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Bautin P, Fortier MA, Sean M, Little G, Martel M, Descoteaux M, Léonard G, Tétreault P. What has brain diffusion magnetic resonance imaging taught us about chronic primary pain: a narrative review. Pain 2024:00006396-990000000-00689. [PMID: 39172945 DOI: 10.1097/j.pain.0000000000003345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/13/2024] [Indexed: 08/24/2024]
Abstract
ABSTRACT Chronic pain is a pervasive and debilitating condition with increasing implications for public health, affecting millions of individuals worldwide. Despite its high prevalence, the underlying neural mechanisms and pathophysiology remain only partly understood. Since its introduction 35 years ago, brain diffusion magnetic resonance imaging (MRI) has emerged as a powerful tool to investigate changes in white matter microstructure and connectivity associated with chronic pain. This review synthesizes findings from 58 articles that constitute the current research landscape, covering methods and key discoveries. We discuss the evidence supporting the role of altered white matter microstructure and connectivity in chronic primary pain conditions, highlighting the importance of studying multiple chronic pain syndromes to identify common neurobiological pathways. We also explore the prospective clinical utility of diffusion MRI, such as its role in identifying diagnostic, prognostic, and therapeutic biomarkers. Furthermore, we address shortcomings and challenges associated with brain diffusion MRI in chronic primary pain studies, emphasizing the need for the harmonization of data acquisition and analysis methods. We conclude by highlighting emerging approaches and prospective avenues in the field that may provide new insights into the pathophysiology of chronic pain and potential new therapeutic targets. Because of the limited current body of research and unidentified targeted therapeutic strategies, we are forced to conclude that further research is required. However, we believe that brain diffusion MRI presents a promising opportunity for enhancing our understanding of chronic pain and improving clinical outcomes.
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Affiliation(s)
- Paul Bautin
- Department of Anesthesiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Marc-Antoine Fortier
- Department of Anesthesiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Monica Sean
- Department of Anesthesiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Graham Little
- Sherbrooke Connectivity Imaging Lab (SCIL), Computer Science Department, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marylie Martel
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Lab (SCIL), Computer Science Department, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Guillaume Léonard
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging du Centre intégré universitaire de santé et de services sociaux de l'Estrie-Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Pascal Tétreault
- Department of Anesthesiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Department of Medical Imaging and Radiation Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
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Shibata Y, Ishiyama S. Neurite Damage in Patients with Migraine. Neurol Int 2024; 16:299-311. [PMID: 38525701 PMCID: PMC10961799 DOI: 10.3390/neurolint16020021] [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: 12/26/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
We examined neurite orientation dispersion and density imaging in patients with migraine. We found that patients with medication overuse headache exhibited lower orientation dispersion than those without. Moreover, orientation dispersion in the body of the corpus callosum was statistically negatively correlated with migraine attack frequencies. These findings indicate that neurite dispersion is damaged in patients with chronic migraine. Our study results indicate the orientation preference of neurite damage in migraine.
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Affiliation(s)
- Yasushi Shibata
- Department of Neurosurgery, Headache Clinic, Mito Medical Center, University of Tsukuba, Mito Kyodo General Hospital, Mito 3100015, Japan
| | - Sumire Ishiyama
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami 3000394, Japan
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Singh S A, Ansari MN, M. Elossaily G, Vellapandian C, Prajapati B. Investigating the Potential Impact of Air Pollution on Alzheimer's Disease and the Utility of Multidimensional Imaging for Early Detection. ACS OMEGA 2024; 9:8615-8631. [PMID: 38434844 PMCID: PMC10905749 DOI: 10.1021/acsomega.3c06328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/25/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024]
Abstract
Pollution is ubiquitous, and much of it is anthropogenic in nature, which is a severe risk factor not only for respiratory infections or asthma sufferers but also for Alzheimer's disease, which has received a lot of attention recently. This Review aims to investigate the primary environmental risk factors and their profound impact on Alzheimer's disease. It underscores the pivotal role of multidimensional imaging in early disease identification and prevention. Conducting a comprehensive review, we delved into a plethora of literature sources available through esteemed databases, including Science Direct, Google Scholar, Scopus, Cochrane, and PubMed. Our search strategy incorporated keywords such as "Alzheimer Disease", "Alzheimer's", "Dementia", "Oxidative Stress", and "Phytotherapy" in conjunction with "Criteria Pollutants", "Imaging", "Pathology", and "Particulate Matter". Alzheimer's disease is not only a result of complex biological factors but is exacerbated by the infiltration of airborne particles and gases that surreptitiously breach the nasal defenses to traverse the brain, akin to a Trojan horse. Various imaging modalities and noninvasive techniques have been harnessed to identify disease progression in its incipient stages. However, each imaging approach possesses inherent limitations, prompting exploration of a unified technique under a single umbrella. Multidimensional imaging stands as the linchpin for detecting and forestalling the relentless march of Alzheimer's disease. Given the intricate etiology of the condition, identifying a prospective candidate for Alzheimer's disease may take decades, rendering the development of a multimodal imaging technique an imperative. This research underscores the pressing need to recognize the chronic ramifications of invisible particulate matter and to advance our understanding of the insidious environmental factors that contribute to Alzheimer's disease.
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Affiliation(s)
- Ankul Singh S
- Department
of Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Tamil Nadu 603203, India
| | - Mohd Nazam Ansari
- Department
of Pharmacology and Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Gehan M. Elossaily
- Department
of Basic Medical Sciences, College of Medicine, AlMaarefa University, P.O. Box 71666, Riyadh 13713, Saudi Arabia
| | - Chitra Vellapandian
- Department
of Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Tamil Nadu 603203, India
| | - Bhupendra Prajapati
- Department
of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy,
Shree S.K. Patel College of Pharmaceutical Education and Research, Ganpat University, Gozaria Highway, Mehsana, North Gujarat 384012, India
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Dobos D, Kökönyei G, Gyebnár G, Szabó E, Kocsel N, Galambos A, Gecse K, Baksa D, Kozák LR, Juhász G. Microstructural differences in migraine: A diffusion-tensor imaging study. Cephalalgia 2023; 43:3331024231216456. [PMID: 38111172 DOI: 10.1177/03331024231216456] [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] [Indexed: 12/20/2023]
Abstract
BACKGROUND Diffusion-tensor imaging can be applied to describe the microstructural integrity of the whole brain. As findings about microstructural alterations in migraine are inconsistent, we aimed to replicate the most frequent results and assess a relationship between migraine parameters and changes in microstructure. METHODS Diffusion-weighted MRI data of 37 migraine patients and 40 controls were collected. Two indices of diffusion of water molecules, fractional anisotropy and mean diffusivity were used in a voxel-wise analysis. Group comparisons were carried out in SPM12 using age and sex as covariates. Statistically significant results survived family-wise error correction (pFWE < 0.05). Migraine intensity, frequency, and duration were self-reported and correlated with mean fractional anisotropy and mean diffusivity values across clusters. RESULTS Migraine patients showed significantly lower fractional anisotropy in occipital regions, and significantly higher fractional anisotropy in thirteen clusters across the brain. Mean diffusivity of migraine patients was significantly decreased in the cerebellum and pons, but it was not increased in any area. Correlation between migraine duration and fractional anisotropy was significantly positive in the frontal cortex and significantly negative in the superior parietal lobule. CONCLUSION We suggest that microstructural integrity of the migraine brain is impaired in visual areas and shows duration-related alterations in regions of the default mode network.
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Affiliation(s)
- Dóra Dobos
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- SE NAP 2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmaceutical Sciences, Semmelweis University, Budapest, Hungary
| | - Gyöngyi Kökönyei
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- SE NAP 2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmaceutical Sciences, Semmelweis University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Gyula Gyebnár
- Magnetic Resonance Research Centre, Semmelweis University, Budapest, Hungary
| | - Edina Szabó
- SE NAP 2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Natália Kocsel
- SE NAP 2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Attila Galambos
- SE NAP 2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Kinga Gecse
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- SE NAP 2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmaceutical Sciences, Semmelweis University, Budapest, Hungary
| | - Dániel Baksa
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- SE NAP 2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmaceutical Sciences, Semmelweis University, Budapest, Hungary
- Department of Personality and Clinical Psychology, Institute of Psychology, Faculty of Humanities and Social Sciences, Pazmany Peter Catholic University, Budapest, Hungary
| | - Lajos R Kozák
- Magnetic Resonance Research Centre, Semmelweis University, Budapest, Hungary
| | - Gabriella Juhász
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- SE NAP 2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmaceutical Sciences, Semmelweis University, Budapest, Hungary
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Mei Y, Wang W, Qiu D, Yuan Z, Bai X, Tang H, Zhang P, Zhang X, Zhang Y, Yu X, Sui B, Wang Y. Micro-structural white matter abnormalities in new daily persistent headache: a DTI study using TBSS analysis. J Headache Pain 2023; 24:80. [PMID: 37394419 DOI: 10.1186/s10194-023-01620-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND New daily persistent headache (NDPH) is a rare primary headache disorder characterized by daily and persistent sudden onset headaches. The pathogenesis of NDPH remains unclear, and there are few white matter imaging studies related to NDPH. The purpose of this study was to investigate the micro-structural abnormalities of white matter in NDPH and provided insights into the pathogenesis of this disease based on tract-based spatial statistics (TBSS). METHODS Twenty-one patients with NDPH and 25 healthy controls (HCs) were included in this study. T1 structural and diffusion magnetic resonance imaging (MRI) were acquired from all participants. Differences in the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) between patients with NDPH and HCs were investigated using TBSS analysis. RESULTS Significantly decreased FA, increased MD and RD were found in patients with NDPH compared to HCs. White matter regions overlaid with decreased FA, increased MD and RD were found in 16 white matter tracts from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas and Johns Hopkins University White-Matter Tractography Atlas. Specifically, these white matter regions included the right anterior thalamic radiation (ATR), body of the corpus callosum (BCC), bilateral cingulum, left hippocampal cingulum (CGH), left corticospinal tract (CST), forceps major, fornix, left inferior fronto-occipital fasciculus (IFOF), bilateral inferior longitudinal fasciculus (ILF), left posterior limb of the internal capsule (PLIC), right retrolenticular part of the internal capsule (RPIC), splenium of the corpus callosum (SCC), right superior longitudinal fasciculus (SLF) and left uncinate fasciculus (UF). After Bonferroni correction, there were no correlations between the FA, MD, AD and RD values and the clinical characteristics of patients with NDPH (p > 0.05/96). CONCLUSION The results of our research indicated that patients with NDPH might have widespread abnormalities in the white matter of the brain.
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Affiliation(s)
- Yanliang Mei
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Dong Qiu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Ziyu Yuan
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xiaoyan Bai
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Neurosurgical Institute, Beijing, China
| | - Hefei Tang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Peng Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xue Zhang
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Neurosurgical Institute, Beijing, China
| | - Yaqing Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xueying Yu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
| | - Yonggang Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
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Liu J, Liu W, Thakur D, Mack J, Spina A, Montell C. Alleviation of thermal nociception depends on heat-sensitive neurons and a TRP channel in the brain. Curr Biol 2023; 33:2397-2406.e6. [PMID: 37201520 PMCID: PMC10330845 DOI: 10.1016/j.cub.2023.04.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 05/20/2023]
Abstract
Acute avoidance of dangerous temperatures is critical for animals to prevent or minimize injury. Therefore, surface receptors have evolved to endow neurons with the capacity to detect noxious heat so that animals can initiate escape behaviors. Animals including humans have evolved intrinsic pain-suppressing systems to attenuate nociception under some circumstances. Here, using Drosophila melanogaster, we uncovered a new mechanism through which thermal nociception is suppressed. We identified a single descending neuron in each brain hemisphere, which is the center for suppression of thermal nociception. These Epi neurons, for Epione-the goddess of soothing of pain-express a nociception-suppressing neuropeptide Allatostatin C (AstC), which is related to a mammalian anti-nociceptive peptide, somatostatin. Epi neurons are direct sensors for noxious heat, and when activated they release AstC, which diminishes nociception. We found that Epi neurons also express the heat-activated TRP channel, Painless (Pain), and thermal activation of Epi neurons and the subsequent suppression of thermal nociception depend on Pain. Thus, while TRP channels are well known to sense noxious temperatures to promote avoidance behavior, this work reveals the first role for a TRP channel for detecting noxious temperatures for the purpose of suppressing rather than enhancing nociception behavior in response to hot thermal stimuli.
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Affiliation(s)
- Jiangqu Liu
- Neuroscience Research Institute and Department of Molecular, Cellular and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Weiwei Liu
- Neuroscience Research Institute and Department of Molecular, Cellular and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Dhananjay Thakur
- Neuroscience Research Institute and Department of Molecular, Cellular and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - John Mack
- Neuroscience Research Institute and Department of Molecular, Cellular and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Aidin Spina
- Neuroscience Research Institute and Department of Molecular, Cellular and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Craig Montell
- Neuroscience Research Institute and Department of Molecular, Cellular and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA 93106, USA.
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Hsu PS, Cheng CM, Chao HT, Lin MW, Li WC, Lee LC, Liu CH, Chen LF, Hsieh JC. OPRM1 A118G polymorphism modulating motor pathway for pain adaptability in women with primary dysmenorrhea. Front Neurosci 2023; 17:1179851. [PMID: 37378013 PMCID: PMC10291086 DOI: 10.3389/fnins.2023.1179851] [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: 03/05/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction Primary dysmenorrhea (PDM) is a common condition among women of reproductive age, characterized by menstrual pain in the absence of any organic causes. Previous research has established a link between the A118G polymorphism in the mu-opioid receptor (OPRM1) gene and pain experience in PDM. Specifically, carriers of the G allele have been found to exhibit maladaptive functional connectivity between the descending pain modulatory system and the motor system in young women with PDM. This study aims to explore the potential relationship between the OPRM1 A118G polymorphism and changes in white matter in young women with PDM. Methods The study enrolled 43 individuals with PDM, including 13 AA homozygotes and 30 G allele carriers. Diffusion tensor imaging (DTI) scans were performed during both the menstrual and peri-ovulatory phases, and tract-based spatial statistics (TBSS) and probabilistic tractography were used to explore variations in white matter microstructure related to the OPRM1 A118G polymorphism. The short-form McGill Pain Questionnaire (MPQ) was used to access participants' pain experience during the MEN phase. Results Two-way ANOVA on TBSS analysis revealed a significant main effect of genotype, with no phase effect or phase-gene interaction detected. Planned contrast analysis showed that during the menstrual phase, G allele carriers had higher fractional anisotropy (FA) and lower radial diffusivity in the corpus callosum and the left corona radiata compared to AA homozygotes. Tractographic analysis indicated the involvement of the left internal capsule, left corticospinal tract, and bilateral medial motor cortex. Additionally, the mean FA of the corpus callosum and the corona radiata was negatively correlated with MPQ scales in AA homozygotes, but this correlation was not observed in G allele carriers. No significant genotype difference was found during the pain-free peri-ovulary phase. Discussion OPRM1 A118G polymorphism may influence the connection between structural integrity and dysmenorrheic pain, where the G allele could impede the pain-regulating effects of the A allele. These novel findings shed light on the underlying mechanisms of both adaptive and maladaptive structural neuroplasticity in PDM, depending on the specific OPRM1 polymorphism.
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Affiliation(s)
- Pei-Shan Hsu
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chou-Ming Cheng
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiang-Tai Chao
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Wei Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Chi Li
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Lin-Chien Lee
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Ching-Hsiung Liu
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Neurology, Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Li-Fen Chen
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Biomedical Informatics, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jen-Chuen Hsieh
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-devices, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
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Mosch B, Hagena V, Herpertz S, Diers M. Brain morphometric changes in fibromyalgia and the impact of psychometric and clinical factors: a volumetric and diffusion-tensor imaging study. Arthritis Res Ther 2023; 25:81. [PMID: 37208755 DOI: 10.1186/s13075-023-03064-0] [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: 12/08/2022] [Accepted: 05/07/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Previous studies have repeatedly found distinct brain morphometric changes in patients with fibromyalgia (FM), mainly affecting gray and white matter abnormalities in areas related to sensory and affective pain processing. However, few studies have thus far linked different types of structural changes and not much is known about behavioral and clinical determinants that might influence the emergence and progression of such changes. METHODS We used voxel-based morphometry (VBM) and diffusion-tensor imaging (DTI) to detect regional patterns of (micro)structural gray (GM) and white matter (WM) alterations in 23 patients with FM compared to 21 healthy controls (HC), while considering the influence of demographic, psychometric, and clinical variables (age, symptom severity, pain duration, heat pain threshold, depression scores). RESULTS VBM and DTI revealed striking patterns of brain morphometric changes in FM patients. Bilateral middle temporal gyrus (MTG), parahippocampal gyrus, left dorsal anterior cingulate cortex (dACC), right putamen, right caudate nucleus, and left dorsolateral prefrontal cortex (DLPFC) showed significantly decreased GM volumes. In contrast, increased GM volume was observed in bilateral cerebellum and left thalamus. Beyond that, patients displayed microstructural changes of WM connectivity within the medial lemniscus, corpus callosum, and tracts surrounding and connecting the thalamus. Sensory-discriminative aspects of pain (pain severity, pain thresholds) primarily showed negative correlations with GM within bilateral putamen, pallidum, right midcingulate cortex (MCC), and multiple thalamic substructures, whereas the chronicity of pain was negatively correlated with GM volumes within right insular cortex and left rolandic operculum. Affective-motivational aspects of pain (depressive mood, general activity) were related to GM and FA values within bilateral putamen and thalamus. CONCLUSIONS Our results suggest a variety of distinct structural brain changes in FM, particularly affecting areas involved in pain and emotion processing such as the thalamus, putamen, and insula.
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Affiliation(s)
- Benjamin Mosch
- Clinical and Experimental Behavioral Medicine, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Verena Hagena
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Martin Diers
- Clinical and Experimental Behavioral Medicine, Alexandrinenstraße 1-3, 44791, Bochum, Germany.
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9
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Tantik Pak A, Nacar Dogan S, Sengul Y. Structural integrity of corpus callosum in patients with migraine: a diffusion tensor imaging study. Acta Neurol Belg 2023; 123:385-390. [PMID: 35303287 DOI: 10.1007/s13760-021-01863-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/27/2021] [Indexed: 12/20/2022]
Abstract
The aim of this study was to compare structural changes of corpus callosum (CC), which is the largest collection of white matter in the brain, among migraineurs and healthy controls (HC). Diffusion tensor imaging (DTI) method which provides information about microscopic organization of the cell, especially white matter was used for this purpose. Fifty-one patients who were diagnosed with migraine and 44 age- and sex-matched HC were included in the study. Socio-demographic and clinical characteristics of the patients were noted. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) measurements of CC genu, splenium, and body were performed for all participants. A significant difference was determined between migraine patients and HC regarding the FA values in the genu of CC (p < 0.001). When the clinical data of migraine patients and FA values in the genu of CC were analyzed via linear regression analysis, no significant finding was detected (p > 0.05). In conclusion, it can be suggested that there are microstructural changes in the CC of migraneurs; however, the clinical variable associated with this structural deterioration could not be determined.
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Affiliation(s)
- Aygul Tantik Pak
- Department of Neurology, University of Ministry Health, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.
| | - Sebahat Nacar Dogan
- Depertmant of Radiology, University of Ministry Health, Gaziosmanpasa Training and Research Hospital, Karayollari, Osmanbey Street 621, 34255, Gaziosmanpasa, Istanbul, Turkey
| | - Yildizhan Sengul
- Department of Neurology, University of Ministry Health, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey
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10
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Jotwani ML, Wu Z, Lunde CE, Sieberg CB. The missing mechanistic link: Improving behavioral treatment efficacy for pediatric chronic pain. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 3:1022699. [PMID: 36313218 PMCID: PMC9614027 DOI: 10.3389/fpain.2022.1022699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/26/2022] [Indexed: 11/07/2022]
Abstract
Pediatric chronic pain is a significant global issue, with biopsychosocial factors contributing to the complexity of the condition. Studies have explored behavioral treatments for pediatric chronic pain, but these treatments have mixed efficacy for improving functional and psychological outcomes. Furthermore, the literature lacks an understanding of the biobehavioral mechanisms contributing to pediatric chronic pain treatment response. In this mini review, we focus on how neuroimaging has been used to identify biobehavioral mechanisms of different conditions and how this modality can be used in mechanistic clinical trials to identify markers of treatment response for pediatric chronic pain. We propose that mechanistic clinical trials, utilizing neuroimaging, are warranted to investigate how to optimize the efficacy of behavioral treatments for pediatric chronic pain patients across pain types and ages.
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Affiliation(s)
- Maya L. Jotwani
- Department of Psychiatry and Behavioral Sciences, Biobehavioral Pain Innovations Lab, Boston Children's Hospital, Boston, MA, United States,Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care, Pain Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Ziyan Wu
- Department of Psychiatry and Behavioral Sciences, Biobehavioral Pain Innovations Lab, Boston Children's Hospital, Boston, MA, United States,Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care, Pain Medicine, Boston Children's Hospital, Boston, MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Claire E. Lunde
- Department of Psychiatry and Behavioral Sciences, Biobehavioral Pain Innovations Lab, Boston Children's Hospital, Boston, MA, United States,Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care, Pain Medicine, Boston Children's Hospital, Boston, MA, United States,Nuffield Department of Women's and Reproductive Health, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Christine B. Sieberg
- Department of Psychiatry and Behavioral Sciences, Biobehavioral Pain Innovations Lab, Boston Children's Hospital, Boston, MA, United States,Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care, Pain Medicine, Boston Children's Hospital, Boston, MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United States,Correspondence: Christine B. Sieberg
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11
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Microstructural white matter alterations associated with migraine headaches: a systematic review of diffusion tensor imaging studies. Brain Imaging Behav 2022; 16:2375-2401. [PMID: 35710680 PMCID: PMC9581876 DOI: 10.1007/s11682-022-00690-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/04/2022]
Abstract
The pathophysiology of migraine as a headache disorder is still undetermined. Diffusion tensor imaging (DTI) has significantly improved our knowledge about brain microstructure in this disease. Here, we aimed to systematically review DTI studies in migraine and survey the sources of heterogeneity by investigating diffusion parameter changes associated with clinical characteristics and migraine subtypes. Microstructural changes, as revealed by widespread alteration of diffusion metrics in white matter (WM) tracts, subcortical and cortical regions, were reported by several migraine DTI studies. Specifically, we reported changes in the corpus callosum, thalamic radiations, corona radiata, and brain stem. These alterations showed high variability across migraine cycle phases. Additionally, migraine associated with depressive/anxiety symptoms revealed significant changes in the corpus callosum, internal capsule, and superior longitudinal fasciculus. No significant WM microstructural differences were observed between migraine patients with and without aura. Overall, differences between chronic and episodic migraine showed inconsistency across studies. Migraine is associated with microstructural changes in widespread regions including thalamic radiations, corpus callosum, and brain stem. These alterations can highlight neuronal damage and neuronal plasticity mechanisms either following pain stimulations occurring in migraine cycle or as a compensatory response to pain in chronic migraine. Longitudinal studies applying advanced modalities may shed new light on the underlying microstructural changes in migraine subtypes.
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12
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Imaging as a Pain Biomarker. Neurosurg Clin N Am 2022; 33:345-350. [DOI: 10.1016/j.nec.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Kim SK, Nikolova S, Schwedt TJ. Structural aberrations of the brain associated with migraine: A narrative review. Headache 2021; 61:1159-1179. [PMID: 34407215 DOI: 10.1111/head.14189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To summarize major results from imaging studies investigating brain structure in migraine. BACKGROUND Neuroimaging studies, using several different imaging and analysis techniques, have demonstrated aberrations in brain structure associated with migraine. This narrative review summarizes key imaging findings and relates imaging findings with clinical features of migraine. METHODS We searched PubMed for English language articles using the key words "neuroimaging" AND/OR "MRI" combined with "migraine" through August 20, 2020. The titles and abstracts of resulting articles were reviewed for their possible inclusion in this manuscript, followed by examination of the full texts and reference lists of relevant articles. RESULTS Migraine is associated with structural brain aberrations within regions that participate in pain processing, the processing of other sensory stimuli, multisensory integration, and in white matter fiber tracts. Furthermore, migraine is associated with magnetic resonance imaging T2/fluid-attenuated inversion recovery white matter hyperintensities. Some structural aberrations are correlated with the severity and clinical features of migraine, whereas others are not. These findings suggest that some structural abnormalities are associated with or amplified by recurrent migraine attacks, whereas others are intrinsic to the migraine brain. CONCLUSIONS Migraine is associated with aberrant brain structure. Structural neuroimaging studies contribute to understanding migraine pathophysiology and identification of brain regions associated with migraine and its individual symptoms. Additional work is needed to determine the extent to which structural aberrations are a result of recurrent migraine attacks, and perhaps reversible with effective treatment or migraine resolution, versus being intrinsic traits of the migraine brain.
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Affiliation(s)
- Soo-Kyoung Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea
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14
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Abstract
This study aims to investigate whether intranetwork dynamic functional connectivity and causal interactions of the salience network is altered in the interictal term of migraine. Thirty-two healthy controls, 37 migraineurs without aura, and 20 migraineurs with aura were recruited. Participants underwent a T1-weighted scan and resting-state fMRI protocol inside a 1.5T MR scanner. We obtained average spatial maps of resting-state networks using group independent component analysis, which yielded subject-specific time series through a dual regression approach. Salience network regions of interest (bilateral insulae and prefrontal cortices, dorsal anterior cingulate cortex) were obtained from the group average map through cluster-based thresholding. To describe intranetwork connectivity, average and dynamic conditional correlation was calculated. Causal interactions between the default-mode, dorsal attention, and salience network were characterised by spectral Granger's causality. Time-averaged correlation was lower between the right insula and prefrontal cortex in migraine without aura vs with aura and healthy controls (P < 0.038, P < 0.037). Variance of dynamic conditional correlation was higher in migraine with aura vs healthy controls and migraine with aura vs without aura between the right insula and dorsal anterior cingulate cortex (P < 0.011, P < 0.026), and in migraine with aura vs healthy controls between the dorsal anterior cingulate and left prefrontal cortex (P < 0.021). Causality was weaker in the <0.05 Hz frequency range between the salience and dorsal attention networks in migraine with aura (P < 0.032). Overall, migraineurs with aura exhibit more fluctuating connections in the salience network, which also affect network interactions, and could be connected to altered cortical excitability and increased sensory gain.
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15
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Xu Q, Weng Y, Liu C, Qiu L, Yang Y, Zhou Y, Wang F, Lu G, Zhang LJ, Qi R. Distributed Functional Connectome of White Matter in Patients With Functional Dyspepsia. Front Hum Neurosci 2021; 15:589578. [PMID: 33935665 PMCID: PMC8085333 DOI: 10.3389/fnhum.2021.589578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/25/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose: We aimed to find out the distributed functional connectome of white matter in patients with functional dyspepsia (FD). Methods: 20 patients with FD and 24 age- and gender-matched healthy controls were included into the study. The functional connectome of white matter and graph theory were used to these participants. Two-sample t-test was used for the detection the abnormal graph properties in FD. Pearson correlation was used for the relationship between properties and the clinical and neuropshychological information. Results: Patients with FD and healthy controls showed small-world properties in functional connectome of white matter. Compared with healthy controls, the FD group showed decreased global properties (Cp, S, Eglobal, and Elocal). Four pairs of fiber bundles that are connected to the frontal lobe, insula, and thalamus were affected in the FD group. Duration and Pittsburgh Sleep Quality Index positively correlated with the betweenness centrality of white matter regions of interest. Conclusion: FD patients turned to a non-optimized functional organization of WM brain network. Frontal lobe, insula, and thalamus were key regions in brain information exchange of FD. It provided some novel imaging evidences for the mechanism of FD.
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Affiliation(s)
- Qiang Xu
- College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yifei Weng
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chang Liu
- Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lianli Qiu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yulin Yang
- Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yifei Zhou
- Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Fangyu Wang
- Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guangming Lu
- College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
- State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, China
| | - Long Jiang Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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16
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Alternative Microstructural Measures to Complement Diffusion Tensor Imaging in Migraine Studies with Standard MRI Acquisition. Brain Sci 2020; 10:brainsci10100711. [PMID: 33036306 PMCID: PMC7599963 DOI: 10.3390/brainsci10100711] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 01/03/2023] Open
Abstract
The white matter state in migraine has been investigated using diffusion tensor imaging (DTI) measures, but results using this technique are conflicting. To overcome DTI measures, we employed ensemble average diffusion propagator measures obtained with apparent measures using reduced acquisitions (AMURA). The AMURA measures were return-to-axis (RTAP), return-to-origin (RTOP) and return-to-plane probabilities (RTPP). Tract-based spatial statistics was used to compare fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity from DTI, and RTAP, RTOP and RTPP, between healthy controls, episodic migraine and chronic migraine patients. Fifty healthy controls, 54 patients with episodic migraine and 56 with chronic migraine were assessed. Significant differences were found between both types of migraine, with lower axial diffusivity values in 38 white matter regions and higher RTOP values in the middle cerebellar peduncle in patients with a chronic migraine (p < 0.05 family-wise error corrected). Significantly lower RTPP values were found in episodic migraine patients compared to healthy controls in 24 white matter regions (p < 0.05 family-wise error corrected), finding no significant differences using DTI measures. The white matter microstructure is altered in a migraine, and in chronic compared to episodic migraine. AMURA can provide additional results with respect to DTI to uncover white matter alterations in migraine.
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17
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Coppola G, Di Renzo A, Tinelli E, Petolicchio B, Di Lorenzo C, Parisi V, Serrao M, Calistri V, Tardioli S, Cartocci G, Caramia F, Di Piero V, Pierelli F. Patients with chronic migraine without history of medication overuse are characterized by a peculiar white matter fiber bundle profile. J Headache Pain 2020; 21:92. [PMID: 32682393 PMCID: PMC7368770 DOI: 10.1186/s10194-020-01159-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/13/2020] [Indexed: 12/13/2022] Open
Abstract
Background We investigated intracerebral fiber bundles using a tract-based spatial statistics (TBSS) analysis of diffusion tensor imaging (DTI) data to verify microstructural integrity in patients with episodic (MO) and chronic migraine (CM). Methods We performed DTI in 19 patients with MO within interictal periods, 18 patients with CM without any history of drug abuse, and 18 healthy controls (HCs) using a 3 T magnetic resonance imaging scanner. We calculated diffusion metrics, including fractional anisotropy (FA), axial diffusion (AD), radial diffusion (RD), and mean diffusion (MD). Results TBSS revealed no significant differences in the FA, MD, RD, and AD maps between the MO and HC groups. In comparison to the HC group, the CM group exhibited widespread increased RD (bilateral superior [SCR] and posterior corona radiata [PCR], bilateral genu of the corpus callosum [CC], bilateral posterior limb of internal capsule [IC], bilateral superior longitudinal fasciculus [LF]) and MD values (tracts of the right SCR and PCR, right superior LF, and right splenium of the CC). In comparison to the MO group, the CM group showed decreased FA (bilateral SCR and PCR, bilateral body of CC, right superior LF, right forceps minor) and increased MD values (bilateral SCR and right PCR, right body of CC, right superior LF, right splenium of CC, and right posterior limb of IC). Conclusion Our results suggest that chronic migraine can be associated with the widespread disruption of normal white matter integrity in the brain.
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Affiliation(s)
- Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Antonio Di Renzo
- IRCCS - Fondazione Bietti, Research Unit of Neurophysiology of Vision and Neuro-Ophthalmology, Via Livenza 3, 00198, Rome, Italy
| | - Emanuele Tinelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Vincenzo Parisi
- IRCCS - Fondazione Bietti, Research Unit of Neurophysiology of Vision and Neuro-Ophthalmology, Via Livenza 3, 00198, Rome, Italy.
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Valentina Calistri
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Stefano Tardioli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Gaia Cartocci
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Francesca Caramia
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Vittorio Di Piero
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy.,IRCCS - Neuromed, Pozzilli, IS, Italy
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18
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Davis KD, Aghaeepour N, Ahn AH, Angst MS, Borsook D, Brenton A, Burczynski ME, Crean C, Edwards R, Gaudilliere B, Hergenroeder GW, Iadarola MJ, Iyengar S, Jiang Y, Kong JT, Mackey S, Saab CY, Sang CN, Scholz J, Segerdahl M, Tracey I, Veasley C, Wang J, Wager TD, Wasan AD, Pelleymounter MA. Discovery and validation of biomarkers to aid the development of safe and effective pain therapeutics: challenges and opportunities. Nat Rev Neurol 2020; 16:381-400. [PMID: 32541893 PMCID: PMC7326705 DOI: 10.1038/s41582-020-0362-2] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 02/06/2023]
Abstract
Pain medication plays an important role in the treatment of acute and chronic pain conditions, but some drugs, opioids in particular, have been overprescribed or prescribed without adequate safeguards, leading to an alarming rise in medication-related overdose deaths. The NIH Helping to End Addiction Long-term (HEAL) Initiative is a trans-agency effort to provide scientific solutions to stem the opioid crisis. One component of the initiative is to support biomarker discovery and rigorous validation in collaboration with industry leaders to accelerate high-quality clinical research into neurotherapeutics and pain. The use of objective biomarkers and clinical trial end points throughout the drug discovery and development process is crucial to help define pathophysiological subsets of pain, evaluate target engagement of new drugs and predict the analgesic efficacy of new drugs. In 2018, the NIH-led Discovery and Validation of Biomarkers to Develop Non-Addictive Therapeutics for Pain workshop convened scientific leaders from academia, industry, government and patient advocacy groups to discuss progress, challenges, gaps and ideas to facilitate the development of biomarkers and end points for pain. The outcomes of this workshop are outlined in this Consensus Statement.
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Affiliation(s)
- Karen D Davis
- Department of Surgery and Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Division of Brain, Imaging and Behaviour, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Martin S Angst
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - David Borsook
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, USA
| | | | | | | | - Robert Edwards
- Pain Management Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Brice Gaudilliere
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Georgene W Hergenroeder
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Michael J Iadarola
- Department of Perioperative Medicine, Clinical Center, NIH, Rockville, MD, USA
| | - Smriti Iyengar
- Division of Translational Research, National Institute of Neurological Disorders and Stroke, NIH, Rockville, MD, USA
| | - Yunyun Jiang
- The Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Jiang-Ti Kong
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Sean Mackey
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Carl Y Saab
- Department of Neuroscience and Department of Neurosurgery, Carney Institute for Brain Science, Brown University, Providence, RI, USA
| | - Christine N Sang
- Department of Anesthesiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Joachim Scholz
- Neurocognitive Disorders, Pain and New Indications, Biogen, Cambridge, MA, USA
| | | | - Irene Tracey
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Jing Wang
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU School of Medicine, New York, NY, USA
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Ajay D Wasan
- Anesthesiology and Perioperative Medicine and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mary Ann Pelleymounter
- Division of Translational Research, National Institute of Neurological Disorders and Stroke, NIH, Rockville, MD, USA
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19
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Russo A, Silvestro M, Trojsi F, Bisecco A, De Micco R, Caiazzo G, Di Nardo F, Esposito F, Tessitore A, Tedeschi G. Cognitive Networks Disarrangement in Patients With Migraine Predicts Cutaneous Allodynia. Headache 2020; 60:1228-1243. [DOI: 10.1111/head.13860] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Antonio Russo
- Headache Center Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Centre SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
- Institute for Diagnosis and Care “Hermitage‐Capodimonte” Naples Italy
| | - Marcello Silvestro
- Headache Center Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Centre SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Francesca Trojsi
- Headache Center Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Centre SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Alvino Bisecco
- Headache Center Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Centre SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Rosa De Micco
- Headache Center Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Centre SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Giuseppina Caiazzo
- MRI Research Centre SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Federica Di Nardo
- MRI Research Centre SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry Scuola Medica Salernitana University of Salerno Baronissi Italy
| | - Alessandro Tessitore
- Headache Center Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Centre SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Gioacchino Tedeschi
- Headache Center Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Centre SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
- Institute for Diagnosis and Care “Hermitage‐Capodimonte” Naples Italy
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20
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Kincses B, Spisák T, Faragó P, Király A, Szabó N, Veréb D, Kocsis K, Bozsik B, Tóth E, Vécsei L, Kincses ZT. Brain MRI Diffusion Encoding Direction Number Affects Tract-Based Spatial Statistics Results in Multiple Sclerosis. J Neuroimaging 2020; 30:512-522. [PMID: 32447822 DOI: 10.1111/jon.12705] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Diffusion tensor imaging (DTI) is a promising approach to detect the underlying brain pathology. These alterations can be seen in several diseases such as multiple sclerosis. Tract-based spatial statistics (TBSS) is an easy to use and robust way for analyzing diffusion data. The effect of acquisition parameters of DTI on TBSS has not been evaluated, especially the number of diffusion encoding directions (NDED), which is directly proportional with scan time. METHODS We analyzed a large set of DTI data of healthy controls (N = 126) and multiple sclerosis patients (N = 78). The highest NDED (60 directions) was reduced and a tensor calculation was done separately for every subset. We calculated the mean and standard deviation of DTI parameters under the white matter mask. Moreover, the FMRIB Software Library TBSS pipeline was used on DTI images with 15, 30, 45, and 60 directions to compare differences between groups. Mean DTI parameters were compared between groups as a function of NDED. RESULTS The mean value of FA and AD decreased with increasing number of directions. This was more pronounced in areas with smaller FA values. RD and MD were constant. The skeleton size reduced with elevating NDED along with the number of significant voxels. The TBSS analysis showed significant differences between groups throughout the majority of the skeleton and the group difference was associated with NDED. CONCLUSION Our results suggested that results of TBSS depended on the NDED, which should be considered when comparing DTI data with varying protocols.
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Affiliation(s)
- Bálint Kincses
- Department of Neurology, University of Szeged, Szeged, Hungary.,Department of Psychiatry, University of Szeged, Szeged, Hungary
| | - Tamás Spisák
- Bingel Laboratory, University of Essen, Essen, Germany
| | - Péter Faragó
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - András Király
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - Nikoletta Szabó
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - Dániel Veréb
- Department of Neurology, University of Szeged, Szeged, Hungary
| | | | - Bence Bozsik
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - Eszter Tóth
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, University of Szeged, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Zsigmond Tamás Kincses
- Department of Neurology, University of Szeged, Szeged, Hungary.,Department of Radiology, University of Szeged, Szeged, Hungary
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21
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Ulusoy EK. Correlations between the monocyte to high-density lipoprotein cholesterol ratio and white matter hyperintensities in migraine. Neurol Res 2020; 42:126-132. [DOI: 10.1080/01616412.2019.1710406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Ersin Kasım Ulusoy
- Neurology Department, Kayseri Training and Research Hospital, Kayseri, Turkey
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22
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Planchuelo-Gómez Á, García-Azorín D, Guerrero ÁL, Aja-Fernández S, Rodríguez M, de Luis-García R. White matter changes in chronic and episodic migraine: a diffusion tensor imaging study. J Headache Pain 2020; 21:1. [PMID: 31898478 PMCID: PMC6941267 DOI: 10.1186/s10194-019-1071-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/24/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND White matter alterations have been observed in patients with migraine. However, no microstructural white matter alterations have been found particularly in episodic or chronic migraine patients, and there is limited research focused on the comparison between these two groups of migraine patients. METHODS Fifty-one healthy controls, 55 episodic migraine patients and 57 chronic migraine patients were recruited and underwent brain T1-weighted and diffusion-weighted MRI acquisition. Using Tract-Based Spatial Statistics (TBSS), fractional anisotropy, mean diffusivity, radial diffusivity and axial diffusivity were compared between the different groups. On the one hand, all migraine patients were compared against healthy controls. On the other hand, patients from each migraine group were compared between them and also against healthy controls. Correlation analysis between clinical features (duration of migraine in years, time from onset of chronic migraine in months, where applicable, and headache and migraine frequency, where applicable) and Diffusion Tensor Imaging measures was performed. RESULTS Fifty healthy controls, 54 episodic migraine and 56 chronic migraine patients were finally included in the analysis. Significant decreased axial diffusivity (p < .05 false discovery rate and by number of contrasts corrected) was found in chronic migraine compared to episodic migraine in 38 white matter regions from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas. Significant positive correlation was found between time from onset of chronic migraine and mean fractional anisotropy in the bilateral external capsule, and negative correlation between time from onset of chronic migraine and mean radial diffusivity in the bilateral external capsule. CONCLUSIONS These findings suggest global white matter structural differences between episodic migraine and chronic migraine. Patients with chronic migraine could present axonal integrity impairment in the first months of chronic migraine with respect to episodic migraine patients. White matter changes after the onset of chronic migraine might reflect a set of maladaptive plastic changes.
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Affiliation(s)
| | - David García-Azorín
- Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47005, Valladolid, Spain
| | - Ángel L Guerrero
- Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47005, Valladolid, Spain.
- Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
- Department of Medicine, Universidad de Valladolid, Valladolid, Spain.
| | | | - Margarita Rodríguez
- Department of Radiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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Vécsei L, Lukács M, Tajti J, Fülöp F, Toldi J, Edvinsson L. The Therapeutic Impact of New Migraine Discoveries. Curr Med Chem 2019; 26:6261-6281. [PMID: 29848264 DOI: 10.2174/0929867325666180530114534] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 04/18/2018] [Accepted: 05/03/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Migraine is one of the most disabling neurological conditions and associated with high socio-economic costs. Though certain aspects of the pathomechanism of migraine are still incompletely understood, the leading hypothesis implicates the role of the activation of the trigeminovascular system. Triptans are considered to be the current gold standard therapy for migraine attacks; however, their use in clinical practice is limited. Prophylactic treatment includes non-specific approaches for migraine prevention. All these support the need for future studies in order to develop innovative anti-migraine drugs. OBJECTIVE The present study is a review of the current literature regarding new therapeutic lines in migraine research. METHODS A systematic literature search in the database of PUBMED was conducted concerning therapeutic strategies in a migraine published until July 2017. RESULTS Ongoing clinical trials with 5-HT1F receptor agonists and glutamate receptor antagonists offer promising new aspects for acute migraine treatment. Monoclonal antibodies against CGRP and the CGRP receptor are revolutionary in preventive treatment; however, further long-term studies are needed to test their tolerability. Preclinical studies show positive results with PACAP- and kynurenic acid-related treatments. Other promising therapeutic strategies (such as those targeting TRPV1, substance P, NOS, or orexin) have failed to show efficacy in clinical trials. CONCLUSION Due to their side-effects, current therapeutic approaches are not suitable for all migraine patients. Especially frequent episodic and chronic migraine represents a therapeutic challenge for researchers. Clinical and preclinical studies are needed to untangle the pathophysiology of migraine in order to develop new and migraine-specific therapies.
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Affiliation(s)
- László Vécsei
- Department of Neurology, University of Szeged, Szeged, Hungary.,MTASZTE Neuroscience Research Group, Szeged, Hungary
| | - Melinda Lukács
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - János Tajti
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - Ferenc Fülöp
- Institute of Pharmaceutical Chemistry and MTA-SZTE Research Group for Stereochemistry, University of Szeged, Szeged, Hungary
| | - József Toldi
- Department of Physiology, Anatomy and Neuroscience, University of Szeged, Szeged, Hungary
| | - Lars Edvinsson
- Department of Clinical Sciences, Division of Experimental Vascular Research, Lund University, Lund, Sweden.,Department of Clinical Experimental Research, Copenhagen University, Glostrup Hospital, Copenhagen, Denmark
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Coppola G, Parisi V, Di Renzo A, Pierelli F. Cortical pain processing in migraine. J Neural Transm (Vienna) 2019; 127:551-566. [DOI: 10.1007/s00702-019-02089-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/28/2019] [Indexed: 12/17/2022]
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25
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Faragó P, Tóth E, Kocsis K, Kincses B, Veréb D, Király A, Bozsik B, Tajti J, Párdutz Á, Szok D, Vécsei L, Szabó N, Kincses ZT. Altered Resting State Functional Activity and Microstructure of the White Matter in Migraine With Aura. Front Neurol 2019; 10:1039. [PMID: 31632336 PMCID: PMC6779833 DOI: 10.3389/fneur.2019.01039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 09/13/2019] [Indexed: 01/18/2023] Open
Abstract
Introduction: Brain structure and function were reported to be altered in migraine. Importantly our earlier results showed that white matter diffusion abnormalities and resting state functional activity were affected differently in the two subtypes of the disease, migraine with and without aura. Resting fluctuation of the BOLD signal in the white matter was reported recently. The question arising whether the white matter activity, that is strongly coupled with gray matter activity is also perturbed differentially in the two subtypes of the disease and if so, is it related to the microstructural alterations of the white matter. Methods: Resting state fMRI, 60 directional DTI images and high-resolution T1 images were obtained from 51 migraine patients and 32 healthy volunteers. The images were pre-processed and the white matter was extracted. Independent component analysis was performed to obtain white matter functional networks. The differential expression of the white matter functional networks in the two subtypes of the disease was investigated with dual-regression approach. The Fourier spectrum of the resting fMRI fluctuations were compared between groups. Voxel-wise correlation was calculated between the resting state functional activity fluctuations and white matter microstructural measures. Results: Three white matter networks were identified that were expressed differently in migraine with and without aura. Migraineurs with aura showed increased functional connectivity and amplitude of BOLD fluctuation. Fractional anisotropy and radial diffusivity showed strong correlation with the expression of the frontal white matter network in patients with aura. Discussion: Our study is the first to describe changes in white matter resting state functional activity in migraine with aura, showing correlation with the underlying microstructure. Functional and structural differences between disease subtypes suggest at least partially different pathomechanism, which may necessitate handling of these subtypes as separate entities in further studies.
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Affiliation(s)
- Péter Faragó
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Eszter Tóth
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Krisztián Kocsis
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Bálint Kincses
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Dániel Veréb
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - András Király
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Bence Bozsik
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - János Tajti
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Árpád Párdutz
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Délia Szok
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,MTA-SZTE, Neuroscience Research Group, Szeged, Hungary
| | - Nikoletta Szabó
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Zsigmond Tamás Kincses
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,Department of Radiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
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26
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Diffusion tensor imaging in middle-aged headache sufferers in the general population: a cross-sectional population-based imaging study in the Nord-Trøndelag health study (HUNT-MRI). J Headache Pain 2019; 20:78. [PMID: 31291903 PMCID: PMC6734377 DOI: 10.1186/s10194-019-1028-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several studies have investigated white matter with diffusion tensor imaging (DTI) in those suffering from headache, but so far only in clinic based samples and with conflicting results. METHODS In the present study, 1006 individuals (50-66 years) from the general population (Nord-Trøndelag Health Study) participated in an imaging study of the head at 1.5 T (HUNT-MRI). Hundred and ninety-six individuals were excluded because of errors in the data acquisition or brain pathology. Two hundred and forty-six of the remaining participants reported suffering from headache (69 from migraine and 76 from tension-type headache) the year prior to the scanning. DTI data were analysed with Tract-Based Spatial Statistics and automated tractography. Type of headache, frequency of attacks and evolution of headache were investigated for an association with white matter fractional anisotropy (FA), mean diffusivity (MD), axonal diffusivity (AD), radial diffusivity (RD) and tract volume. Correction for various demographical and clinical variables were performed. RESULTS Headache sufferers had widespread higher white matter MD, AD and RD compared to headache free individuals (n = 277). The effect sizes were mostly small with the largest seen in those with middle-age onset headache, who also had lower white matter FA. There were no associations between white matter microstructure and attack frequency or type of headache. CONCLUSION Middle-age onset headache may be related to a widespread process in the white matter leading to altered microstructure.
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Ellingson BM, Hesterman C, Johnston M, Dudeck NR, Charles AC, Villablanca JP. Advanced Imaging in the Evaluation of Migraine Headaches. Neuroimaging Clin N Am 2019; 29:301-324. [PMID: 30926119 PMCID: PMC8765285 DOI: 10.1016/j.nic.2019.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The use of advanced imaging in routine diagnostic practice appears to provide only limited value in patients with migraine who have not experienced recent changes in headache characteristics or symptoms. However, advanced imaging may have potential for studying the biological manifestations and pathophysiology of migraine headaches. Migraine with aura appears to have characteristic spatiotemporal changes in structural anatomy, function, hemodynamics, metabolism, and biochemistry, whereas migraine without aura produces more subtle and complex changes. Large, controlled, multicenter imaging-based observational trials are needed to confirm the anecdotal evidence in the literature and test the scientific hypotheses thought to underscore migraine pathophysiology.
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Affiliation(s)
- Benjamin M Ellingson
- UCLA Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA; Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA; UCLA Brain Research Institute (BRI), David Geffen School of Medicine, University of California Los Angeles, 695 Charles E Young Dr S, Los Angeles, CA 90095, USA; UCLA Brain Tumor Imaging Laboratory (BTIL), Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA; UCLA Brain Tumor Imaging Laboratory (BTIL), Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA.
| | - Chelsea Hesterman
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA
| | - Mollie Johnston
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA
| | - Nicholas R Dudeck
- UCLA Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA; Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA
| | - Andrew C Charles
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA
| | - Juan Pablo Villablanca
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA
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28
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Multivariate pattern classification of brain white matter connectivity predicts classic trigeminal neuralgia. Pain 2019; 159:2076-2087. [PMID: 29905649 DOI: 10.1097/j.pain.0000000000001312] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Trigeminal neuralgia (TN) is a severe form of chronic facial neuropathic pain. Increasing interest in the neuroimaging of pain has highlighted changes in the root entry zone in TN, but also group-level central nervous system gray and white matter (WM) abnormalities. Group differences in neuroimaging data are frequently evaluated with univariate statistics; however, this approach is limited because it is based on single, or clusters of, voxels. By contrast, multivariate pattern analyses consider all the model's neuroanatomical features to capture a specific distributed spatial pattern. This approach has potential use as a prediction tool at the individual level. We hypothesized that a multivariate pattern classification method can distinguish specific patterns of abnormal WM connectivity of classic TN from healthy controls (HCs). Diffusion-weighted scans in 23 right-sided TN and matched controls were processed to extract whole-brain interregional streamlines. We used a linear support vector machine algorithm to differentiate interregional normalized streamline count between TN and HC. This algorithm successfully differentiated between TN and HC with an accuracy of 88%. The structural pattern emphasized WM connectivity of regions that subserve sensory, affective, and cognitive dimensions of pain, including the insula, precuneus, inferior and superior parietal lobules, and inferior and medial orbital frontal gyri. Normalized streamline counts were associated with longer pain duration and WM metric abnormality between the connections. This study demonstrates that machine-learning algorithms can detect characteristic patterns of structural alterations in TN and highlights the role of structural brain imaging for identification of neuroanatomical features associated with neuropathic pain disorders.
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29
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Shibata Y, Ishiyama S, Matsushita A. White matter diffusion abnormalities in migraine and medication overuse headache: A 1.5-T tract-based spatial statistics study. Clin Neurol Neurosurg 2018; 174:167-173. [DOI: 10.1016/j.clineuro.2018.09.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 08/06/2018] [Accepted: 09/15/2018] [Indexed: 01/03/2023]
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30
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Negm M, Housseini AM, Abdelfatah M, Asran A. Relation between migraine pattern and white matter hyperintensities in brain magnetic resonance imaging. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2018; 54:24. [PMID: 30237692 PMCID: PMC6133060 DOI: 10.1186/s41983-018-0027-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 08/26/2018] [Indexed: 01/03/2023] Open
Abstract
Background Migraine is a common disorder in general population. Presence of white matter hyperintensities (WMHs) in brain MRI of migraine patients was not studied clearly. Detection of the prevalence of white matter hyperintensities in migraine patients determines its correlation with migraine severity, type and duration. Methods Cross sectional analytic study was conducted on migraine patients attending neurology clinic Suez Canal University Hospital. Sixty-five patients with migraine aged from 18 to 50 years were included. We excluded smokers and patients with hypertension, cardiac disease, diabetes mellitus, endocrine dysfunction, oncological and hematological diseases, infectious diseases, demyelinating disorders, and Alzheimer disease. Brain MRI and laboratory investigation was done for all patients. Results White matter hyperintensities were significant more frequent in migraine with aura than those without aura. According to MIGSEV scale, white matter hyperintensities were highly significantly more frequent in grade III severity than grades II and I. The number of white matter hyperintensities increases significantly with increase intensity of pain during attack. The number of white matter hyperintensities increases significantly with increase intensity of nausea, disability, tolerability during attack and age. Resistance to treatment also shows statistically significant difference in increase number of WMHs. Conclusions White matter hyperintensities are present in 43.1% of migraine patients. Age, presence of aura, nausea, disability during attack, resistance to treatment, and severity of headache and duration of migraine are considered a risk factor for development of white matter hyperintensities.
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Affiliation(s)
- Mohamed Negm
- 1Neurology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | | | - Alshimaa Asran
- 3Neuropsychiatry, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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31
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Liu P, Fan Y, Wei Y, Zeng F, Li R, Fei N, Qin W. Altered structural and functional connectivity of the insula in functional dyspepsia. Neurogastroenterol Motil 2018; 30:e13345. [PMID: 29687532 DOI: 10.1111/nmo.13345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 03/02/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Functional dyspepsia (FD) is a common functional gastrointestinal disease. Neuroimaging studies have identified that insula is involved in the pathogenesis of FD. However, less is known about structural and functional connectivity of insula in FD. METHODS In this study, 67 FD patients and 46 healthy controls (HCs) underwent structural MRI, resting-state functional MRI, diffusion tensor imaging (DTI) scans, and clinical assessment. We used the 3 neuroimaging modalities to investigate structural and functional connectivity of insula between FD patients and HCs, and we examined relationships between the neuroimaging findings and clinical symptoms. KEY RESULTS Compared with HCs, (i) FD patients had decreased gray matter density in right insula according to voxel-based morphometry method, which region was targeted as region of interest for further analysis of structural and functional connectivity; (ii) FD patients had lower connection probability in right anterior insula with right thalamus, right internal capsule (IC), and right external capsule (EC); (iii) FD patients had decreased functional connectivity of the right anterior insula with right thalamus and right pregenual anterior cingulate cortex (pACC); and (iv) FD patients had negative correlation between disease duration and the functional connectivity of right anterior insula with thalamus. CONCLUSIONS AND INFERENCES The present findings reveal that alterations of structural and/or functional connectivity of right anterior insula with regions, including thalamus, IC, EC, and pACC, may be mainly implicated in abnormalities of visceral sensory processing and related affective responses in FD patients. Finally, this study could enhance understanding of the pathophysiology of FD.
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Affiliation(s)
- P Liu
- School of Life Science and Technology, Life Science Research Center, Xidian University, Xi'an, China.,School of Life Science and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi'an, China
| | - Y Fan
- School of Life Science and Technology, Life Science Research Center, Xidian University, Xi'an, China.,School of Life Science and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi'an, China
| | - Y Wei
- School of Life Science and Technology, Life Science Research Center, Xidian University, Xi'an, China.,School of Life Science and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi'an, China
| | - F Zeng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - R Li
- School of Life Science and Technology, Life Science Research Center, Xidian University, Xi'an, China.,School of Life Science and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi'an, China
| | - N Fei
- School of Life Science and Technology, Life Science Research Center, Xidian University, Xi'an, China.,School of Life Science and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi'an, China
| | - W Qin
- School of Life Science and Technology, Life Science Research Center, Xidian University, Xi'an, China.,School of Life Science and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi'an, China
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Petrušić I, Daković M, Kačar K, Mićić O, Zidverc-Trajković J. Migraine with aura and white matter tract changes. Acta Neurol Belg 2018; 118:485-491. [PMID: 30006859 DOI: 10.1007/s13760-018-0984-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/10/2018] [Indexed: 11/29/2022]
Abstract
We aimed to explore whether a migraine with aura (MA) is associated with structural changes in tracts of a white matter and to compare parameters of diffusivity between subgroups in migraineurs. Forty-three MA and 20 healthy subjects (HS), balanced by sex and age, were selected for this study. Analysis of diffusion tensor parameters was used to identify differences between MA patients and HS, and then between MA subgroups. A diffusion tensor probabilistic tractography analysis showed that there is no difference between MA patients and HS. However, using more-liberal uncorrected statistical threshold, we noted a trend in MA patients toward lower diffusivity indices of selected white matter tracts located in the forceps minor and right anterior thalamic radiation (ATR), superior longitudinal fasciculus (temporal part) (SLFT), cingulum-cingulate tract, and left uncinate fasciculus. Migraineurs who experienced somatosensory and dysphasic aura, besides visual symptoms, had tendency toward lower diffusivity indices, relative to migraineurs who experienced only visual symptoms, in the right inferior longitudinal fasciculus, forceps minor, and right superior longitudinal fasciculus (parietal part), SLFT, and cingulum-angular bundle. Aura frequency were negatively correlated with axial diffusivity and mean diffusivity of the right ATR (partial correlation = - 0.474; p = 0.002; partial correlation = - 0.460; p = 0.002), respectively. There were no significant differences between MA patients and HS, neither between MA subgroups. Migraineurs with abundant symptoms during the aura possibly have more myelinated fibers relative to those who experience only visual symptoms. Lower diffusivity indices of the right ATR are linked to more frequent migraine with aura attacks.
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Affiliation(s)
- Igor Petrušić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
- Faculty of Physical Chemistry, University of Belgrade, Belgrade, Serbia.
| | - Marko Daković
- Faculty of Physical Chemistry, University of Belgrade, Belgrade, Serbia
| | - Katarina Kačar
- Department of Radiology, Special hospital for prevention and Treatment of Cerebrovascular Diseases "Sveti Sava", Belgrade, Serbia
| | - Olivera Mićić
- Faculty of Physical Chemistry, University of Belgrade, Belgrade, Serbia
| | - Jasna Zidverc-Trajković
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Center for headaches, Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia
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Fang J, Li S, Li M, Chan Q, Ma X, Su H, Wang T, Zhan W, Yan J, Xu M, Zhang Y, Zeng L, Tian J, Jiang G. Altered white matter microstructure identified with tract-based spatial statistics in irritable bowel syndrome: a diffusion tensor imaging study. Brain Imaging Behav 2018; 11:1110-1116. [PMID: 27627891 DOI: 10.1007/s11682-016-9573-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The neural mechanisms underlying the pathophysiology of irritable bowel syndrome(IBS) are far from being completely understood. The purpose of the present study was to investigate potential white matter (WM) microstructural changes and underlying causes for WM impairment in IBS using diffusion tensor imaging. The present prospective study involved 19 patients with IBS and 20 healthy controls. Whole-brain voxel-wise analyses of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were performed by tract-based spatial statistics (TBSS) to localize abnormal WM regions between the 2 groups. We found that IBS patients had significantly reduced FA (P < 0.05) in the splenium of the corpus callosum, the right retrolenticular area of the internal capsule and the right superior corona radiata. We also found increased MD (P < 0.05) in the splenium and body of the corpus callosum, the right retrolenticular area of the internal capsule, the right superior corona radiata and the right posterior limb of the internal capsule. In addition, IBS patients had significantly increased AD (P < 0.05) in the splenium of the corpus callosum, the bilateral retrolenticular area of the internal capsule and the left posterior limb of the internal capsule. We conclude that the WM microstructure is changed in IBS and the underlying pathological basis may be attributed to the axonal injury and loss. These results may lead to a better understanding of the pathophysiology of IBS.
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Affiliation(s)
- Jin Fang
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Shumei Li
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Meng Li
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | | | - Xiaofen Ma
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Huanhuan Su
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Tianyue Wang
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Wenfeng Zhan
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Jianhao Yan
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Ming Xu
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Yaxi Zhang
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Luxian Zeng
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Junzhang Tian
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong No.2 Provincial People's Hospital, Guangzhou, 510317, People's Republic of China.
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Veréb D, Szabó N, Tuka B, Tajti J, Király A, Faragó P, Kocsis K, Tóth E, Kincses B, Bagoly T, Helyes Z, Vécsei L, Kincses ZT. Correlation of neurochemical and imaging markers in migraine: PACAP38 and DTI measures. Neurology 2018; 91:e1166-e1174. [PMID: 30135251 DOI: 10.1212/wnl.0000000000006201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/26/2018] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To examine whether interictal plasma pituitary adenylate cyclase-activating peptide 38-like immunoreactivity (PACAP38-LI) shows correlation with the microstructural integrity of the white matter in migraine. METHODS Interictal plasma PACAP38-LI was measured by radioimmunoassay in 26 patients with migraine (24 women) who underwent diffusion tensor imaging afterward using a 1.5-tesla magnetic resonance scanner. Data were analyzed using tract-based spatial statistics included in FMRIB's Software Library. RESULTS Interictal plasma PACAP38-LI showed significant correlation with mean diffusivity (p < 0.0179) mostly in the bilateral occipital white matter spreading into parietal and temporal white matter. Axial and radial diffusivity showed positive correlation with interictal PACAP38-LI (p < 0.0432 and p < 0.0418, respectively) in the left optic radiation and left posterior corpus callosum. Fractional anisotropy did not correlate significantly with PACAP38-LI. With disease duration as a nuisance regressor in the model, PACAP38-LI correlated with axial and mean diffusivity in the left thalamus (p < 0.01). CONCLUSION We report a link between PACAP38, a pathobiologically important neurochemical biomarker, and imaging markers of the disease that may bolster further research into the role of PACAP38 in migraine.
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Affiliation(s)
- Dániel Veréb
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Nikoletta Szabó
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Bernadett Tuka
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - János Tajti
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - András Király
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Péter Faragó
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Krisztián Kocsis
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Eszter Tóth
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Bálint Kincses
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Teréz Bagoly
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Zsuzsanna Helyes
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - László Vécsei
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Zsigmond Tamás Kincses
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary.
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Ma M, Zhang J, Chen N, Guo J, Zhang Y, He L. Exploration of intrinsic brain activity in migraine with and without comorbid depression. J Headache Pain 2018; 19:48. [PMID: 29943098 PMCID: PMC6020083 DOI: 10.1186/s10194-018-0876-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/15/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Major depressive disorder is a common comorbidity in migraineurs. Depression may affect the progression and prognosis of migraine. Few studies have examined the brain function in migraineurs that may cause this comorbidity. Here, we aimed to explore depression-related abnormalities in the intrinsic brain activity of interictal migraineurs with comorbid depression using resting-state functional magnetic resonance imaging. RESULTS Significant main effects of migraine and depression provided evidence that migraine and depression jointly affected the left medial prefrontal cortex, which was thought to be the neural basis of self-referential mental activity in previous studies. Abnormalities in this region may contribute to determining the common symptoms of migraine and depression and even result in comorbidity. Additionally, migraineurs with comorbid depression had different developmental trajectories in the right thalamus and fusiform, which were associated with recognizing, transmitting, controlling and remembering pain and emotion. CONCLUSIONS Based on our findings, the abnormal mPFC which may contribute to determining the common symptoms in migraine and depression and may be a therapeutic target for migraineurs comorbid depression. The different developmental trajectory in thalamus and fusiform indicates that the comorbidity may arise through a specific mechanism rather than simple superposition of migraine and depression.
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Affiliation(s)
- Mengmeng Ma
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Junran Zhang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, China
| | - Ning Chen
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Jian Guo
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Yang Zhang
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Li He
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu, 610041, Sichuan, China.
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36
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Szabó N, Faragó P, Király A, Veréb D, Csete G, Tóth E, Kocsis K, Kincses B, Tuka B, Párdutz Á, Szok D, Tajti J, Vécsei L, Kincses ZT. Evidence for Plastic Processes in Migraine with Aura: A Diffusion Weighted MRI Study. Front Neuroanat 2018; 11:138. [PMID: 29387002 PMCID: PMC5776127 DOI: 10.3389/fnana.2017.00138] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 12/26/2017] [Indexed: 01/03/2023] Open
Abstract
Background: Formerly white matter abnormalities in a mixed group of migraine patients with and without aura were shown. Here, we aimed to explore white matter alterations in a homogeneous group of migraineurs with aura and to delineate possible relationships between white matter changes and clinical variables. Methods: Eighteen patients with aura, 25 migraine patients without aura and 28 controls were scanned on a 1.5T MRI scanner. Diffusivity parameters of the white matter were estimated and compared between patients’ groups and controls using whole-brain tract-based spatial statistics. Results: Decreased radial diffusivity (p < 0.036) was found bilaterally in the parieto-occipital white matter, the corpus callosum, and the cingular white matter of migraine with aura (MwA) patients compared to controls. Migraine without aura (MwoA) patients showed no alteration compared to controls. MwA compared to MwoA showed increased fractional anisotropy (p < 0.048) in the left parieto-occipital white matter. In MwA a negative correlation was found between axial diffusivity and disease duration in the left superior longitudinal fascicle (left parieto-occipital region) and in the left corticospinal tract (p < 0.036) and with the number of the attacks in the right superior longitudinal fascicle (p < 0.048). Conclusion: We showed for the first time that there are white matter microstructural differences between these two subgroups of migraine and hence it is important to handle the two groups separately in further researches. We propose that degenerative and maladaptive plastic changes coexist in the disease and the diffusion profile is a result of these processes.
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Affiliation(s)
- Nikoletta Szabó
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Péter Faragó
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - András Király
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Dániel Veréb
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Gergő Csete
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Eszter Tóth
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Krisztián Kocsis
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Bálint Kincses
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | | | - Árpád Párdutz
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Délia Szok
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - János Tajti
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Zsigmond T Kincses
- Neuroimaging Research Group, Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Right-to-left shunt may be prone to affect the white matter integrity of posterior circulation in migraine without aura. Neurol Sci 2017; 39:119-125. [DOI: 10.1007/s10072-017-3161-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/13/2017] [Indexed: 01/03/2023]
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38
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Cerebral white matter structure is disrupted in Gulf War Veterans with chronic musculoskeletal pain. Pain 2017; 158:2364-2375. [DOI: 10.1097/j.pain.0000000000001038] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Hotta J, Zhou G, Harno H, Forss N, Hari R. Complex regional pain syndrome: The matter of white matter? Brain Behav 2017; 7:e00647. [PMID: 28523214 PMCID: PMC5434177 DOI: 10.1002/brb3.647] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 11/18/2016] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Many central pathophysiological aspects of complex regional pain syndrome (CRPS) are still unknown. Although brain-imaging studies are increasingly supporting the contribution of the central nervous system to the generation and maintenance of the CRPS pain, the brain's white-matter alterations are seldom investigated. METHODS In this study, we used diffusion tensor imaging to explore white-matter changes in twelve CRPS-type-1 female patients suffering from chronic right upper-limb pain compared with twelve healthy control subjects. RESULTS Tract-based spatial-statistics analysis revealed significantly higher mean diffusivity, axial diffusivity, and radial diffusivity in the CRPS patients, suggesting that the structural connectivity is altered in CRPS. All these measures were altered in the genu, body, and splenium of corpus callosum, as well as in the left anterior and posterior and the right superior parts of the corona radiata. Axial diffusivity was significantly correlated with clinical motor symptoms at whole-brain level, supporting the physiological significance of the observed white-matter abnormalities. CONCLUSIONS Altogether, our findings further corroborate the involvement of the central nervous system in CRPS.
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Affiliation(s)
- Jaakko Hotta
- Department of Neuroscience and Biomedical Engineering Aalto University Espoo Finland.,Aalto NeuroImaging Aalto University Espoo Finland.,Clinical Neurosciences, Neurology University of Helsinki and Department of Neurology, Helsinki University Hospital Helsinki Finland
| | - Guangyu Zhou
- Department of Neuroscience and Biomedical Engineering Aalto University Espoo Finland.,Department of Neurology Northwestern University Chicago IL USA
| | - Hanna Harno
- Clinical Neurosciences, Neurology University of Helsinki and Department of Neurology, Helsinki University Hospital Helsinki Finland.,Pain Clinic Department of Anesthesiology, Intensive Care and Pain Medicine University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Nina Forss
- Department of Neuroscience and Biomedical Engineering Aalto University Espoo Finland.,Clinical Neurosciences, Neurology University of Helsinki and Department of Neurology, Helsinki University Hospital Helsinki Finland
| | - Riitta Hari
- Department of Neuroscience and Biomedical Engineering Aalto University Espoo Finland.,Department of Art Aalto University Helsinki Finland
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Király A, Szabó N, Párdutz Á, Tóth E, Tajti J, Csete G, Faragó P, Bodnár P, Szok D, Tuka B, Pálinkás É, Ertsey C, Vécsei L, Kincses ZT. Macro- and microstructural alterations of the subcortical structures in episodic cluster headache. Cephalalgia 2017; 38:662-673. [PMID: 28425325 DOI: 10.1177/0333102417703762] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Previous functional and structural imaging studies have revealed that subcortical structures play a key a role in pain processing. The recurring painful episodes might trigger maladaptive plasticity or alternatively degenerative processes that might be detected by MRI as changes in size or microstructure. In the current investigation, we aimed to identify the macro- and microstructural alterations of the subcortical structures in episodic cluster headache. Methods High-resolution T1-weighted and diffusion-weighted MRI images with 60 gradient directions were acquired from 22 patients with cluster headache and 94 healthy controls. Surface-based segmentation analysis was used to measure the volume of the subcortical nuclei, and mean diffusion parameters (fractional anisotropy, mean, radial and axial diffusivity) were determined for these structures. In order to understand whether the size and diffusion parameters could be investigated in a headache lateralised manner, first the asymmetry of the size and diffusion parameters of the subcortical structures was analysed. Volumes and diffusion parameters were compared between groups and correlated with the cumulative number of headache days. To account for the different size of the patient and control group, a bootstrap approach was used to investigate the stability of the findings. Results A significant lateralisation of the size (caudate, putamen and thalamus) and the diffusion parameters of the subcortical structures were found in normal controls. In cluster headache patients, the mean fractional anisotropy of the right amygdalae, the mean axial and mean diffusivity of the right caudate nucleus and the radial diffusivity of the right pallidum were higher. The mean anisotropy of the right pallidum was lower in patients. Conclusion The analysis of the pathology in the subcortical structures in episodic cluster headache reveals important features of the disease, which might allow a deeper insight into the pathomechanism of the pain processing in this headache condition.
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Affiliation(s)
- András Király
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nikoletta Szabó
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,2 International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Árpád Párdutz
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Eszter Tóth
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - János Tajti
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Gergő Csete
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Faragó
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Bodnár
- 3 Department of Image Processing and Computer Graphics, Faculty of Science and Informatics, Szeged, Hungary
| | - Délia Szok
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Bernadett Tuka
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,4 MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Éva Pálinkás
- 5 Bacs-Kiskun County Hospital, Kecskemét, Hungary
| | - Csaba Ertsey
- 6 Department of Neurology, Semmelweis University, Budapest, Hungary
| | - László Vécsei
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,4 MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Zsigmond Tamás Kincses
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,2 International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
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DeSouza DD, Hodaie M, Davis KD. Structural Magnetic Resonance Imaging Can Identify Trigeminal System Abnormalities in Classical Trigeminal Neuralgia. Front Neuroanat 2016; 10:95. [PMID: 27807409 PMCID: PMC5070392 DOI: 10.3389/fnana.2016.00095] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/27/2016] [Indexed: 01/28/2023] Open
Abstract
Classical trigeminal neuralgia (TN) is a chronic pain disorder that has been described as one of the most severe pains one can suffer. The most prevalent theory of TN etiology is that the trigeminal nerve is compressed at the root entry zone (REZ) by blood vessels. However, there is significant evidence showing a lack of neurovascular compression (NVC) for many cases of classical TN. Furthermore, a considerable number of patients who are asymptomatic have MR evidence of NVC. Since there is no validated animal model that reproduces the clinical features of TN, our understanding of TN pathology mainly comes from biopsy studies that have limitations. Sophisticated structural MRI techniques including diffusion tensor imaging provide new opportunities to assess the trigeminal nerves and CNS to provide insight into TN etiology and pathogenesis. Specifically, studies have used high-resolution structural MRI methods to visualize patterns of trigeminal nerve-vessel relationships and to detect subtle pathological features at the trigeminal REZ. Structural MRI has also identified CNS abnormalities in cortical and subcortical gray matter and white matter and demonstrated that effective neurosurgical treatment for TN is associated with a reversal of specific nerve and brain abnormalities. In conclusion, this review highlights the advanced structural neuroimaging methods that are valuable tools to assess the trigeminal system in TN and may inform our current understanding of TN pathology. These methods may in the future have clinical utility for the development of neuroimaging-based biomarkers of TN.
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Affiliation(s)
- Danielle D DeSouza
- Department of Neurology and Neurological Sciences, Stanford University Stanford, CA, USA
| | - Mojgan Hodaie
- Division of Brain, Imaging and Behavior-Systems Neuroscience, Krembil Research Institute, University Health NetworkToronto, ON, Canada; Institute of Medical Science, University of TorontoToronto, ON, Canada; Division of Neurosurgery, Toronto Western Hospital and Department of Surgery, University of TorontoToronto, ON, Canada
| | - Karen D Davis
- Division of Brain, Imaging and Behavior-Systems Neuroscience, Krembil Research Institute, University Health NetworkToronto, ON, Canada; Institute of Medical Science, University of TorontoToronto, ON, Canada; Division of Neurosurgery, Toronto Western Hospital and Department of Surgery, University of TorontoToronto, ON, Canada
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Kincses ZT, Király A, Veréb D, Vécsei L. Structural Magnetic Resonance Imaging Markers of Alzheimer's Disease and Its Retranslation to Rodent Models. J Alzheimers Dis 2016; 47:277-90. [PMID: 26401552 DOI: 10.3233/jad-143195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The importance of imaging biomarkers has been acknowledged in the diagnosis and in the follow-up of Alzheimer's disease (AD), one of the major causes of dementia. Next to the molecular biomarkers and PET imaging investigations, structural MRI approaches provide important information about the disease progression and about the pathomechanism. Furthermore,a growing body of literature retranslates these imaging biomarkers to various rodent models of the disease. The goal of this review is to provide an overview of the macro- and microstructural imaging biomarkers of AD, concentrating on atrophy measures and diffusion MRI alterations. A survey is also given of the imaging approaches used in rodent models of dementias that can promote drug development.
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Affiliation(s)
- Zsigmond Tamas Kincses
- Department of Neurology, University of Szeged, Szeged, Hungary.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - András Király
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - Dániel Veréb
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, University of Szeged, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
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43
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Liu P, Wang G, Liu Y, Yu Q, Yang F, Jin L, Sun J, Yang X, Qin W, Calhoun VD. White matter microstructure alterations in primary dysmenorrhea assessed by diffusion tensor imaging. Sci Rep 2016; 6:25836. [PMID: 27161845 PMCID: PMC4861968 DOI: 10.1038/srep25836] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 04/22/2016] [Indexed: 11/12/2022] Open
Abstract
Primary dysmenorrhea (PDM), a significant public health problem for adolescents and young women, is characterized by painful menstrual cramps. Recent neuroimaging studies have revealed that brain functional and structural abnormalities are related to the pathomechanism of PDM. However, it is not clear whether there are white matter (WM) alterations in PDM. We analyzed diffusion tensor imaging data from 35 patients and 35 healthy controls (HCs) matched for age and handedness. Tract-based spatial statistics and probabilistic tractography were used to measure integrity of WM microstructure. Compared to HCs, patients had increased fractional anisotropy (FA) along with decreased mean diffusivity (MD) and radial diffusivity (RD) in the corpus callosum (CC), superior longitudinal fasciculus (LF), corona radiata (CR), internal capsule (IC) and external capsule (EC). The FA of the splenium CC and right IC positively correlated with PDM duration while FA of the right anterior CR positively correlated with PDM severity in patient group. These WM tracts were found to show connections to other brain regions implicated in sensoimotor, affective, cognitive and pain processing functions through tractography. These findings provide preliminary evidence for WM microstructure alterations in PDM, which is potentially valuable for understanding pathomechanism of PDM.
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Affiliation(s)
- Peng Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Geliang Wang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Yanfei Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Qingbao Yu
- The Mind Research Network, Albuquerque, New Mexico 87106, USA
| | - Fan Yang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Lingmin Jin
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Jinbo Sun
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Xuejuan Yang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Wei Qin
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, New Mexico 87106, USA.,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, New Mexico 87131, USA
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Gomez-Beldarrain M, Oroz I, Zapirain BG, Ruanova BF, Fernandez YG, Cabrera A, Anton-Ladislao A, Aguirre-Larracoechea U, Garcıa-Monco JC. Right fronto-insular white matter tracts link cognitive reserve and pain in migraine patients. J Headache Pain 2016; 17:4. [PMID: 26830863 PMCID: PMC4735096 DOI: 10.1186/s10194-016-0593-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/21/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Structural white matter abnormalities in pain-modulating, regions are present in migraine. Whether they are associated with pain chronification and with cognitive reserve is unclear. METHODS Prospective, cohort, six-month study of adult patients with episodic or chronic migraine, and controls. Cognitive reserve, quality of life, impact of pain on daily living, depression and anxiety were assessed. Participants underwent a diffusion-tensor MRI to establish the integrity of white matter tracts of three regions of interest (ROIs) implicated in pain modulation, emotion, cognition and resilience (anterior insula, anterior cingulate gyrus, and uncinate fasciculus). RESULTS Fifty-two individuals were enrolled: 19 episodic migraine patients, 18 chronic migraine patients, and 15 controls. The analysis of the fractional anisotropy in the ROIs showed that those patients with the poorest prognosis (i.e., those with chronic migraine despite therapy at six months--long-term chronic migraneurs) had a significantly lower fractional anisotropy in the right ROIs. Participants with higher cognitive reserve also had greater fractional anisotropy in the right anterior insula and both cingulate gyri. Multivariate analysis showed a significant association between cognitive reserve, migraine frequency, and fractional anisotropy in the right-sided regions of interest. CONCLUSIONS Long-term chronic migraine patients show abnormalities in anterior white matter tracts, particularly of the right hemisphere, involved in pain modulation emotion, cognition and resilience. Robustness in these areas is associated with a higher cognitive reserve, which in turn might result in a lower tendency to migraine chronification.
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Affiliation(s)
| | - Isabel Oroz
- Service of Neurology Hospital de Galdakao-Usansolo, Galdakao, 48960, Vizcaya, Spain
| | | | | | | | - Alberto Cabrera
- Research and Innovation Department, Magnetic Resonance Imaging Unit, OSATEK, Vizcaya, Spain
| | - Ane Anton-Ladislao
- REDISSEC, Health Services Research on Chronic Patients Network Research Unit Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, Spain
| | - Urko Aguirre-Larracoechea
- REDISSEC, Health Services Research on Chronic Patients Network Research Unit Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, Spain
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45
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Ito K, Kudo M, Sasaki M, Saito A, Yamashita F, Harada T, Yokosawa S, Uwano I, Kameda H, Terayama Y. Detection of changes in the periaqueductal gray matter of patients with episodic migraine using quantitative diffusion kurtosis imaging: preliminary findings. Neuroradiology 2015; 58:115-20. [PMID: 26446146 DOI: 10.1007/s00234-015-1603-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/28/2015] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The periaqueductal gray matter (PAG) is considered to play an important role in generating migraine, but findings from imaging studies remain unclear. Therefore, we investigated whether diffusion kurtosis imaging (DKI) can detect changes in the PAG of migraine patients. METHODS We obtained source images for DKI from 20 patients with episodic migraine and 20 healthy controls using a 3 T magnetic resonance imaging scanner. Mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD) maps were generated, and the values of the PAG and other deep gray and white matter structures were automatically measured using an atlas-based region-of-interest analysis. The metrics of these structures were compared between the patients and controls. RESULTS The MK and MD values of the PAG were significantly increased in the migraine patients compared with the controls (p < 0.05). The FA values were not significantly different. There were no significant differences in the metrics of the other structures between the patients and controls. The MK values of the PAG were significantly positively correlated with both age and the untreated period in the patient group under univariate analysis (r = 0.53 and 0.56, respectively; p < 0.05) but not multivariate analysis. CONCLUSIONS DKI detected significant increases in the MK and MD values of the PAG in patients with migraine, which suggests that structural changes in the PAG are associated with the pathophysiological mechanisms of migraine.
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Affiliation(s)
- Kenji Ito
- Division of Ultra-High Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate, 028-3694, Japan.
| | - Masako Kudo
- Department of Neurology and Gerontology, Iwate Medical University, Iwate, Japan
| | - Makoto Sasaki
- Division of Ultra-High Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate, 028-3694, Japan
| | - Ayumi Saito
- Department of Neurology and Gerontology, Iwate Medical University, Iwate, Japan
| | - Fumio Yamashita
- Division of Ultra-High Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate, 028-3694, Japan
| | - Taisuke Harada
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Hokkaido, Japan
| | | | - Ikuko Uwano
- Division of Ultra-High Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate, 028-3694, Japan
| | - Hiroyuki Kameda
- Division of Ultra-High Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate, 028-3694, Japan
| | - Yasuo Terayama
- Department of Neurology and Gerontology, Iwate Medical University, Iwate, Japan
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46
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Neural Plasticity in Common Forms of Chronic Headaches. Neural Plast 2015; 2015:205985. [PMID: 26366304 PMCID: PMC4558449 DOI: 10.1155/2015/205985] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 08/02/2015] [Indexed: 01/03/2023] Open
Abstract
Headaches are universal experiences and among the most common disorders. While headache may be physiological in the acute setting, it can become a pathological and persistent condition. The mechanisms underlying the transition from episodic to chronic pain have been the subject of intense study. Using physiological and imaging methods, researchers have identified a number of different forms of neural plasticity associated with migraine and other headaches, including peripheral and central sensitization, and alterations in the endogenous mechanisms of pain modulation. While these changes have been proposed to contribute to headache and pain chronification, some findings are likely the results of repetitive noxious stimulation, such as atrophy of brain areas involved in pain perception and modulation. In this review, we provide a narrative overview of recent advances on the neuroimaging, electrophysiological and genetic aspects of neural plasticity associated with the most common forms of chronic headaches, including migraine, cluster headache, tension-type headache, and medication overuse headache.
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Dai Z, Zhong J, Xiao P, Zhu Y, Chen F, Pan P, Shi H. Gray matter correlates of migraine and gender effect: A meta-analysis of voxel-based morphometry studies. Neuroscience 2015; 299:88-96. [PMID: 25943478 DOI: 10.1016/j.neuroscience.2015.04.066] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 04/24/2015] [Accepted: 04/27/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND An increasing number of neuroimaging studies have revealed gray matter (GM) anomalies of several brain regions by voxel-based morphometry (VBM) studies in migraineurs. However, not all the studies reported entirely consistent findings. Our aim is to investigate concurrence across VBM studies to help clarify the structural anomalies underpinning this condition. METHODS A systematic search of VBM studies of patients with migraine and healthy controls (HC) published in PubMed and Embase databases from January 2000 to March 2014 was conducted. A quantitative meta-analysis of whole-brain VBM studies in patients with migraine compared with HC was performed by means of anisotropic effect size version of signed differential mapping (AES-SDM) software package. RESULTS Nine studies comprising 222 patients with migraine and 230 HC subjects were included in the present study. Compared to HC subjects, the patients group showed consistent decreased GM in the posterior insular-opercular regions, the prefrontal cortex, and the anterior cingulate cortex. Results remained largely unchanged in the following jackknife sensitivity analyses. Meta-regression analysis showed that a higher percentage of females in the patient sample was associated with decreased GM in the right dorsolateral prefrontal cortex. CONCLUSIONS This is the first quantitative whole-brain VBM meta-analysis in migraine showing strong evidence of brain GM anomalies within the pain-processing neural network. Further longitudinal investigations are needed to determine whether these structural anomalies are reversible with effective treatment on migraine.
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Affiliation(s)
- Z Dai
- Department of Radiology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China
| | - J Zhong
- Department of Neurology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China
| | - P Xiao
- Department of Neurology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China
| | - Y Zhu
- Department of Neurology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China
| | - F Chen
- Department of Radiology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China
| | - P Pan
- Department of Neurology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China.
| | - H Shi
- Department of Neurology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China.
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Messina R, Rocca MA, Colombo B, Pagani E, Falini A, Comi G, Filippi M. White matter microstructure abnormalities in pediatric migraine patients. Cephalalgia 2015; 35:1278-86. [PMID: 25795038 DOI: 10.1177/0333102415578428] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 02/26/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Diffusion tensor (DT) magnetic resonance imaging (MRI) provides several quantities with the potential to disclose white matter (WM) microstructural abnormalities. We explored alterations of WM architecture in pediatric migraine patients using DT MRI and two different methods of analysis. METHODS Dual-echo and DT MRI scans were acquired from 15 pediatric migraine patients and 15 age-matched controls. Whole-brain voxel-wise comparisons of WM DT MRI abnormalities were performed using tract-based-spatial-statistics (TBSS). A DT probabilistic tractography analysis was also run. RESULTS Both TBSS and DT tractography analysis showed that, compared to controls, pediatric migraine patients had significant lower mean (MD), axial (AD) and radial (RD) diffusivity of WM tracts located in the brainstem, thalamus and fronto-temporo-occipital lobes, bilaterally. Patients also experienced increased fractional anisotropy (FA) of the optic radiations. No correlation was found between WM tract abnormalities and disease duration and attack frequency. CONCLUSIONS Pediatric migraine patients harbor diffuse brain WM microstructural abnormalities. High FA and low MD, AD and RD in these patients might be explained by repeated neuronal activation, which may lead to cell swelling and stimulate activity-dependent myelin-modulation, or by increased fiber and dendritic densities. Both these mechanisms might reflect a hyperexcitability of the brain in migraineurs.
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Affiliation(s)
- Roberta Messina
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Milan, Italy Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Milan, Italy Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Bruno Colombo
- Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Falini
- Department of Neuroradiology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy
| | - Giancarlo Comi
- Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Milan, Italy Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
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49
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Neeb L, Bastian K, Villringer K, Gits HC, Israel H, Reuter U, Fiebach JB. No microstructural white matter alterations in chronic and episodic migraineurs: a case-control diffusion tensor magnetic resonance imaging study. Headache 2015; 55:241-51. [PMID: 25644380 DOI: 10.1111/head.12496] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND In patients with episodic migraine (EM), diffusion tensor imaging (DTI) revealed microstructural white matter alterations in various brain regions related to pain processing. Some of these changes were correlated with migraine duration and attack frequency, suggesting that migraine is a progressive disease with proceeding structural alterations of the brain. This study aimed to identify possible microstructural white matter alterations in patients with chronic migraine (CM) using DTI. We hypothesized that alterations in DTI are more pronounced in patients with CM compared with EM. METHODS Individually, age- and sex-matched subjects with CM without aura, EM without aura, and healthy controls (n = 21 per group) underwent conventional head magnetic resonance imaging and DTI imaging in a 3T MRI scanner and were included in analysis. DTI data were analyzed using a tract-based spatial statistics approach. Fractional anisotropy (FA), mean diffusivity, radial diffusivity, and axial diffusivity were compared between subjects with CM and EM, CM and controls, EM and controls, as well as between all subjects with migraine (EM + CM) and controls. RESULTS In chronic migraineurs (mean age 49 ± 7.5 years), we did not find any statistically significant difference (P < .05, threshold-free cluster enhancement corrected for multiple comparison) in DTI-derived parameters in comparison with episodic migraineurs (FA: P > .245) and healthy controls (FA: P > .099). In contrast to previous DTI studies, we did not find alterations in DTI-derived indices in subjects with EM compared with healthy controls (FA: P > .486). CONCLUSIONS No microstructural white matter changes could be observed in middle-aged chronic and episodic migraineurs using DTI. CM does not seem to be a risk factor for progressive microstructural changes in DTI.
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Affiliation(s)
- Lars Neeb
- Klinik und Hochschulambulanz für Neurologie, Charité Universitätsmedizin Berlin, Berlin, Germany; Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
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Coppola G, Di Renzo A, Tinelli E, Iacovelli E, Lepre C, Di Lorenzo C, Di Lorenzo G, Di Lenola D, Parisi V, Serrao M, Pauri F, Fiermonte G, Bianco F, Pierelli F. Evidence for brain morphometric changes during the migraine cycle: a magnetic resonance-based morphometry study. Cephalalgia 2014; 35:783-91. [PMID: 25414472 DOI: 10.1177/0333102414559732] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 10/15/2014] [Indexed: 01/09/2023]
Abstract
Neurophysiological investigations have demonstrated that there are unique fluctuations in the migraine brain functional activity between the ictal and interictal periods. Here we investigated the possibility that there are fluctuations over time also in whole brain morphometry of patients affected by episodic migraine without aura (MO).Twenty-four patients with untreated MO underwent 3T MRI scans during (n = 10) or between attacks (n = 14) and were compared to a group of 15 healthy volunteers (HVs). We then performed voxel-based-morphometry (VBM) analysis of structural T1-weighted MRI scans to determine if changes in brain structure were observed over the course of the migraine cycle.Interictally, MO patients had a significantly lower gray matter (GM) density within the right inferior parietal lobule, right temporal inferior gyrus, right superior temporal gyrus, and left temporal pole than did HVs. Ictally, GM density increased within the left temporal pole, bilateral insula, and right lenticular nuclei, but no areas exhibited decreased GM density.These morphometric GM changes between ictal and interictal phases suggest that abnormal structural plasticity may be an important mechanism of migraine pathology. Given the functional neuroanatomy of these areas, our findings suggest that migraine is a condition associated with global dysfunction of multisensory integration and memory processing.
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Affiliation(s)
- Gianluca Coppola
- G.B. Bietti Foundation IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Italy
| | - Antonio Di Renzo
- G.B. Bietti Foundation IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Italy
| | - Emanuele Tinelli
- "Sapienza" University of Rome, Department of Neurology and Psychiatry, Neuroradiology Section, Italy
| | - Elisa Iacovelli
- "Sapienza" University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, Italy
| | - Chiara Lepre
- "Sapienza" University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, Italy
| | | | - Giorgio Di Lorenzo
- University of Rome "Tor Vergata," Laboratory of Psychophysiology, Psychiatric Clinic, Department of Systems Medicine, Italy
| | - Davide Di Lenola
- "Sapienza" University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Italy
| | - Vincenzo Parisi
- G.B. Bietti Foundation IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Italy
| | - Mariano Serrao
- "Sapienza" University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Italy
| | - Flavia Pauri
- "Sapienza" University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, Italy
| | - Giancarlo Fiermonte
- "Sapienza" University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, Italy
| | - Federico Bianco
- "Sapienza" University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, Italy
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