entropy of lateral thalamus was significantly increased in migraine, which was positively correlated with the baseline headache duration, and negatively correlated with headache duration reduction following preventive medications at 3-month follow-up. Network-wise entropy of the sensorimotor network was significantly elevated in migraine. The community similarity between lateral thalamus and postcentral gyrus was enhanced in migraine. Migraine patients showed overrepresented L-shape and diverse motifs, and underrepresented forked motifs with lateral thalamus serving as the reference node. Furthermore, migraine patients presented with overrepresented L-shape triads, where the postcentral gyrus shared different edges with the lateral thalamus. The classification model showed that entropy of the lateral thalamus had the highest discriminative power, with an area under the curve of 0.86. INTERPRETATION Our findings indicated an abnormal higher-order thalamo-cortical communication pattern in migraine patients. The thalamo-cortical-somatosensory disturbance of concerted working may potentially lead to aberrant information flow and deficit pain processing of migraine. ANN NEUROL 2023;94:1168-1181.
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Affiliation(s)
- Wei Dai
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Enchao Qiu
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Xiaoxue Lin
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shuhua Zhang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Mingjie Zhang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xun Han
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhihua Jia
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hui Su
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiangbing Bian
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiao Zang
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Meng Li
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qingkui Zhang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ye Ran
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zihua Gong
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaolin Wang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Rongfei Wang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lixia Tian
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China
| | - Zhao Dong
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
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24
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Rudolph M, Kopruszinski C, Wu C, Navratilova E, Schwedt TJ, Dodick DW, Porreca F, Anderson T. Identification of brain areas in mice with peak neural activity across the acute and persistent phases of post-traumatic headache. Cephalalgia 2023; 43:3331024231217469. [PMID: 38016977 PMCID: PMC11149587 DOI: 10.1177/03331024231217469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Post-traumatic headache is very common after a mild traumatic brain injury. Post-traumatic headache may persist for months to years after an injury in a substantial proportion of people. The pathophysiology underlying post-traumatic headache remains unknown but is likely distinct from other headache disorders. Identification of brain areas activated in acute and persistent phases of post-traumatic headache can provide insights into the underlying circuits mediating headache pain. We used an animal model of mild traumatic brain injury-induced post-traumatic headache and c-fos immunohistochemistry to identify brain regions with peak activity levels across the acute and persistent phases of post-traumatic headache. METHODS Male and female C57BL/6 J mice were briefly anesthetized and subjected to a sham procedure or a weight drop closed-head mild traumatic brain injury . Cutaneous allodynia was assessed in the periorbital and hindpaw regions using von Frey filaments. Immunohistochemical c-fos based neural activity mapping was then performed on sections from whole brain across the development of post-traumatic headache (i.e. peak of the acute phase at 2 days post- mild traumatic brain injury), start of the persistent phase (i.e. >14 days post-mild traumatic brain injury) or after provocation with stress (bright light). Brain areas with consistent and peak levels of c-fos expression across mild traumatic brain injury induced post-traumatic headache were identified and included for further analysis. RESULTS Following mild traumatic brain injury, periorbital and hindpaw allodynia was observed in both male and female mice. This allodynia was transient and subsided within the first 14 days post-mild traumatic brain injury and is representative of acute post-traumatic headache. After this acute post-traumatic headache phase, exposure of mild traumatic brain injury mice to a bright light stress reinstated periorbital and hindpaw allodynia for several hours - indicative of the development of persistent post-traumatic headache. Acute post-traumatic headache was coincident with an increase in neuronal c-fos labeling in the spinal nucleus of the trigeminal caudalis, primary somatosensory cortex, and the nucleus accumbens. Neuronal activation returned to baseline levels by the persistent post-traumatic headache phase in the spinal nucleus of the trigeminal caudalis and primary somatosensory cortex but remained elevated in the nucleus accumbens. In the persistent post-traumatic headache phase, coincident with allodynia observed following bright light stress, we observed bright light stress-induced c-fos neural activation in the spinal nucleus of the trigeminal caudalis, primary somatosensory cortex, and nucleus accumbens. CONCLUSION Examination of mild traumatic brain injury-induced changes in peak c-fos expression revealed brain regions with significantly increased neural activity across the acute and persistent phases of post-traumatic headache. Our findings suggest mild traumatic brain injury-induced post-traumatic headache produces neural activation along pain relevant pathways at time-points matching post-traumatic headache-like pain behaviors. These observations suggest that the spinal nucleus of the trigeminal caudalis, primary somatosensory cortex, and nucleus accumbens may contribute to both the induction and maintenance of post-traumatic headache.
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Affiliation(s)
- Megan Rudolph
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Department of Basic Medical Sciences, College of Medicine, University of Arizona, Phoenix, Arizona, USA
| | - Caroline Kopruszinski
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Chen Wu
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Department of Basic Medical Sciences, College of Medicine, University of Arizona, Phoenix, Arizona, USA
| | - Edita Navratilova
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Department of Neurology, Mayo Clinic, Phoenix, USA
| | | | - David W Dodick
- Mayo Clinic College of Medicine, Scottsdale, Arizona, USA
- Atria Academy of Science and Medicine, New York City, New York, USA
| | - Frank Porreca
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Trent Anderson
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Department of Basic Medical Sciences, College of Medicine, University of Arizona, Phoenix, Arizona, USA
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25
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Sturaro C, Fakhoury B, Targowska-Duda KM, Zribi G, Schoch J, Ruzza C, Calò G, Toll L, Cippitelli A. Preclinical effects of cannabidiol in an experimental model of migraine. Pain 2023; 164:2540-2552. [PMID: 37310430 DOI: 10.1097/j.pain.0000000000002960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/25/2023] [Indexed: 06/14/2023]
Abstract
ABSTRACT Migraine is a disabling disorder characterized by recurrent headaches, accompanied by abnormal sensory sensitivity and anxiety. Despite extensive historical use of cannabis in headache disorders, there is limited research on the nonpsychoactive cannabidiol (CBD) for migraine and there is no scientific evidence to prove that CBD is an effective treatment. The effects of CBD are examined here using a calcitonin gene-related peptide (CGRP)-induced migraine model that provides measures of cephalic allodynia, spontaneous pain, altered light sensitivity (photophobia), and anxiety-like behavior in C57BL/6J mice. A single administration of CGRP induced facial hypersensitivity in both female and male mice. Repeated CGRP treatment produced progressively decreased levels in basal thresholds of allodynia in females, but not in males. A single CBD administration protected both females and males from periorbital allodynia induced by a single CGRP injection. Repeated CBD administration prevented increased levels of basal allodynia induced by repeated CGRP treatment in female mice and did not lead to responses consistent with migraine headache as occurs with triptans. Cannabidiol, injected after CGRP, reversed CGRP-evoked allodynia. Cannabidiol also reduced spontaneous pain traits induced by CGRP administration in female mice. Finally, CBD blocked CGRP-induced anxiety in male mice, but failed in providing protection from CGRP-induced photophobia in females. These results demonstrate the efficacy of CBD in preventing episodic and chronic migraine-like states with reduced risk of causing medication overuse headache. Cannabidiol also shows potential as an abortive agent for treating migraine attacks and headache-related conditions such as spontaneous pain and anxiety.
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Affiliation(s)
- Chiara Sturaro
- Biomedical Science Department, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
- Department of Neuroscience and Rehabilitation, Section of Pharmacology, University of Ferrara, Ferrara, Italy
| | - Bianca Fakhoury
- Biomedical Science Department, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
| | - Katarzyna M Targowska-Duda
- Biomedical Science Department, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
- Department of Biopharmacy, Medical University of Lublin, Lublin, Poland
| | - Gilles Zribi
- Biomedical Science Department, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
| | - Jennifer Schoch
- Biomedical Science Department, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
| | - Chiara Ruzza
- Department of Neuroscience and Rehabilitation, Section of Pharmacology, University of Ferrara, Ferrara, Italy
| | - Girolamo Calò
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Lawrence Toll
- Biomedical Science Department, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
| | - Andrea Cippitelli
- Biomedical Science Department, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
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26
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Noseda R, Villanueva L. Central generators of migraine and autonomic cephalalgias as targets for personalized pain management: Translational links. Eur J Pain 2023; 27:1126-1138. [PMID: 37421221 PMCID: PMC10979820 DOI: 10.1002/ejp.2158] [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: 03/16/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Migraine oscillates between different states in association with internal homeostatic functions and biological rhythms that become more easily dysregulated in genetically susceptible individuals. Clinical and pre-clinical data on migraine pathophysiology support a primary role of the central nervous system (CNS) through 'dysexcitability' of certain brain networks, and a critical contribution of the peripheral sensory and autonomic signalling from the intracranial meningeal innervation. This review focuses on the most relevant back and forward translational studies devoted to the assessment of CNS dysfunctions involved in primary headaches and discusses the role they play in rendering the brain susceptible to headache states. METHODS AND RESULTS We collected a body of scientific literature from human and animal investigations that provide a compelling perspective on the anatomical and functional underpinnings of the CNS in migraine and trigeminal autonomic cephalalgias. We focus on medullary, hypothalamic and corticofugal modulation mechanisms that represent strategic neural substrates for elucidating the links between trigeminovascular maladaptive states, migraine triggering and the temporal phenotype of the disease. CONCLUSION It is argued that a better understanding of homeostatic dysfunctional states appears fundamental and may benefit the development of personalized therapeutic approaches for improving clinical outcomes in primary headache disorders. SIGNIFICANCE This review focuses on the most relevant back and forward translational studies showing the crucial role of top-down brain modulation in triggering and maintaining primary headache states and how these central dysfunctions may interact with personalized pain management strategies.
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Affiliation(s)
- Rodrigo Noseda
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Luis Villanueva
- Institute of Psychiatry and Neuroscience of Paris (IPNP), Université Paris-Cité, Team Imaging Biomarkers of Brain Disorders (IMA-Brain), INSERM U1266, Paris, France
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27
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Hugger SS, Do TP, Ashina H, Goicochea MT, Jenkins B, Sacco S, Lee MJ, Brennan KC, Amin FM, Steiner TJ, Ashina M. Migraine in older adults. Lancet Neurol 2023; 22:934-945. [PMID: 37717587 DOI: 10.1016/s1474-4422(23)00206-5] [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: 10/02/2022] [Revised: 03/20/2023] [Accepted: 05/23/2023] [Indexed: 09/19/2023]
Abstract
Migraine is an evolving, and sometimes lifelong disorder. The prevalence of episodic migraine peaks among individuals aged in their late 30s, implying a tendency for the disorder to remit with increasing age thereafter, whereas chronic migraine is more likely to persist into later life. Diagnosis and treatment of migraine in older adults, defined as individuals aged 60 years or older, is rendered more complex by increasing probabilities of atypical clinical features and comorbidities, with patients' comorbidities sometimes limiting their therapeutic options. However, the changing clinical presentation of migraine over an individual's lifespan is not well characterised. The neurobiological basis of remission in older adults remains unclear, although vascular, neuronal, and hormonal changes are likely to be involved. Long-term longitudinal studies of individuals with migraine would be particularly informative, with the potential not only to suggest new research directions, but also to lead to the identification of novel therapeutic agents. Although several novel migraine medications are becoming available, their effectiveness, tolerability, and safety often remain uncertain in older adults, who have commonly been excluded from the evaluation of these agents in randomised controlled trials, or who constitute only a small proportion of study populations. There is a need to recognise these limitations in the available evidence, and the specific, and often unmet, clinical needs of older adults with migraine, not least because older adults constitute an increasing proportion of populations worldwide.
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Affiliation(s)
- Sarah Sonja Hugger
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Thien Phu Do
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Danish Knowledge Center on Headache Disorders, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Håkan Ashina
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Brain and Spinal Cord Injury, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | | | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Mi Ji Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - K C Brennan
- Headache Physiology Laboratory, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Faisal Mohammad Amin
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Brain and Spinal Cord Injury, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Timothy J Steiner
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway; Division of Brain Sciences, Imperial College London, London, UK
| | - Messoud Ashina
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Danish Knowledge Center on Headache Disorders, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neurology, Azerbaijan Medical University, Baku, Azerbaijan.
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28
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Vitale M, Tottene A, Zarin Zadeh M, Brennan KC, Pietrobon D. Mechanisms of initiation of cortical spreading depression. J Headache Pain 2023; 24:105. [PMID: 37553625 PMCID: PMC10408042 DOI: 10.1186/s10194-023-01643-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND There is increasing evidence from human and animal studies that cortical spreading depression (CSD) is the neurophysiological correlate of migraine aura and a trigger of migraine pain mechanisms. The mechanisms of initiation of CSD in the brain of migraineurs remain unknown, and the mechanisms of initiation of experimentally induced CSD in normally metabolizing brain tissue remain incompletely understood and controversial. Here, we investigated the mechanisms of CSD initiation by focal application of KCl in mouse cerebral cortex slices. METHODS High KCl puffs of increasing duration up to the threshold duration eliciting a CSD were applied on layer 2/3 whilst the membrane potential of a pyramidal neuron located very close to the site of KCl application and the intrinsic optic signal were simultaneously recorded. This was done before and after the application of a specific blocker of either NMDA or AMPA glutamate receptors (NMDARs, AMPARs) or voltage-gated Ca2+ (CaV) channels. If the drug blocked CSD, stimuli up to 12-15 times the threshold were applied. RESULTS Blocking either NMDARs with MK-801 or CaV channels with Ni2+ completely inhibited CSD initiation by both CSD threshold and largely suprathreshold KCl stimuli. Inhibiting AMPARs with NBQX was without effect on the CSD threshold and velocity. Analysis of the CSD subthreshold and threshold neuronal depolarizations in control conditions and in the presence of MK-801 or Ni2+ revealed that the mechanism underlying ignition of CSD by a threshold stimulus (and not by a just subthreshold stimulus) is the CaV-dependent activation of a threshold level of NMDARs (and/or of channels whose opening depends on the latter). The delay of several seconds with which this occurs underlies the delay of CSD initiation relative to the rapid neuronal depolarization produced by KCl. CONCLUSIONS Both NMDARs and CaV channels are necessary for CSD initiation, which is not determined by the extracellular K+ or neuronal depolarization levels per se, but requires the CaV-dependent activation of a threshold level of NMDARs. This occurs with a delay of several seconds relative to the rapid depolarization produced by the KCl stimulus. Our data give insights into potential mechanisms of CSD initiation in migraine.
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Affiliation(s)
- Marina Vitale
- Department of Biomedical Sciences, University of Padova, 35131, Padova, Italy
| | - Angelita Tottene
- Department of Biomedical Sciences, University of Padova, 35131, Padova, Italy
| | - Maral Zarin Zadeh
- Department of Biomedical Sciences, University of Padova, 35131, Padova, Italy
| | - K C Brennan
- Department of Neurology, University of Utah School of Medicine, UT, 84108, Salt Lake City, USA
| | - Daniela Pietrobon
- Department of Biomedical Sciences, University of Padova, 35131, Padova, Italy.
- Padova Neuroscience Center (PNC), University of Padova, 35131, Padova, Italy.
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29
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Liu RH, Zhang M, Xue M, Wang T, Lu JS, Li XH, Chen YX, Fan K, Shi W, Zhou SB, Chen QY, Kang L, Song Q, Yu S, Zhuo M. Inhibiting neuronal AC1 for treating anxiety and headache in the animal model of migraine. iScience 2023; 26:106790. [PMID: 37235050 PMCID: PMC10206497 DOI: 10.1016/j.isci.2023.106790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/03/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Migraines are a common medical condition. From a basic science point of view, the central mechanism for migraine and headache is largely unknown. In the present study, we demonstrate that cortical excitatory transmission is significantly enhanced in the anterior cingulate cortex (ACC)-a brain region which is critical for pain perception. Biochemical studies found that the phosphorylation levels of both the NMDA receptor GluN2B and AMPA receptor GluA1 were enhanced in ACC of migraine rats. Both the presynaptic release of glutamate and postsynaptic responses of AMPA receptors and NMDA receptors were enhanced. Synaptic long-term potentiation (LTP) was occluded. Furthermore, behavioral anxiety and nociceptive responses were increased, which were reversed by application of AC1 inhibitor NB001 within ACC. Our results provide strong evidence that cortical LTPs contribute to migraine-related pain and anxiety. Drugs that inhibit cortical excitation such as NB001 may serve as potential medicines for treating migraine in the future.
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Affiliation(s)
- Ren-Hao Liu
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Mingjie Zhang
- Department of Neurology, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Man Xue
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Tao Wang
- Department of Neurology, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Jing-Shan Lu
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Xu-Hui Li
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Yu-Xin Chen
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Kexin Fan
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Wantong Shi
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Si-Bo Zhou
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Qi-Yu Chen
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Li Kang
- Department of Neurology, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Qian Song
- Neuroscience Research Center, Institute of Mitochondrial Biology and Medicine, Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology and Core Facilities Sharing Platform, Xi’an Jiaotong University, Xi’an 710049, China
| | - Shengyuan Yu
- Department of Neurology, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Min Zhuo
- Institute of Brain Research, Qingdao International Academician Park, Qingdao 266000, China
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China
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30
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Rao Y, Liu W, Zhu Y, Lin Q, Kuang C, Huang H, Jiao B, Ma L, Lin J. Altered functional brain network patterns in patients with migraine without aura after transcutaneous auricular vagus nerve stimulation. Sci Rep 2023; 13:9604. [PMID: 37311825 DOI: 10.1038/s41598-023-36437-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/03/2023] [Indexed: 06/15/2023] Open
Abstract
Transcutaneous auricular vagus nerve stimulation (taVNS) shows excellent effects on relieving clinical symptoms in migraine patients. Nevertheless, the neurological mechanisms of taVNS for migraineurs remain unclear. In recent years, voxel-wise degree centrality (DC) and functional connectivity (FC) methods were extensively utilized for exploring alterations in patterns of FC in the resting-state brain. In the present study, thirty-five migraine patients without aura and thirty-eight healthy controls (HCs) were recruited for magnetic resonance imaging scans. Firstly, this study used voxel-wise DC analysis to explore brain regions where abnormalities were present in migraine patients. Secondly, for elucidating neurological mechanisms underlying taVNS in migraine, seed-based resting-state functional connectivity analysis was employed to the taVNS treatment group. Finally, correlation analysis was performed to explore the relationship between alterations in neurological mechanisms and clinical symptoms. Our findings indicated that migraineurs have lower DC values in the inferior temporal gyrus (ITG) and paracentral lobule than in healthy controls (HCs). In addition, migraineurs have higher DC values in the cerebellar lobule VIII and the fusiform gyrus than HCs. Moreover, after taVNS treatment (post-taVNS), patients displayed increased FC between the ITG with the inferior parietal lobule (IPL), orbitofrontal gyrus, angular gyrus, and posterior cingulate gyrus than before taVNS treatment (pre-taVNS). Besides, the post-taVNS patients showed decreased FC between the cerebellar lobule VIII with the supplementary motor area and postcentral gyrus compared with the pre-taVNS patients. The changed FC of ITG-IPL was significantly related to changes in headache intensity. Our study suggested that migraine patients without aura have altered brain connectivity patterns in several hub regions involving multisensory integration, pain perception, and cognitive function. More importantly, taVNS modulated the default mode network and the vestibular cortical network related to the dysfunctions in migraineurs. This paper provides a new perspective on the potential neurological mechanisms and therapeutic targets of taVNS for treating migraine.
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Affiliation(s)
- Yuyang Rao
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Wenting Liu
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Yunpeng Zhu
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Qiwen Lin
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Changyi Kuang
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Huiyuan Huang
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Bingqing Jiao
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China
| | - Lijun Ma
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China.
| | - Jiabao Lin
- Department of Psychology, School of Public Health and Management, Guangzhou University of Chinese Medicine, No.232, Huandong Road, University Town, Guangzhou, 510006, China.
- Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5229, Université Claude Bernard Lyon 1, Lyon, France.
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Cortez MM, Martindale C, Brennan KC, Kean J, Millar MM, Knudson A, Katz BJ, Digre KB, Presson AP, Zhang C. Validation of the Utah Photophobia Symptom Impact Scale (version 2) as a headache-specific photophobia assessment tool. Headache 2023; 63:672-682. [PMID: 37140215 PMCID: PMC10368178 DOI: 10.1111/head.14516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To present an updated version of the Utah Photophobia Symptom Impact Scale version 2 (UPSIS2), providing robust clinical and psychometric validation, to improve headache-specific evaluation of light sensitivity and headache-related photophobia. BACKGROUND The original UPSIS filled a gap in available tools for assessment of headache-associated light sensitivity by providing patient-reported evaluation of the impact of light sensitivity on activities of daily living (ADLs). We have since revised the original questionnaire to provide a more robust item construct and refined validation approach. METHODS We conducted a psychometric validation of the UPSIS2 through a primary analysis of an online survey of volunteers with recurrent headaches recruited from the University of Utah clinics and surrounding community. Volunteers completed the original UPSIS and UPSIS2 questionnaire versions in addition to measures of headache impact, disability, and frequency. The UPSIS2 now includes a pre-defined recall period and a 1-4 Likert scale with standardized response anchors to improve clarity. Internal construct validity, external construct validity, and test-retest reliability, were evaluated. RESULTS Responses were obtained from 163 volunteers, with UPSIS2 scores ranging from 15 to 57 (out of a possible 15-60) with a mean (standard deviation) of 32.4 (8.80). Construct validity was satisfactory, as evidenced by sufficient unidimensionality, monotonicity, and local independence. Reliability was excellent, with Rasch test reliability = 0.90 and Cronbach's alpha = 0.92, and an intraclass correlation of 0.79 (95% confidence interval 0.65-0.88) for participants who took the test twice. UPSIS2 correlates well with other headache measures (Spearman's correlations >0.50), as well as the original UPSIS (Spearman's correlation = 0.87), indicating good convergent validity. UPSIS2 scores differ significantly across International Classification of Headache Disorders (third edition) groups, indicating good known group validity. CONCLUSION The UPSIS2 provides a well-validated headache-specific outcome measure for the assessment of photophobia impact on ADLs.
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Affiliation(s)
- Melissa M. Cortez
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Cecilia Martindale
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - KC Brennan
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jacob Kean
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Morgan M. Millar
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Alexander Knudson
- School of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Bradley J. Katz
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Ophthalmology and Visual Sciences, John Moran Eye Center, University of Utah, Salt Lake City UT USA
| | - Kathleen B. Digre
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Ophthalmology and Visual Sciences, John Moran Eye Center, University of Utah, Salt Lake City UT USA
| | - Angela P. Presson
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Chong Zhang
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
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Wang W, Yuan Z, Zhang X, Bai X, Tang H, Mei Y, Qiu D, Zhang Y, Zhang P, Zhang X, Zhang Y, Yu X, Sui B, Wang Y. Mapping the aberrant brain functional connectivity in new daily persistent headache: a resting-state functional magnetic resonance imaging study. J Headache Pain 2023; 24:46. [PMID: 37098469 PMCID: PMC10131335 DOI: 10.1186/s10194-023-01577-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/13/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND AND PURPOSE The pathogenesis of new daily persistent headache (NDPH) is not fully understood. We aim to map aberrant functional connectivity (FC) in patients with NDPH using resting-state functional magnetic resonance imaging (MRI). METHODS Brain structural and functional MRI data were acquired from 29 patients with NDPH and 37 well-matched healthy controls (HCs) in this cross-sectional study. Region of interest (ROI) based analysis was used to compare FC between patients and HCs, with 116 brain regions in the automated anatomical labeling (AAL) atlas were defined as seeds. The correlations between aberrant FC and patients' clinical characteristics, and neuropsychological evaluation were also investigated. RESULTS Compared with HCs, patients with NDPH showed increased FC in the left inferior occipital gyrus, right thalamus and decreased FC in right lingual gyrus, left superior occipital gyrus, right middle occipital gyrus, left inferior occipital gyrus, right inferior occipital gyrus, right fusiform gyrus, left postcentral gyrus, right postcentral gyrus, right thalamus and right superior temporal gyrus. There were no correlation between FC of these brain regions and clinical characteristics, neuropsychological evaluation after Bonferroni correction (p > 0.05/266). CONCLUSIONS Patients with NDPH showed aberrant FC in multiple brain regions involved in perception and regulation of emotion and pain. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05334927.
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Affiliation(s)
- Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Ziyu Yuan
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xueyan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Xiaoyan Bai
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, 100070, China
| | - Hefei Tang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Yanliang Mei
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Dong Qiu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Yingkui Zhang
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Peng Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xue Zhang
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, 100070, China
| | - Yaqing Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xueying Yu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China.
| | - Yonggang Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
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Xu X, Zhou M, Wu X, Zhao F, Luo X, Li K, Zeng Q, He J, Cheng H, Guan X, Huang P, Zhang M, Liu K. Increased iron deposition in nucleus accumbens associated with disease progression and chronicity in migraine. BMC Med 2023; 21:136. [PMID: 37024948 PMCID: PMC10080952 DOI: 10.1186/s12916-023-02855-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/29/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Migraine is one of the world's most prevalent and disabling diseases. Despite huge advances in neuroimaging research, more valuable neuroimaging markers are still urgently needed to provide important insights into the brain mechanisms that underlie migraine symptoms. We therefore aim to investigate the regional iron deposition in subcortical nuclei of migraineurs as compared to controls and its association with migraine-related pathophysiological assessments. METHODS A total of 200 migraineurs (56 chronic migraine [CM], 144 episodic migraine [EM]) and 41 matched controls were recruited. All subjects underwent MRI and clinical variables including frequency/duration of migraine, intensity of migraine, 6-item Headache Impact Test (HIT-6), Migraine Disability Assessment (MIDAS), and Pittsburgh Sleep Quality Index (PSQI) were recorded. Quantitative susceptibility mapping was employed to quantify the regional iron content in subcortical regions. Associations between clinical variables and regional iron deposition were studied as well. RESULTS Increased iron deposition in the putamen, caudate, and nucleus accumbens (NAC) was observed in migraineurs more than controls. Meanwhile, patients with CM had a significantly higher volume of iron deposits compared to EM in multiple subcortical nuclei, especially in NAC. Volume of iron in NAC can be used to distinguish patients with CM from EM with a sensitivity of 85.45% and specificity of 71.53%. As the most valuable neuroimaging markers in all of the subcortical nuclei, higher iron deposition in NAC was significantly associated with disease progression, and higher HIT-6, MIDAS, and PSQI. CONCLUSIONS These findings provide evidence that iron deposition in NAC may be a biomarker for migraine chronicity and migraine-related dysfunctions, thus may help to understand the underlying vascular and neural mechanisms of migraine. TRIAL REGISTRATION ClinicalTrials.gov, number NCT04939922.
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Affiliation(s)
- Xiaopei Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Mengting Zhou
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Xiao Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Fangling Zhao
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Kaicheng Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Qingze Zeng
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Jiahui He
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Hongrong Cheng
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China.
| | - Kaiming Liu
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China.
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Conti F, Pietrobon D. Astrocytic Glutamate Transporters and Migraine. Neurochem Res 2023; 48:1167-1179. [PMID: 36583835 DOI: 10.1007/s11064-022-03849-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/07/2022] [Accepted: 12/17/2022] [Indexed: 12/31/2022]
Abstract
Glutamate levels and lifetime in the brain extracellular space are dinamically regulated by a family of Na+- and K+-dependent glutamate transporters, which thereby control numerous brain functions and play a role in numerous neurological and psychiatric diseases. Migraine is a neurological disorder characterized by recurrent attacks of typically throbbing and unilateral headache and by a global dysfunction in multisensory processing. Familial hemiplegic migraine type 2 (FHM2) is a rare monogenic form of migraine with aura caused by loss-of-function mutations in the α2 Na/K ATPase (α2NKA). In the adult brain, this pump is expressed almost exclusively in astrocytes where it is colocalized with glutamate transporters. Knockin mouse models of FHM2 (FHM2 mice) show a reduced density of glutamate transporters in perisynaptic astrocytic processes (mirroring the reduced expression of α2NKA) and a reduced rate of glutamate clearance at cortical synapses during neuronal activity and sensory stimulation. Here we review the migraine-relevant alterations produced by the astrocytic glutamate transport dysfunction in FHM2 mice and their underlying mechanisms, in particular regarding the enhanced brain susceptibility to cortical spreading depression (the phenomenon that underlies migraine aura and can also initiate the headache mechanisms) and the enhanced algesic response to a migraine trigger.
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Affiliation(s)
- Fiorenzo Conti
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy.
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy.
| | - Daniela Pietrobon
- Department of Biomedical Sciences and Padova Neuroscience Center (PNC), University of Padova, 35131, Padua, Italy.
- CNR Institute of Neuroscience, 35131, Padua, Italy.
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Russo AF, Hay DL. CGRP physiology, pharmacology, and therapeutic targets: migraine and beyond. Physiol Rev 2023; 103:1565-1644. [PMID: 36454715 PMCID: PMC9988538 DOI: 10.1152/physrev.00059.2021] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022] Open
Abstract
Calcitonin gene-related peptide (CGRP) is a neuropeptide with diverse physiological functions. Its two isoforms (α and β) are widely expressed throughout the body in sensory neurons as well as in other cell types, such as motor neurons and neuroendocrine cells. CGRP acts via at least two G protein-coupled receptors that form unusual complexes with receptor activity-modifying proteins. These are the CGRP receptor and the AMY1 receptor; in rodents, additional receptors come into play. Although CGRP is known to produce many effects, the precise molecular identity of the receptor(s) that mediates CGRP effects is seldom clear. Despite the many enigmas still in CGRP biology, therapeutics that target the CGRP axis to treat or prevent migraine are a bench-to-bedside success story. This review provides a contextual background on the regulation and sites of CGRP expression and CGRP receptor pharmacology. The physiological actions of CGRP in the nervous system are discussed, along with updates on CGRP actions in the cardiovascular, pulmonary, gastrointestinal, immune, hematopoietic, and reproductive systems and metabolic effects of CGRP in muscle and adipose tissues. We cover how CGRP in these systems is associated with disease states, most notably migraine. In this context, we discuss how CGRP actions in both the peripheral and central nervous systems provide a basis for therapeutic targeting of CGRP in migraine. Finally, we highlight potentially fertile ground for the development of additional therapeutics and combinatorial strategies that could be designed to modulate CGRP signaling for migraine and other diseases.
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Affiliation(s)
- Andrew F Russo
- Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, Iowa
- Department of Neurology, University of Iowa, Iowa City, Iowa
- Center for the Prevention and Treatment of Visual Loss, Department of Veterans Affairs Health Center, Iowa City, Iowa
| | - Debbie L Hay
- Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, School of Biological Sciences, The University of Auckland, Auckland, New Zealand
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36
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Yang S, Wu Y, Sun L, You X, Wu Y. Reorganization of brain networks in patients with temporal lobe epilepsy and comorbid headache. Epilepsy Behav 2023; 140:109101. [PMID: 36736237 DOI: 10.1016/j.yebeh.2023.109101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/05/2023] [Accepted: 01/16/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The white matter structural network changes remain poorly understood in patients with temporal lobe epilepsy and comorbid headache (PWH). This study aimed at exploring topological changes in the structural network. METHODS Twenty-five PWH, 32 patients with temporal lobe epilepsy without headache, and 22 healthy controls were recruited in this study. High-resolution structural MRI and diffusion tensor imaging data were acquired from these participants. A graph theory-based approach was employed to characterize the topological properties of the structural network. A network-based statistical analysis was employed to explore abnormal connectivity alterations in PWH. RESULTS Compared with healthy controls, PWH exhibited significantly decreased small-world index, shortest path length, increased clustering coefficient, global efficiency, and local efficiency. Patients with temporal lobe epilepsy and comorbid headache displayed a significantly reduced small-world index, shortest path length, and increased global efficiency when compared with patients with temporal lobe epilepsy without headache. In addition, PWH exhibited abnormal local network parameters, mainly located in the prefrontal, temporal, occipital, and parietal regions. Furthermore, network-based statistical analysis revealed that PWH had abnormal structural connections between the temporoparietal lobe, occipital lobe, insula, cingulate gyrus, and thalamus. CONCLUSION This study reveals the abnormal white matter structural network alterations in PWH, allowing a better insight into the neuroanatomical mechanisms that predispose epileptic patients to comorbid headaches from the network levels.
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Affiliation(s)
- Shengyu Yang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ying Wu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lanfeng Sun
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao You
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yuan Wu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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Al-Hayani M, AboTaleb H, Bazi A, Alghamdi B. Depression, anxiety and stress in Saudi migraine patients using DASS-21: local population-based cross-sectional survey. Int J Neurosci 2023; 133:248-256. [PMID: 33843418 DOI: 10.1080/00207454.2021.1909011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Psychiatric comorbidity is common among migraineurs, such as anxiety and depression. This type of comorbidity contributed to migraine chronicity, management efficacy, and increasing the risk for other comorbidities. This study designed to estimate the prevalence of depression, anxiety, and stress (DAS) symptoms among Saudi migraine patients using the validated instrument (DASS-21) and considering socio-demographic factors and individual differences that affect migraine progression and prognosis.Design/methods: Cross-sectional, self-administered, web-based-questionnaire distributed among Saudi Arabia general population. Only migraine patients with clinical diagnosis allowed to complete the survey.Results: A total of 247 migraine patients participated and they are predominantly females, with ages between 16 and 45 years, Saudi nationals, married, non-smokers but do not exercise regularly. About 73.3% met the abnormal score in anxiety on DASS-21, as well as 70.9% in depression and 72.3% in stress. Four statistically significant correlations with DAS were identified. Migraine patients who are smoking have a higher prevalence of depression and stress (p < 0.05). Those who do not exercise regularly have a higher prevalence only for depression (p = 0.03). A higher prevalence of all emotional states was found in patients with more than one co-morbidity and patients with a clinical diagnosis of depression and anxiety disorders (p < 0.02). The sensitivity of DASS-21 for depression and anxiety are 96.9% and 93.3%, respectively.Conclusions: Both smoking cessation and exercise to prevent migraine attacks deserve a clinical trial. A holistic approach is needed to decrease psychiatry-related disability and promote management outcomes in migraineurs. Using DASS-21 for migraine patients as a routine screening instrument is valuable to prevent psychiatric comorbidity.
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Affiliation(s)
- Majed Al-Hayani
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hanin AboTaleb
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulrahman Bazi
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Badrah Alghamdi
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.,Neuroscience Unit, Faculty of Medicine, King Abdulaziz University, Jeddah, Saud Arabia.,Pre-Clinical Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Lozano-Soto E, Cruz-Gómez ÁJ, Rashid-López R, Sanmartino F, Espinosa-Rosso R, Forero L, González-Rosa JJ. Neuropsychological and Neuropsychiatric Features of Chronic Migraine Patients during the Interictal Phase. J Clin Med 2023; 12:jcm12020523. [PMID: 36675452 PMCID: PMC9864628 DOI: 10.3390/jcm12020523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
This study aimed to examine the presence of neuropsychological deficits and their relationships with clinical, pharmacological, and neuropsychiatric characteristics in chronic migraine (CM) patients assessed during a headache-free period. We enrolled 39 CM patients (mean age: 45.4 years; male/female ratio: 3/36) and 20 age-, sex-, and education-matched healthy controls (HCs, mean age: 45.5 years; male/female ratio: 2/18) in a case-control study. All CM patients underwent a full and extensive clinical, neuropsychiatric, and neuropsychological evaluation to evaluate cognitive domains, including sustained attention (SA), information processing speed (IPS), visuospatial episodic memory, working memory (WM), and verbal fluency (VF), as well as depressive and anxiety symptoms. CM patients exhibited higher scores than HCs for all clinical and neuropsychiatric measures, but no differences were found in personality characteristics. Although more than half of the CM patients (54%) showed mild-to-severe neuropsychological impairment (NI), with the most frequent impairments occurring in short- and long-term verbal episodic memory and inhibitory control (in approximately 90% of these patients), almost half of the patients (46%) showed no NI. Moreover, the severity of NI was positively associated with the number of pharmacological treatments received. Remarkably, disease-related symptom severity and headache-related disability explained global neuropsychological performance in CM patients. The presence of cognitive and neuropsychiatric dysfunction during the interictal phase occurred in more than half of CM patients, increasing migraine-related disability and possibly exerting a negative impact on health-related quality of life and treatment adherence.
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Affiliation(s)
- Elena Lozano-Soto
- Department of Psychology, University of Cadiz, 11003 Cadiz, Spain
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
| | - Álvaro Javier Cruz-Gómez
- Department of Psychology, University of Cadiz, 11003 Cadiz, Spain
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
| | - Raúl Rashid-López
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
- Department of Neurology, Puerta del Mar Universitary Hospital, 11009 Cadiz, Spain
| | - Florencia Sanmartino
- Department of Psychology, University of Cadiz, 11003 Cadiz, Spain
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
| | - Raúl Espinosa-Rosso
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
- Department of Neurology, Jerez de la Frontera University Hospital, 11407 Jerez de la Frontera, Spain
| | - Lucía Forero
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
- Department of Neurology, Puerta del Mar Universitary Hospital, 11009 Cadiz, Spain
| | - Javier J. González-Rosa
- Department of Psychology, University of Cadiz, 11003 Cadiz, Spain
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
- Correspondence:
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Chou TM, Lee ZF, Wang SJ, Lien CC, Chen SP. CGRP-dependent sensitization of PKC-δ positive neurons in central amygdala mediates chronic migraine. J Headache Pain 2022; 23:157. [PMID: 36510143 PMCID: PMC9746101 DOI: 10.1186/s10194-022-01531-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To investigate specific brain regions and neural circuits that are responsible for migraine chronification. METHODS We established a mouse model of chronic migraine with intermittent injections of clinically-relevant dose of nitroglycerin (0.1 mg/kg for 9 days) and validated the model with cephalic and extracephalic mechanical sensitivity, calcitonin gene-related peptide (CGRP) expression in trigeminal ganglion, and responsiveness to sumatriptan or central CGRP blockade. We explored the neurons that were sensitized along with migraine chronification and investigated their roles on migraine phenotypes with chemogenetics. RESULTS After repetitive nitroglycerin injections, mice displayed sustained supraorbital and hind paw mechanical hyperalgesia, which lasted beyond discontinuation of nitroglycerin infusion and could be transiently reversed by sumatriptan. The CGRP expression in trigeminal ganglion was also upregulated. We found the pERK positive cells were significantly increased in the central nucleus of the amygdala (CeA), and these sensitized cells in the CeA were predominantly protein kinase C-delta (PKC-δ) positive neurons co-expressing CGRP receptors. Remarkably, blockade of the parabrachial nucleus (PBN)-CeA CGRP neurotransmission by CGRP8-37 microinjection to the CeA attenuated the sustained cephalic and extracephalic mechanical hyperalgesia. Furthermore, chemogenetic silencing of the sensitized CeA PKC-δ positive neurons reversed the mechanical hyperalgesia and CGRP expression in the trigeminal ganglion. In contrast, repetitive chemogenetic activation of the CeA PKC-δ positive neurons recapitulated chronic migraine-like phenotypes in naïve mice. CONCLUSIONS Our data suggest that CeA PKC-δ positive neurons innervated by PBN CGRP positive neurons might contribute to the chronification of migraine, which may serve as future therapeutic targets for chronic migraine.
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Affiliation(s)
- Tse-Ming Chou
- grid.260539.b0000 0001 2059 7017Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.28665.3f0000 0001 2287 1366Interdisciplinary Neuroscience Program, Taiwan International Graduate Program, Academia Sinica, Taipei, 115 Taiwan
| | - Zhung-Fu Lee
- grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.39382.330000 0001 2160 926XDevelopment, Disease Models and Therapeutics Graduate Program, Baylor College of Medicine, Houston, TX 77030 USA
| | - Shuu-Jiun Wang
- grid.260539.b0000 0001 2059 7017Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017College of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, 112 Taiwan
| | - Cheng-Chang Lien
- grid.260539.b0000 0001 2059 7017Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.28665.3f0000 0001 2287 1366Interdisciplinary Neuroscience Program, Taiwan International Graduate Program, Academia Sinica, Taipei, 115 Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan
| | - Shih-Pin Chen
- grid.28665.3f0000 0001 2287 1366Interdisciplinary Neuroscience Program, Taiwan International Graduate Program, Academia Sinica, Taipei, 115 Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017College of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.278247.c0000 0004 0604 5314Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, 112 Taiwan
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Yang Y, Xu H, Deng Z, Cheng W, Zhao X, Wu Y, Chen Y, Wei G, Liu Y. Functional connectivity and structural changes of thalamic subregions in episodic migraine. J Headache Pain 2022; 23:119. [PMID: 36088305 PMCID: PMC9463803 DOI: 10.1186/s10194-022-01491-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background The thalamus plays a crucial role in transmitting nociceptive information to various cortical regions involving migraine-related allodynia and photophobia. Abnormal structural and functional alterations related to the thalamus have been well established. However, it is unknown whether the brain structure and function of the thalamic subregions are differentially affected in this disorder. In this study, we aimed to clarify this issue by comparing the structure and function of 16 thalamic subregions between patients with episodic migraine (EM) and healthy controls (HCs). Methods Twenty-seven patients with EM and 30 sex-, age- and education-matched HCs underwent resting-state functional and structural magnetic resonance imaging scans. Functional connectivity (rsFC), grey matter volume (GMV), and diffusion tensor imaging (DTI) parameters of each subregion of the thalamus were calculated and compared between the two groups. Furthermore, correlation analyses between neuroimaging changes and clinical features were performed in this study. Results First, compared with HCs, patients with EM exhibited decreased rsFC between the anterior-medial-posterior subregions of the thalamus and brain regions mainly involved in the medial system of the pain processing pathway and default mode network (DMN). Second, for the whole thalamus and each of its subregions, there were no significant differences in GMV between patients with EM and HCs (P > 0.05, Bonferroni corrected). Third, there was no significant difference in DTI parameters between the two groups (P > 0.05). Finally, decreased rsFC was closely related to scores on the Hamilton Rating Scale for Anxiety (HAMA) and Big Five Inventory (BFI) scales. Conclusion Selective functional hypoconnectivity in the thalamic subregions provides neuroimaging evidence supporting the important role of thalamocortical pathway dysfunction in episodic migraine, specifically, that it may modulate emotion and different personality traits in migraine patients.
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Shibata Y. Migraine Pathophysiology Revisited: Proposal of a New Molecular Theory of Migraine Pathophysiology and Headache Diagnostic Criteria. Int J Mol Sci 2022; 23:13002. [PMID: 36361791 PMCID: PMC9653875 DOI: 10.3390/ijms232113002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 08/13/2023] Open
Abstract
Various explanations for the pathophysiology of migraines have been proposed; however, none of these provide a complete explanation. The author critically reviews previous theories and proposes a new molecular theory of migraine pathophysiology. The diagnosis of primary headaches is generally based on clinical histories and symptoms only because there is no reliable diagnostic examination. The author proposes a new classification system and set of diagnostic criteria for headaches based on molecular markers.
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Affiliation(s)
- Yasushi Shibata
- Mito Medical Center, Mito Kyodo General Hospital, University of Tsukuba, Tsukuba 310-0015, Ibaraki, Japan
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42
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Wang M, Tutt JO, Dorricott NO, Parker KL, Russo AF, Sowers LP. Involvement of the cerebellum in migraine. Front Syst Neurosci 2022; 16:984406. [PMID: 36313527 PMCID: PMC9608746 DOI: 10.3389/fnsys.2022.984406] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 09/27/2022] [Indexed: 11/14/2022] Open
Abstract
Migraine is a disabling neurological disease characterized by moderate or severe headaches and accompanied by sensory abnormalities, e.g., photophobia, allodynia, and vertigo. It affects approximately 15% of people worldwide. Despite advancements in current migraine therapeutics, mechanisms underlying migraine remain elusive. Within the central nervous system, studies have hinted that the cerebellum may play an important sensory integrative role in migraine. More specifically, the cerebellum has been proposed to modulate pain processing, and imaging studies have revealed cerebellar alterations in migraine patients. This review aims to summarize the clinical and preclinical studies that link the cerebellum to migraine. We will first discuss cerebellar roles in pain modulation, including cerebellar neuronal connections with pain-related brain regions. Next, we will review cerebellar symptoms and cerebellar imaging data in migraine patients. Lastly, we will highlight the possible roles of the neuropeptide calcitonin gene-related peptide (CGRP) in migraine symptoms, including preclinical cerebellar studies in animal models of migraine.
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Affiliation(s)
- Mengya Wang
- Department of Neuroscience and Pharmacology, University of Iowa, Iowa City, IA, United States
| | - Joseph O. Tutt
- Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | | | - Krystal L. Parker
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
| | - Andrew F. Russo
- Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA, United States,Department of Neurology, University of Iowa, Iowa City, IA, United States,Center for the Prevention and Treatment of Visual Loss, Veterans Administration Health Center, Iowa City, IA, United States
| | - Levi P. Sowers
- Center for the Prevention and Treatment of Visual Loss, Veterans Administration Health Center, Iowa City, IA, United States,Department of Pediatrics, University of Iowa, Iowa City, IA, United States,*Correspondence: Levi P. Sowers
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Sacca V, Zhang Y, Cao J, Li H, Yan Z, Ye Y, Hou X, McDonald CM, Todorova N, Kong J, Liu B. Evaluation of the Modulation Effects Evoked by Different Transcutaneous Auricular Vagus Nerve Stimulation Frequencies Along the Central Vagus Nerve Pathway in Migraine: A Functional Magnetic Resonance Imaging Study. Neuromodulation 2022; 26:620-628. [PMID: 36307355 DOI: 10.1016/j.neurom.2022.08.459] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/05/2022] [Accepted: 08/31/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising treatment option for migraines. This study aims to investigate the modulation effects of different taVNS frequencies along the central vagus nerve pathway in migraineurs. MATERIALS AND METHODS Twenty-four migraineurs were recruited for a single-blind, crossover magnetic resonance imaging (MRI) study. The study consisted of two taVNS MRI scan sessions, in which either 1-Hz or 20-Hz taVNS was applied in a random order. Seed-based static and dynamic functional connectivity (FC) analyses were performed using two key nodes of the vagus nerve pathway, the nucleus tractus solitarius (NTS) and the locus coeruleus (LC). RESULTS Static FC (sFC) analysis showed that 1) continuous 1-Hz taVNS resulted in an increase of NTS/LC-occipital cortex sFC and a decrease of NTS-thalamus sFC compared with the pre-1-Hz taVNS resting state, 2) continuous 20-Hz taVNS resulted in an increase of the LC-anterior cingulate cortex (ACC) sFC compared with the pre-20-Hz taVNS resting state, 3) 1-Hz taVNS produced a greater LC-precuneus and LC-inferior parietal cortex sFC than 20 Hz, and 4) 20-Hz taVNS increased LC-ACC and LC-super temporal gyrus/insula sFC in comparison with 1 Hz. Dynamic FC (dFC) analysis showed that compared with the pre-taVNS resting state, 1-Hz taVNS decreased NTS-postcentral gyrus dFC (less variability), 20-Hz taVNS decreased dFC of the LC-superior temporal gyrus and the LC-occipital cortex. Finally, a positive correlation was found between the subjects' number of migraine attacks in the past four weeks and the NTS-thalamus sFC during pre-taVNS resting state. CONCLUSIONS 1-Hz and 20-Hz taVNS may modulate the sFC and dFC of key nodes in the central vagus nerve pathway differently. Our findings highlight the importance of stimulation parameters (frequencies) in taVNS treatment.
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Abstract
It is well established that migraine is a multifactorial disorder. A deep understanding of migraine should be based upon both the underlying traits and the current states affected by different physiological, psychological, and environmental factors. At this point, there is no framework fully meeting these criteria. Here, we describe a broader view of the migraine disorder defined as a dysfunctional brain state and trait interaction. In this model, we consider events that may enhance or diminish migraine responsivity based on an individual's trait and state. This could provide an expanded view for considering how migraine attacks are sometimes precipitated by "triggers" and sometimes not, how these factors only lead to migraine attacks in migraine patients, or how individuals with an increased risk for migraine do not show any symptoms at all. Summarizing recent studies and evidence that support the concept of migraine as a brain state-trait interaction can also contribute to improving patient care by highlighting the importance of precision medicine and applying measures that are able to capture how different traits and states work together to determine migraine.
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45
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Wu S, Ren X, Zhu C, Wang W, Zhang K, Li Z, Liu X, Wang Y. A c-Fos activation map in nitroglycerin/levcromakalim-induced models of migraine. J Headache Pain 2022; 23:128. [PMID: 36180824 PMCID: PMC9524028 DOI: 10.1186/s10194-022-01496-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Chronic migraine is a common and highly disabling disorder. Functional MRI has indicated that abnormal brain region activation is linked with chronic migraine. Drugs targeting the calcitonin gene-related peptide (CGRP) or its receptor have been reported to be efficient for treating chronic migraine. The CGRP signaling was also shared in two types of chronic migraine models (CMMs). However, it remains unclear whether the activation of specific brain regions could contribute to persistent behavioral sensitization, and CGRP receptor antagonists relieve migraine-like pain in CMMs by altering specific brain region activation. Therefore, it’s of great interest to investigate brain activation pattern and the effect of olcegepant (a CGRP receptor-specific antagonist) treatment on alleviating hyperalgesia by altering brain activation in two CMMs, and provide a reference for future research on neural circuits. Methods Repeated administration of nitroglycerin (NTG) or levcromakalim (LEV) was conducted to stimulate human migraine-like pain and establish two types of CMMs in mice. Mechanical hypersensitivity was evaluated by using the von Frey filament test. Then, we evaluated the activation of different brain regions with c-Fos and NeuN staining. Olcegepant was administered to explore its effect on mechanical hyperalgesia and brain region activation. Results In two CMMs, acute and basal mechanical hyperalgesia was observed, and olcegepant alleviated mechanical hyperalgesia. In the NTG-induced CMM, the medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), and the caudal part of the spinal trigeminal nucleus (Sp5c) showed a significant increase of c-Fos expression in the NTG group (p < 0.05), while pre-treatment with olcegepant reduced c-Fos expression compared with NTG group (p < 0.05). No significant difference of c-Fos expression was found in the paraventricular thalamic nucleus (PVT) and ventrolateral periaqueductal gray (vlPAG) between the vehicle control and NTG group (p > 0.05). In the LEV-induced CMM, mPFC, PVT, and Sp5c showed a significant increase of c-Fos expression between vehicle control and LEV group, and olcegepant reduced c-Fos expression (p < 0.05). No significant difference in c-Fos expression was found in vlPAG and ACC (p > 0.05). Conclusions Our study demonstrated the activation of mPFC and Sp5c in two CMMs. Olcegepant may alleviate hyperalgesia of the hind paw and periorbital area by attenuating brain activation in CMMs. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01496-8.
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Affiliation(s)
- Shouyi Wu
- Department of Neurology, Lanzhou University Second Hospital, Cuiying Gate, No. 82Linxia Road, Chengguan District, Lanzhou, 730000, China
| | - Xiao Ren
- Department of Neurology, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, China
| | - Chenlu Zhu
- Department of Neurology, Lanzhou University Second Hospital, Cuiying Gate, No. 82Linxia Road, Chengguan District, Lanzhou, 730000, China
| | - Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, FengtaiDistrict, Beijing, 100070, China
| | - Kaibo Zhang
- Department of Neurology, Lanzhou University Second Hospital, Cuiying Gate, No. 82Linxia Road, Chengguan District, Lanzhou, 730000, China
| | - Zhilei Li
- Department of Neurology, Lanzhou University Second Hospital, Cuiying Gate, No. 82Linxia Road, Chengguan District, Lanzhou, 730000, China
| | - Xuejiao Liu
- Department of Neurology, Lanzhou University Second Hospital, Cuiying Gate, No. 82Linxia Road, Chengguan District, Lanzhou, 730000, China
| | - Yonggang Wang
- Department of Neurology, Lanzhou University Second Hospital, Cuiying Gate, No. 82Linxia Road, Chengguan District, Lanzhou, 730000, China. .,Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, FengtaiDistrict, Beijing, 100070, China.
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Kopruszinski CM, Vizin R, Watanabe M, Martinez AL, de Souza LHM, Dodick DW, Porreca F, Navratilova E. Exploring the neurobiology of the premonitory phase of migraine preclinically - a role for hypothalamic kappa opioid receptors? J Headache Pain 2022; 23:126. [PMID: 36175828 PMCID: PMC9524131 DOI: 10.1186/s10194-022-01497-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022] Open
Abstract
Background The migraine premonitory phase is characterized in part by increased thirst, urination and yawning. Imaging studies show that the hypothalamus is activated in the premonitory phase. Stress is a well know migraine initiation factor which was demonstrated to engage dynorphin/kappa opioid receptors (KOR) signaling in several brain regions, including the hypothalamus. This study proposes the exploration of the possible link between hypothalamic KOR and migraine premonitory symptoms in rodent models. Methods Rats were treated systemically with the KOR agonist U-69,593 followed by yawning and urination monitoring. Apomorphine, a dopamine D1/2 agonist, was used as a positive control for yawning behaviors. Urination and water consumption following systemic administration of U-69,593 was also assessed. To examine if KOR activation specifically in the hypothalamus can promote premonitory symptoms, AAV8-hSyn-DIO-hM4Di (Gi-DREADD)-mCherry viral vector was microinjected into the right arcuate nucleus (ARC) of female and male KORCRE or KORWT mice. Four weeks after the injection, clozapine N-oxide (CNO) was administered systemically followed by the assessment of urination, water consumption and tactile sensory response. Results Systemic administration of U-69,593 increased urination but did not produce yawning in rats. Systemic KOR agonist also increased urination in mice as well as water consumption. Cell specific Gi-DREADD activation (i.e., inhibition through Gi-coupled signaling) of KORCRE neurons in the ARC also increased water consumption and the total volume of urine in mice but did not affect tactile sensory responses. Conclusion Our studies in rodents identified the KOR in a hypothalamic region as a mechanism that promotes behaviors consistent with clinically-observed premonitory symptoms of migraine, including increased thirst and urination but not yawning. Importantly, these behaviors occurred in the absence of pain responses, consistent with the emergence of the premonitory phase before the headache phase. Early intervention for preventive treatment even before the headache phase may be achievable by targeting the hypothalamic KOR. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01497-7.
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Affiliation(s)
| | - Robson Vizin
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Moe Watanabe
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Ashley L Martinez
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | | | | | - Frank Porreca
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA.,Department of Collaborative Research, Mayo Clinic, Scottsdale, USA
| | - Edita Navratilova
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA. .,Department of Collaborative Research, Mayo Clinic, Scottsdale, USA.
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Meneghetti N, Cerri C, Vannini E, Tantillo E, Tottene A, Pietrobon D, Caleo M, Mazzoni A. Synaptic alterations in visual cortex reshape contrast-dependent gamma oscillations and inhibition-excitation ratio in a genetic mouse model of migraine. J Headache Pain 2022; 23:125. [PMID: 36175826 PMCID: PMC9523950 DOI: 10.1186/s10194-022-01495-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/09/2022] [Indexed: 11/21/2022] Open
Abstract
Background Migraine affects a significant fraction of the world population, yet its etiology is not completely understood. In vitro results highlighted thalamocortical and intra-cortical glutamatergic synaptic gain-of-function associated with a monogenic form of migraine (familial-hemiplegic-migraine-type-1: FHM1). However, how these alterations reverberate on cortical activity remains unclear. As altered responsivity to visual stimuli and abnormal processing of visual sensory information are common hallmarks of migraine, herein we investigated the effects of FHM1-driven synaptic alterations in the visual cortex of awake mice. Methods We recorded extracellular field potentials from the primary visual cortex (V1) of head-fixed awake FHM1 knock-in (n = 12) and wild type (n = 12) mice in response to square-wave gratings with different visual contrasts. Additionally, we reproduced in silico the obtained experimental results with a novel spiking neurons network model of mouse V1, by implementing in the model both the synaptic alterations characterizing the FHM1 genetic mouse model adopted. Results FHM1 mice displayed similar amplitude but slower temporal evolution of visual evoked potentials. Visual contrast stimuli induced a lower increase of multi-unit activity in FHM1 mice, while the amount of information content about contrast level remained, however, similar to WT. Spectral analysis of the local field potentials revealed an increase in the β/low γ range of WT mice following the abrupt reversal of contrast gratings. Such frequency range transitioned to the high γ range in FHM1 mice. Despite this change in the encoding channel, these oscillations preserved the amount of information conveyed about visual contrast. The computational model showed how these network effects may arise from a combination of changes in thalamocortical and intra-cortical synaptic transmission, with the former inducing a lower cortical activity and the latter inducing the higher frequencies ɣ oscillations. Conclusions Contrast-driven ɣ modulation in V1 activity occurs at a much higher frequency in FHM1. This is likely to play a role in the altered processing of visual information. Computational studies suggest that this shift is specifically due to enhanced cortical excitatory transmission. Our network model can help to shed light on the relationship between cellular and network levels of migraine neural alterations. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01495-9.
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Affiliation(s)
- Nicolò Meneghetti
- The Biorobotics Institute, Scuola Superiore Sant'Anna, 56025, Pisa, Italy.,Department of Excellence for Robotics and AI, Scuola Superiore Sant'Anna, 56025, Pisa, Italy
| | - Chiara Cerri
- Neuroscience Institute, National Research Council (CNR), 56124, Pisa, Italy.,Fondazione Umberto Veronesi, 20122, Milan, Italy.,Department of Pharmacy, University of Pisa, 56126, Pisa, Italy
| | - Eleonora Vannini
- Neuroscience Institute, National Research Council (CNR), 56124, Pisa, Italy.,Fondazione Umberto Veronesi, 20122, Milan, Italy
| | - Elena Tantillo
- Neuroscience Institute, National Research Council (CNR), 56124, Pisa, Italy.,Fondazione Pisana per la Scienza Onlus (FPS), 56017, Pisa, Italy.,Scuola Normale Superiore, 56100, Pisa, Italy
| | - Angelita Tottene
- Department of Biomedical Sciences, University of Padova, 35131, Padova, Italy
| | - Daniela Pietrobon
- Department of Biomedical Sciences, University of Padova, 35131, Padova, Italy.,Padova Neuroscience Center, University of Padova, 35131, Padova, Italy.,CNR Institute of Neuroscience, 35131, Padova, Italy
| | - Matteo Caleo
- Neuroscience Institute, National Research Council (CNR), 56124, Pisa, Italy.,Department of Biomedical Sciences, University of Padova, 35131, Padova, Italy.,Padova Neuroscience Center, University of Padova, 35131, Padova, Italy
| | - Alberto Mazzoni
- The Biorobotics Institute, Scuola Superiore Sant'Anna, 56025, Pisa, Italy. .,Department of Excellence for Robotics and AI, Scuola Superiore Sant'Anna, 56025, Pisa, Italy.
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48
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Wei HL, Yang WJ, Zhou GP, Chen YC, Yu YS, Yin X, Li J, Zhang H. Altered static functional network connectivity predicts the efficacy of non-steroidal anti-inflammatory drugs in migraineurs without aura. Front Mol Neurosci 2022; 15:956797. [PMID: 36176962 PMCID: PMC9513180 DOI: 10.3389/fnmol.2022.956797] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022] Open
Abstract
Brain networks have significant implications for the understanding of migraine pathophysiology and prognosis. This study aimed to investigate whether large-scale network dysfunction in patients with migraine without aura (MwoA) could predict the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs). Seventy patients with episodic MwoA and 33 healthy controls (HCs) were recruited. Patients were divided into MwoA with effective NSAIDs (M-eNSAIDs) and with ineffective NSAIDs (M-ieNSAIDs). Group-level independent component analysis and functional network connectivity (FNC) analysis were used to extract intrinsic networks and detect dysfunction among these networks. The clinical characteristics and FNC abnormalities were considered as features, and a support vector machine (SVM) model with fivefold cross-validation was applied to distinguish the subjects at an individual level. Dysfunctional connections within seven networks were observed, including default mode network (DMN), executive control network (ECN), salience network (SN), sensorimotor network (SMN), dorsal attention network (DAN), visual network (VN), and auditory network (AN). Compared with M-ieNSAIDs and HCs, patients with M-eNSAIDs displayed reduced DMN-VN and SMN-VN, and enhanced VN-AN connections. Moreover, patients with M-eNSAIDs showed increased FNC patterns within ECN, DAN, and SN, relative to HCs. Higher ECN-SN connections than HCs were revealed in patients with M-ieNSAIDs. The SVM model demonstrated that the area under the curve, sensitivity, and specificity were 0.93, 0.88, and 0.89, respectively. The widespread FNC impairment existing in the modulation of medical treatment suggested FNC disruption as a biomarker for advancing the understanding of neurophysiological mechanisms and improving the decision-making of therapeutic strategy.
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Affiliation(s)
- Heng-Le Wei
- Department of Radiology, Nanjing Jiangning Hospital, Nanjing, China
| | - Wen-Juan Yang
- Department of Neurology, Nanjing Jiangning Hospital, Nanjing, China
| | - Gang-Ping Zhou
- Department of Radiology, Nanjing Jiangning Hospital, Nanjing, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yu-Sheng Yu
- Department of Radiology, Nanjing Jiangning Hospital, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Junrong Li
- Department of Neurology, Nanjing Jiangning Hospital, Nanjing, China
| | - Hong Zhang
- Department of Radiology, Nanjing Jiangning Hospital, Nanjing, China
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Tripathi R, Gluckman BJ. Development of Mechanistic Neural Mass (mNM) Models that Link Physiology to Mean-Field Dynamics. FRONTIERS IN NETWORK PHYSIOLOGY 2022; 2:911090. [PMID: 36876035 PMCID: PMC9980379 DOI: 10.3389/fnetp.2022.911090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Brain rhythms emerge from the mean-field activity of networks of neurons. There have been many efforts to build mathematical and computational embodiments in the form of discrete cell-group activities-termed neural masses-to understand in particular the origins of evoked potentials, intrinsic patterns of activities such as theta, regulation of sleep, Parkinson's disease related dynamics, and mimic seizure dynamics. As originally utilized, standard neural masses convert input through a sigmoidal function to a firing rate, and firing rate through a synaptic alpha function to other masses. Here we define a process to build mechanistic neural masses (mNMs) as mean-field models of microscopic membrane-type (Hodgkin Huxley type) models of different neuron types that duplicate the stability, firing rate, and associated bifurcations as function of relevant slow variables - such as extracellular potassium - and synaptic current; and whose output is both firing rate and impact on the slow variables - such as transmembrane potassium flux. Small networks composed of just excitatory and inhibitory mNMs demonstrate expected dynamical states including firing, runaway excitation and depolarization block, and these transitions change in biologically observed ways with changes in extracellular potassium and excitatory-inhibitory balance.
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Affiliation(s)
- Richa Tripathi
- Center for Neural Engineering, The Pennsylvania State University, University Park, PA, United States.,Indian Institute of Technology Gandhinagar, Gandhinagar, India.,Center for Advanced Systems Understanding (CASUS), HZDR, Görlitz, Germany
| | - Bruce J Gluckman
- Center for Neural Engineering, The Pennsylvania State University, University Park, PA, United States.,Departments of Engineering Science and Mechanics, Biomedical Engineering, The Pennsylvania State University, University Park, PA, United States.,Department of Neurosurgery, College of Medicine, The Pennsylvania State University, Hershey, PA, United States
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50
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Marchionni I, Pilati N, Forli A, Sessolo M, Tottene A, Pietrobon D. Enhanced Feedback Inhibition Due to Increased Recruitment of Somatostatin-Expressing Interneurons and Enhanced Cortical Recurrent Excitation in a Genetic Mouse Model of Migraine. J Neurosci 2022; 42:6654-6666. [PMID: 35863891 PMCID: PMC9410751 DOI: 10.1523/jneurosci.0228-22.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/08/2022] [Accepted: 06/18/2022] [Indexed: 11/21/2022] Open
Abstract
Migraine is a complex brain disorder, characterized by attacks of unilateral headache and global dysfunction in multisensory information processing, whose underlying cellular and circuit mechanisms remain unknown. The finding of enhanced excitatory, but unaltered inhibitory, neurotransmission at cortical synapses between pyramidal cells (PCs) and fast-spiking interneurons (FS INs) in mouse models of familial hemiplegic migraine (FHM) suggested the hypothesis that dysregulation of the excitatory-inhibitory (E/I) balance in specific circuits is a key pathogenic mechanism. Here, we investigated the cortical layer 2/3 (L2/3) feedback inhibition microcircuit involving somatostatin-expressing (SOM) INs in FHM1 mice of both sexes carrying a gain-of-function mutation in CaV2.1. Unitary inhibitory neurotransmission at SOM IN-PC synapses was unaltered while excitatory neurotransmission at both PC-SOM IN and PC-PC synapses was enhanced, because of increased probability of glutamate release, in FHM1 mice. Short-term synaptic depression was enhanced at PC-PC synapses while short-term synaptic facilitation was unaltered at PC-SOM IN synapses during 25-Hz repetitive activity. The frequency-dependent disynaptic inhibition (FDDI) mediated by SOM INs was enhanced, lasted longer and required shorter high-frequency bursts to be initiated in FHM1 mice. These findings, together with previous evidence of enhanced disynaptic feedforward inhibition by FS INs, suggest that the increased inhibition may effectively counteract the increased recurrent excitation in FHM1 mice and may even prevail in certain conditions. Considering the involvement of SOM INs in γ oscillations, surround suppression and context-dependent sensory perception, the facilitated recruitment of SOM INs, together with the enhanced recurrent excitation, may contribute to dysfunctional sensory processing in FHM1 and possibly migraine.SIGNIFICANCE STATEMENT Migraine is a complex brain disorder, characterized by attacks of unilateral headache and global dysfunction in multisensory information processing, whose underlying cellular and circuit mechanisms remain unknown, although dysregulation of the excitatory-inhibitory (E/I) balance in specific circuits could be a key pathogenic mechanism. Here, we provide insights into these mechanisms by investigating the cortical feedback inhibition microcircuit involving somatostatin-expressing interneurons (SOM INs) in a mouse model of a rare monogenic migraine. Despite unaltered inhibitory synaptic transmission, the disynaptic feedback inhibition mediated by SOM INs was enhanced in the migraine model because of enhanced recruitment of the INs. Recurrent cortical excitation was also enhanced. These alterations may contribute to context-dependent sensory processing dysfunctions in migraine.
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Affiliation(s)
- Ivan Marchionni
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
| | - Nadia Pilati
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
- Autifony Srl, Istituto di Ricerca Pediatrica Citta' della Speranza, Padova 35127, Italy
| | - Angelo Forli
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
| | - Michele Sessolo
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
| | - Angelita Tottene
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
| | - Daniela Pietrobon
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
- Padova Neuroscience Center, University of Padova, and National Research Council Institute of Neuroscience, Padova 35131, Italy
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