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Fradera A, McLaren J, Gadon L, Cullen B, Evans J. Does the presence of chronic pain affect scores on cognitive screening tests/brief cognitive measures for dementia? A systematic review and meta-analysis. Clin Neuropsychol 2024:1-24. [PMID: 38369508 DOI: 10.1080/13854046.2024.2315739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/27/2023] [Indexed: 02/20/2024]
Abstract
OBJECTIVE Cognitive screening tests can identify potential dementia by indicating a concerning level of cognitive impairment. The older populations for whom this is most relevant are more likely to experience chronic pain, which also impairs cognitive function, but pain's impact on cognitive screening tests specifically remains unknown. METHOD We conducted a systematic review and meta-analysis (SR/MA) following PRISMA guidelines evaluating cognitive screening scores in studies involving participants with chronic pain compared with a pain-free control group. Our question was whether the presence of chronic pain (self-reported or based on diagnosis) was associated with poorer performance on these screens, and to identify the heterogeneity across groups and screens. RESULTS The 51 studies identified yielded 62 effect size estimates. The pooled g was 0.76 (95% confidence interval 0.57 to 0.95). Heterogeneity was high for the full model (= 93.16%) with some reductions in sub-analyses. Around half of the studies were identified as being at a low risk of bias. There was no evidence of publication bias. CONCLUSIONS As a whole, this analysis suggests medium to large effect sizes on cognitive screen performance when people are living with chronic pain. We suggest that clinicians should consider the effect of chronic pain when cognitive screens are employed to investigate dementia. Further research could clarify the effect pain has on different screen sub-domains to aid their effective use with these populations.
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Affiliation(s)
- Alex Fradera
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Lisa Gadon
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Breda Cullen
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jonathan Evans
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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2
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Li X, Liu M, Fan W, Xu H, Chen Z. Altered cerebral neurovascular coupling in medication-overuse headache: A study combining multi-modal resting-state fMRI with 3D PCASL. Front Neurosci 2023; 17:1139086. [PMID: 37008219 PMCID: PMC10050465 DOI: 10.3389/fnins.2023.1139086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/16/2023] [Indexed: 03/17/2023] Open
Abstract
AimStructural and functional changes in the brain have been identified in individuals with medication-overuse headache (MOH) using MRI. However, it has not been clearly established whether neurovascular dysfunction occurs in MOH, which could be elucidated by examining neurovascular coupling (NVC) from the viewpoints of neuronal activity and cerebral blood flow. The aim of this study was to investigate potential alterations in NVC function of the brain in individuals with MOH using resting-state functional MRI (rs-fMRI) and 3D pseudo-continuous arterial spin labeling (3D PCASL) imaging techniques.MethodsA total of 40 patients with MOH and 32 normal controls (NCs) were recruited, and rs-fMRI and 3D PCASL data were obtained using a 3.0 T MR scanner. Standard preprocessing of the rs-fMRI data was performed to generate images representing regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuation (fALFF), and degree centrality (DC); cerebral blood flow (CBF) images were generated using 3D PCASL sequence data. These functional maps were all normalized into Montreal Neurological Institute (MNI) space, and NVC was subsequently determined on the basis of Pearson correlation coefficients between the rs-fMRI maps (ReHo, fALFF, and DC) and CBF maps. The statistical significance of differences between the MOH and NC groups in terms of NVC in different brain regions was established via Z-test. Further analysis was performed to examine correlations between NVC in the brain regions with NVC dysfunction and clinical variables among patients with MOH.ResultsNVC mainly presented a negative correlation in patients with MOH and NCs. No significant difference between the two groups was detected in terms of average NVC over the entire gray matter area. However, several brain regions with significantly decreased NVC in patients with MOH compared to NCs were identified: the left orbital region of the superior frontal gyrus, the bilateral gyrus rectus, and the olfactory cortex (P < 0.05). A correlation analysis revealed that the DC of the brain regions with NVC dysfunction was significantly positively correlated with disease duration (r = 0.323, P = 0.042), and DC–CBF connectivity was negatively correlated with VAS score (r = −0.424, P = 0.035).ConclusionThe current study demonstrated that cerebral NVC dysfunction occurs in patients with MOH, and the NVC technique could function as a new imaging biomarker in headache research.
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Affiliation(s)
- Xin Li
- Department of Radiology, Hainan Hospital of PLA General Hospital, Sanya, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Mengqi Liu
- Department of Radiology, Hainan Hospital of PLA General Hospital, Sanya, China
| | - Wenping Fan
- Department of Radiology, Hainan Hospital of PLA General Hospital, Sanya, China
| | - Huan Xu
- Department of Radiology, Hainan Hospital of PLA General Hospital, Sanya, China
| | - Zhiye Chen
- Department of Radiology, Hainan Hospital of PLA General Hospital, Sanya, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- *Correspondence: Zhiye Chen
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3
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Schramm S, Börner C, Reichert M, Baum T, Zimmer C, Heinen F, Bonfert MV, Sollmann N. Functional magnetic resonance imaging in migraine: A systematic review. Cephalalgia 2023; 43:3331024221128278. [PMID: 36751858 DOI: 10.1177/03331024221128278] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Migraine is a highly prevalent primary headache disorder. Despite a high burden of disease, key disease mechanisms are not entirely understood. Functional magnetic resonance imaging is an imaging method using the blood-oxygen-level-dependent signal, which has been increasingly used in migraine research over recent years. This systematic review summarizes recent findings employing functional magnetic resonance imaging for the investigation of migraine. METHODS We conducted a systematic search and selection of functional magnetic resonance imaging applications in migraine from April 2014 to December 2021 (PubMed and references of identified articles according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines). Methodological details and main findings were extracted and synthesized. RESULTS Out of 224 articles identified, 114 were included after selection. Repeatedly emerging structures of interest included the insula, brainstem, limbic system, hypothalamus, thalamus, and functional networks. Assessment of functional brain changes in response to treatment is emerging, and machine learning has been used to investigate potential functional magnetic resonance imaging-based markers of migraine. CONCLUSIONS A wide variety of functional magnetic resonance imaging-based metrics were found altered across the brain for heterogeneous migraine cohorts, partially correlating with clinical parameters and supporting the concept to conceive migraine as a brain state. However, a majority of findings from previous studies have not been replicated, and studies varied considerably regarding image acquisition and analyses techniques. Thus, while functional magnetic resonance imaging appears to have the potential to advance our understanding of migraine pathophysiology, replication of findings in large representative datasets and precise, standardized reporting of clinical data would likely benefit the field and further increase the value of observations.
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Affiliation(s)
- Severin Schramm
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Corinna Börner
- LMU Hospital, Dr. von Hauner Children's Hospital, Department of Pediatric Neurology and Developmental Medicine, Munich, Germany.,LMU Center for Children with Medical Complexity, iSPZ Hauner, Ludwig Maximilian University, Munich, Germany
| | - Miriam Reichert
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Florian Heinen
- LMU Hospital, Dr. von Hauner Children's Hospital, Department of Pediatric Neurology and Developmental Medicine, Munich, Germany
| | - Michaela V Bonfert
- LMU Hospital, Dr. von Hauner Children's Hospital, Department of Pediatric Neurology and Developmental Medicine, Munich, Germany.,LMU Center for Children with Medical Complexity, iSPZ Hauner, Ludwig Maximilian University, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
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4
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Gomez-Pilar J, Martínez-Cagigal V, García-Azorín D, Gómez C, Guerrero Á, Hornero R. Headache-related circuits and high frequencies evaluated by EEG, MRI, PET as potential biomarkers to differentiate chronic and episodic migraine: Evidence from a systematic review. J Headache Pain 2022; 23:95. [PMID: 35927625 PMCID: PMC9354370 DOI: 10.1186/s10194-022-01465-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background The diagnosis of migraine is mainly clinical and self-reported, which makes additional examinations unnecessary in most cases. Migraine can be subtyped into chronic (CM) and episodic (EM). Despite the very high prevalence of migraine, there are no evidence-based guidelines for differentiating between these subtypes other than the number of days of migraine headache per month. Thus, we consider it timely to perform a systematic review to search for physiological evidence from functional activity (as opposed to anatomical structure) for the differentiation between CM and EM, as well as potential functional biomarkers. For this purpose, Web of Science (WoS), Scopus, and PubMed databases were screened. Findings Among the 24 studies included in this review, most of them (22) reported statistically significant differences between the groups of CM and EM. This finding is consistent regardless of brain activity acquisition modality, ictal stage, and recording condition for a wide variety of analyses. That speaks for a supramodal and domain-general differences between CM and EM that goes beyond a differentiation based on the days of migraine per month. Together, the reviewed studies demonstrates that electro- and magneto-physiological brain activity (M/EEG), as well as neurovascular and metabolic recordings from functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), show characteristic patterns that allow to differentiate between CM and EM groups. Conclusions Although a clear brain activity-based biomarker has not yet been identified to distinguish these subtypes of migraine, research is approaching headache specialists to a migraine diagnosis based not only on symptoms and signs reported by patients. Future studies based on M/EEG should pay special attention to the brain activity in medium and fast frequency bands, mainly the beta band. On the other hand, fMRI and PET studies should focus on neural circuits and regions related to pain and emotional processing.
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Affiliation(s)
- Javier Gomez-Pilar
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina (CIBER-BBN), Valladolid, Spain
| | - Víctor Martínez-Cagigal
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina (CIBER-BBN), Valladolid, Spain
| | - David García-Azorín
- Headache Unit, Neurology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain.
| | - Carlos Gómez
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina (CIBER-BBN), Valladolid, Spain
| | - Ángel Guerrero
- Headache Unit, Neurology Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47003, Valladolid, Spain.,Department of Medicine, University of Valladolid, Valladolid, Spain
| | - Roberto Hornero
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina (CIBER-BBN), Valladolid, Spain
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5
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Liu M, Sun Y, Li X, Chen Z. Hypoperfusion in nucleus accumbens in chronic migraine using 3D pseudo-continuous arterial spin labeling imaging MRI. J Headache Pain 2022; 23:72. [PMID: 35761188 PMCID: PMC9235082 DOI: 10.1186/s10194-022-01444-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background Nucleus accumbens (NAcc) played an important role in pain mediation, and presents changes of neuronal plasticity and functional connectivity. However, less is known about altered perfusion of NAcc in chronic migraine (CM). The aim of this study is to investigate the altered perfusion of the NAcc in CM using a MR three-dimensional pseudo-continuous arterial spin labeling (3D PCASL) imaging. Methods Thirteen CM patients and 15 normal controls (NC) were enrolled and underwent 3D PCASL and brain structural imaging. The cerebral blood flow (CBF) images were co-registered with the brain structural images, and the volume and CBF value of NAcc were extracted from the raw brain structural images and co-registered CBF images using an individual NAcc mask, which was obtained from the AAL3 template under transformation by the inverse deformation field generated from the segmentation of the brain structural images. The independent sample t test and receiver operating characteristic (ROC) curve was used to investigate the altered volume and perfusion of the NAcc in CM patients. Results There was no significant difference for the volume of bilateral NAccs between CM and NC (p > 0.05). CM presented a lower CBF value (49.34 ± 6.09 ml/100 mg/min) compared with that of NC (55.83 ± 6.55 ml/100 mg/min) in left NAcc (p = 0.01), while right NAcc showed no significant difference between CM and NC (p = 0.11). ROC analysis identified that the area under the curve was 0.73 (95CI% 0.53–0.88) with cut-off value 48.63 ml/100 mg/min with sensitivity 50.00% and specificity 93.33%. The correlation analysis found a negative correlation between the CBF value of the left NAcc and VAS score (r = -0.61, p = 0.04). Conclusion Hypoperfusion of the left NAcc was observed in CM, which could be considered as a potential diagnostic imaging biomarker in CM.
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Affiliation(s)
- Mengqi Liu
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China.,Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Yijie Sun
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China
| | - Xin Li
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Zhiye Chen
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China. .,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
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6
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Michels L, Koirala N, Groppa S, Luechinger R, Gantenbein AR, Sandor PS, Kollias S, Riederer F, Muthuraman M. Structural brain network characteristics in patients with episodic and chronic migraine. J Headache Pain 2021; 22:8. [PMID: 33657996 PMCID: PMC7927231 DOI: 10.1186/s10194-021-01216-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/28/2021] [Indexed: 12/28/2022] Open
Abstract
Background Migraine is a primary headache disorder that can be classified into an episodic (EM) and a chronic form (CM). Network analysis within the graph-theoretical framework based on connectivity patterns provides an approach to observe large-scale structural integrity. We test the hypothesis that migraineurs are characterized by a segregated network. Methods 19 healthy controls (HC), 17 EM patients and 12 CM patients were included. Cortical thickness and subcortical volumes were computed, and topology was analyzed using a graph theory analytical framework and network-based statistics. We further used support vector machines regression (SVR) to identify whether these network measures were able to predict clinical parameters. Results Network based statistics revealed significantly lower interregional connectivity strength between anatomical compartments including the fronto-temporal, parietal and visual areas in EM and CM when compared to HC. Higher assortativity was seen in both patients’ group, with higher modularity for CM and higher transitivity for EM compared to HC. For subcortical networks, higher assortativity and transitivity were observed for both patients’ group with higher modularity for CM. SVR revealed that network measures could robustly predict clinical parameters for migraineurs. Conclusion We found global network disruption for EM and CM indicated by highly segregated network in migraine patients compared to HC. Higher modularity but lower clustering coefficient in CM is suggestive of more segregation in this group compared to EM. The presence of a segregated network could be a sign of maladaptive reorganization of headache related brain circuits, leading to migraine attacks or secondary alterations to pain. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-021-01216-8.
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Affiliation(s)
- Lars Michels
- Department of Neuroradiology, University Hospital Zurich, Sternwartstr. 6, CH-8091, Zurich, Switzerland.
| | - Nabin Koirala
- Haskins Laboratories, New Haven, Connecticut, USA.,Section of Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing unit, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Section of Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing unit, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Roger Luechinger
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Andreas R Gantenbein
- Department of Neurology and Neurorehabilitation, RehaClinic, Bad Zurzach, CH-5330, Switzerland.,Department of Neurology, University Hospital Zurich, CH-8091, Zurich, Switzerland
| | - Peter S Sandor
- Department of Neurology and Neurorehabilitation, RehaClinic, Bad Zurzach, CH-5330, Switzerland.,Department of Neurology, University Hospital Zurich, CH-8091, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, University Hospital Zurich, Sternwartstr. 6, CH-8091, Zurich, Switzerland
| | - Franz Riederer
- Department of Neurology, Clinic Hietzing and Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Wolkerssbergenstrasse 1, AT-1130, Vienna, Austria.,University of Zurich, Faculty of Medicine, Rämistrasse 100, CH-8091, Zurich, Switzerland
| | - Muthuraman Muthuraman
- Section of Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing unit, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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7
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The Instant Effects of Continuous Transcutaneous Auricular Vagus Nerve Stimulation at Acupoints on the Functional Connectivity of Amygdala in Migraine without Aura: A Preliminary Study. Neural Plast 2020; 2020:8870589. [PMID: 33381165 PMCID: PMC7759401 DOI: 10.1155/2020/8870589] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Background A growing body of evidence suggests that both auricular acupuncture and transcutaneous auricular vagus nerve stimulation (taVNS) can induce antinociception and relieve symptoms of migraine. However, their instant effects and central treatment mechanism remain unclear. Many studies proved that the amygdalae play a vital role not only in emotion modulation but also in pain processing. In this study, we investigated the modulation effects of continuous taVNS at acupoints on the FC of the bilateral amygdalae in MwoA. Methods Thirty episodic migraineurs were recruited for the single-blind, crossover functional magnetic resonance imaging (fMRI) study. Each participant attended two kinds of eight-minute stimulations, taVNS and sham-taVNS (staVNS), separated by seven days in random order. Finally, 27 of them were included in the analysis of seed-to-voxel FC with the left/right amygdala as seeds. Results Compared with staVNS, the FC decreased during taVNS between the left amygdala and left middle frontal gyrus (MFG), left dorsolateral superior frontal gyrus, right supplementary motor area (SMA), bilateral paracentral lobules, bilateral postcingulum gyrus, and right frontal superior medial gyrus, so did the FC of the right amygdala and left MFG. A significant positive correlation was observed between the FC of the left amygdala and right SMA and the frequency/total time of migraine attacks during the preceding four weeks. Conclusion Continuous taVNS at acupoints can modulate the FC between the bilateral amygdalae and pain-related brain regions in MwoA, involving the limbic system, default mode network, and pain matrix, with obvious differences between the left amygdala and the right amygdala. The taVNS may produce treatment effects by modulating the abnormal FC of the amygdala and pain networks, possibly having the same central mechanism as auricular acupuncture.
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Dai L, Yu Y, Zhao H, Zhang X, Su Y, Wang X, Hu S, Dai H, Hu C, Ke J. Altered local and distant functional connectivity density in chronic migraine: a resting-state functional MRI study. Neuroradiology 2020; 63:555-562. [PMID: 33057747 DOI: 10.1007/s00234-020-02582-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Previous studies have indicated disrupted functional connectivity in multiple brain regions and resting-state networks in episodic migraine, but it is unclear how brain network property is disrupted in chronic migraine. METHODS Using resting-state functional magnetic resonance imaging and voxel-wise functional connectivity density analysis, we examined the large-scale functional connectivity pattern over the whole brain in 17 patients with chronic migraine without medication overuse compared to 35 healthy controls. The associations between functional connectivity density and clinical variables were also explored. RESULTS Compared with controls, chronic migraine patients showed decreased local and distant functional connectivity density in the dorsolateral and medial prefrontal cortexes and precuneus and increased local and distant functional connectivity density in the hippocampal complex. The patients also presented increased local functional connectivity density in the orbital frontal gyrus and cerebellum and increased distant functional connectivity density in the temporal pole. Moreover, local functional connectivity density in several brain regions, such as the left superior temporal gyrus and dorsal anterior cingulate cortex, was found to be correlated with headache frequency or pain intensity. CONCLUSION Chronic migraine is associated with functional connectivity alterations in regions involved in multisensory integration, affective and cognitive processing, and pain modulation. Both local and distant functional connectivity density are complementary biomarkers for investigating the neural mechanism of this disorder. Some local functional connectivity density alterations may be useful for assessing the disease burden of chronic migraine.
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Affiliation(s)
- Lingling Dai
- Department of Radiology, The First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Yang Yu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Hongru Zhao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Soochow, China
| | - Xiaodong Zhang
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Yunyan Su
- Department of Radiology, The First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Ximing Wang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Su Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Hui Dai
- Department of Radiology, The First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Chunhong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Jun Ke
- Department of Radiology, The First Affiliated Hospital of Soochow University, Soochow, China. .,Institute of Medical Imaging, Soochow University, Soochow, China.
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9
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Skorobogatykh K, van Hoogstraten WS, Degan D, Prischepa A, Savitskaya A, Ileen BM, Bentivegna E, Skiba I, D'Acunto L, Ferri L, Sacco S, Hansen JM, Amin FM. Functional connectivity studies in migraine: what have we learned? J Headache Pain 2019; 20:108. [PMID: 31747874 PMCID: PMC6868768 DOI: 10.1186/s10194-019-1047-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Resting-state functional connectivity (FC) MRI has widely been used to understand migraine pathophysiology and to identify an imaging marker of the disorder. Here, we review what we have learned from FC studies. METHODS We performed a literature search on the PubMed website for original articles reporting data obtained from conventional resting-state FC recording in migraine patients compared with healthy controls or during and outside of migraine attacks in the same patients. RESULTS We found 219 articles and included 28 in this review after screening for inclusion and exclusion criteria. Twenty-five studies compared migraine patients with healthy controls, whereas three studies investigated migraine patients during and outside of attacks. In the studies of interictal migraine more alterations of more than 20 FC networks (including amygdala, caudate nucleus, central executive, cerebellum, cuneus, dorsal attention network, default mode, executive control, fronto-parietal, hypothalamus, insula, neostriatum, nucleus accumbens, occipital lobe, periaqueductal grey, prefrontal cortex, salience, somatosensory cortex I, thalamus and visual) were reported. We found a poor level of reproducibility and no migraine specific pattern across these studies. CONCLUSION Based on the findings in the present review, it seems very difficult to extract knowledge of migraine pathophysiology or to identify a biomarker of migraine. There is an unmet need of guidelines for resting-state FC studies in migraine, which promote the use of homogenous terminology, public availability of protocol and the a priori hypothesis in line with for instance randomized clinical trial guidelines.
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Affiliation(s)
| | | | - Diana Degan
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | | | | | | | - Enrico Bentivegna
- Internal Medicine Unit, Sant' Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Iaroslav Skiba
- Neurology Department, Military Medical Academy, St. Petersburg, Russia
| | - Laura D'Acunto
- Clinical Unit of Neurology, Department of Medical Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Livia Ferri
- Internal Medicine Unit, Sant' Andrea Hospital, Sapienza University of Rome, Rome, Italy
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Rome, Italy
| | - Simona Sacco
- Clinical Neurology Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Jakob Møller Hansen
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark
| | - Faisal Mohammad Amin
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen, Valdemar Hansens Vej 5, Glostrup, 2600, Copenhagen, Denmark.
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10
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Coppola G, Di Renzo A, Petolicchio B, Tinelli E, Di Lorenzo C, Parisi V, Serrao M, Calistri V, Tardioli S, Cartocci G, Schoenen J, Caramia F, Di Piero V, Pierelli F. Aberrant interactions of cortical networks in chronic migraine. Neurology 2019; 92:e2550-e2558. [DOI: 10.1212/wnl.0000000000007577] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/29/2019] [Indexed: 01/01/2023] Open
Abstract
ObjectiveWe investigated resting-state (RS)-fMRI using independent component analysis (ICA) to determine the functional connectivity (FC) between networks in chronic migraine (CM) patients and their correlation with clinical features.MethodsTwenty CM patients without preventive therapy or acute medication overuse underwent 3T MRI scans and were compared to a group of 20 healthy controls (HC). We used MRI to collect RS data in 3 selected networks, identified using group ICA: the default mode network (DMN), the executive control network (ECN), and the dorsal attention system (DAS).ResultsCompared to HC, CM patients had significantly reduced functional connectivity between the DMN and the ECN. Moreover, in patients, the DAS showed significantly stronger FC with the DMN and weaker FC with the ECN. The higher the severity of headache, the increased the strength of DAS connectivity, and the lower the strength of ECN connectivity.ConclusionThese results provide evidence for large-scale reorganization of functional cortical networks in chronic migraine. They suggest that the severity of headache is associated with opposite connectivity patterns in frontal executive and dorsal attentional networks.
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11
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Changes in grey matter volume and functional connectivity in cluster headache versus migraine. Brain Imaging Behav 2019; 14:496-504. [DOI: 10.1007/s11682-019-00046-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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12
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Li MG, Chen YY, Chen ZY, Feng J, Liu MY, Lou X, Shu SY, Wang ZF, Ma L. Altered functional connectivity of the marginal division in Parkinson's disease with mild cognitive impairment: A pilot resting-state fMRI study. J Magn Reson Imaging 2019; 50:183-192. [PMID: 30644620 DOI: 10.1002/jmri.26548] [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: 07/26/2018] [Revised: 10/03/2018] [Accepted: 10/03/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The marginal division (MrD) is an important subcortical center involved in learning and memory. Mild cognitive impairment (MCI) is commonly seen in patients with Parkinson's disease (PD), but the neurobiological basis is yet to be elucidated. PURPOSE To use resting-state functional magnetic resonance imaging (rs-fMRI) to explore the altered functional connectivity (FC) of the MrD in patients with PD-MCI. STUDY TYPE Prospective pilot study. POPULATION Twenty-five patients with PD-MCI; 25 PD patients and no cognitive impairment (PD-NCI); and 25 healthy control (HC) participants. SEQUENCE 3.0 T GE Healthcare MRI scanner; three-dimensional T1 -weighted fast spoiled gradient recalled echo (3D T1 -FSPGR); rs-fMRI. ASSESSMENT The MrD was defined using manual delineation, which was the seed point to compute the FC to examine correlations between low-frequency fMRI signal fluctuations in MrD and the whole brain. STATISTICAL TESTS Between-group comparisons of the rs-fMRI data were computed using two-sample t-tests in a voxelwise manner after controlling for age and sex, to determine the brain regions that showed significant differences in FC with the bilateral MrDs. Correlation analyses were performed for FC values and cognitive abilities in patients with PD. RESULTS In the PD-MCI group, compared with the PD-NCI group, we observed lesser FC between the MrD bilaterally and right putamen, left insula, left cerebellum, and left thalamus; greater FC between the MrD bilaterally and left middle cingulate cortex, left middle frontal gyrus, left superior frontal gyrus, left supplementary motor area, and left middle/inferior occipital gyrus. Moreover, the strength of FC between the MrD and regions that showed differences between the PD-MCI and PD-NCI groups was significantly correlated with neuropsychological scores in patients with PD. DATA CONCLUSION The current study suggests that MrD dysfunction may contribute to MCI in PD. However, the mechanisms underlying this process require further investigation. Level of Evidence 1. Technical Efficacy Stage 2. J. Magn. Reson. Imaging 2019;50:183-192.
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Affiliation(s)
- Ming-Ge Li
- School of Medicine, Nankai University, Tianjin, P.R. China.,Department of Radiology, Chinese PLA General Hospital, Beijing, P.R. China
| | | | - Zhi-Ye Chen
- Department of Radiology, Chinese PLA General Hospital, Beijing, P.R. China
| | - Jie Feng
- Department of Radiology, Chinese PLA General Hospital, Beijing, P.R. China
| | - Meng-Yu Liu
- Department of Radiology, Chinese PLA General Hospital, Beijing, P.R. China
| | - Xin Lou
- Department of Radiology, Chinese PLA General Hospital, Beijing, P.R. China
| | - Si-Yun Shu
- Institute of Cognitive Neuroscience, South China Normal University, Guangzhou, P.R. China
| | - Zhen-Fu Wang
- Department of Neurology, Chinese PLA General Hospital, Beijing, P.R. China
| | - Lin Ma
- School of Medicine, Nankai University, Tianjin, P.R. China.,Department of Radiology, Chinese PLA General Hospital, Beijing, P.R. China
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13
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Chen ZY, Chen XY, Liu MQ, Ma L, Yu SY. Volume Gain of Brainstem on Medication-Overuse Headache Using Voxel-Based Morphometry. Chin Med J (Engl) 2018; 131:2158-2163. [PMID: 30203789 PMCID: PMC6144843 DOI: 10.4103/0366-6999.240807] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Histopathology identified the anatomical and molecular abnormalities of brainstem nuclei in migraine patients. However, the exact whole brainstem structural changes in vivo have not yet been identified in medication-overuse headache (MOH) transformed from migraine. The aim of this study was to investigate the regional volume changes over the whole brainstem in the MOH patients using voxel-based morphometry (VBM) in vivo. Methods: High-resolution three-dimensional structural images were obtained using a 3.0-Tesla magnetic resonance system from 36 MOH patients and 32 normal controls (NCs) who were consecutively recruited from the International Headache Center, Chinese People's Liberation Army General Hospital, from March 2013 to June 2016. VBM was used to assess the brainstem structural alteration in the MOH patients, and voxel-wise correlation was performed to evaluate the relationship with the clinical characteristics. Results: The brainstem region with increased volume located in the left ventrolateral periaqueductal gray (MNI coordinate: -1, -33, -8), ventral tegmental area (MNI coordinate: 0, -22, -12), bilateral substantia nigra (MNI coordinate: -8, -16, -12, 9, -16, -12), and trigeminal root entry zone (MNI coordinate: -19, -29, -31; 19, -32, -29) in MOH patients compared with NCs. The headache visual analog scale score was positively related with the left rostral ventromedial medulla (RVM) (MNI coordinate: -1, -37, -56; cluster size: 20; r = 0.602) in the MOH patients. Conclusions: The regional volume gain of brainstem could underlie the neuromechanism of impaired ascending and descending pathway in the MOH patients, and the left RVM volume alteration could imply the impaired tolerance of nociceptive pain input and could be used to assess the headache disability in the MOH patients.
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Affiliation(s)
- Zhi-Ye Chen
- Department of Radiology, Chinese People's Liberation Army General Hospital, Beijing 100853; Department of Radiology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013; Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Xiao-Yan Chen
- Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Meng-Qi Liu
- Department of Radiology, Chinese People's Liberation Army General Hospital, Beijing 100853; Department of Radiology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013, China
| | - Lin Ma
- Department of Radiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Sheng-Yuan Yu
- Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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14
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Hu B, Wang X, He JB, Dai YJ, Zhang J, Yu Y, Sun Q, Lin-FengYan, Hu YC, Nan HY, Yang Y, Kaye AD, Cui GB, Wang W. Structural and functional brain changes in perimenopausal women who are susceptible to migraine: a study protocol of multi-modal MRI trial. BMC Med Imaging 2018; 18:26. [PMID: 30189858 PMCID: PMC6127929 DOI: 10.1186/s12880-018-0272-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/29/2018] [Indexed: 01/01/2023] Open
Abstract
Background As a common clinical symptom that often bothers midlife females, migraine is closely associated with perimenopause. Previous studies suggest that one of the most prominent triggers is the sudden decline of estrogen during perimenopausal period. Hormone replacement therapy (HRT) is widely used to prevent this suffering in perimenopausal women, but effective diagnostic system is lacked for quantifying the severity of the diseaase. To avoid the abuse and overuse of HRT, we propose to conduct a diagnostic trial using multimodal MRI techniques to quantify the severity of these perimenopausal migraineurs who are susceptible to the decline of estrogen. Methods Perimenopausal women suffering from migraine will be recruited from the pain clinic of our hospital. Perimenopausal women not suffering from any kind of headache will be recruited from the local community. Clinical assessment and multi-modal MR imaging examination will be conducted. A follow up will be conducted once half year within 3 years. Pain behavior, neuropsychology scores, fMRI analysis combined with suitable statistical software will be used to reveal the potential association between these above traits and the susceptibility of migraine. Discussion Multi-modal imaging features of both healthy controls and perimenopausal women who are susceptible to estrogen decline will be acquired. Imaging features will include volumetric characteristics, white matter integrity, functional characteristics, topological properties, and perfusion properties. Clinical information, such as basic information, blood estrogen level, information of migraine, and a bunch of neurological scale will also be used for statistic assessment. This clinical trial would help to build an effective screen system for quantifying the severity of illness of those susceptible women during the perimenopausal period. Trial registration This study has already been registered at Clinical Trials. gov (ID: NCT02820974). Registration date: September 28th, 2014.
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Affiliation(s)
- Bo Hu
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Xu Wang
- Student Brigade, Fourth Military Medical University (Air Force Medical University), 169 West Changle Road, Xi'an, 710032, Shaanxi Province, China
| | - Jie-Bing He
- Student Brigade, Fourth Military Medical University (Air Force Medical University), 169 West Changle Road, Xi'an, 710032, Shaanxi Province, China
| | - Yu-Jie Dai
- Department of Clinical Nutrition, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jin Zhang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Ying Yu
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Qian Sun
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Lin-FengYan
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Yu-Chuan Hu
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Hai-Yan Nan
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Yang Yang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Alan D Kaye
- Departments of Anesthesiology and Pharmacology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA
| | - Guang-Bin Cui
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China.
| | - Wen Wang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China.
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15
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Androulakis XM, Rorden C, Peterlin BL, Krebs K. Modulation of salience network intranetwork resting state functional connectivity in women with chronic migraine. Cephalalgia 2017; 38:1731-1741. [PMID: 29237282 DOI: 10.1177/0333102417748570] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective To investigate the intranetwork resting state fMRI connectivity within the Salience Network of chronic migraine with and without medication overuse headache. Methods We compared 351 pairs of intranetwork connectivity in chronic migraine (n = 13) and chronic migraine with medication overuse headache (n = 16) compared to matched controls, and between each chronic migraine subgroup. Results Compared to controls, 17 pairs of intranetwork connections in chronic migraine and 27 pairs in chronic migraine with medication overuse headache were decreased. When comparing chronic migraine with medication overuse headache versus chronic migraine, connectivity between bilateral extended amygdala, and between paracingulate to right ventral tegmental area/substantia nigra were decreased in chronic migraine (chronic migraine < chronic migraine with medication overuse headache). Connectivity between left dorsolateral prefrontal cortex to bilateral ventral striatum/pallidum, to bilateral dorsal anterior cingulate cortex; left anterior prefrontal cortex to contralateral orbitofrontal insula; and left ventral striatum/pallidum to ipsilateral supplementary motor area (SMA)/preSMA were decreased in chronic migraine with medication overuse headache (chronic migraine with medication overuse headache < chronic migraine). Conclusion Both chronic migraine subgroups had shared intranetwork connectivity abnormality, however, each subgroup had unique pattern of disruption within the salience network. The results suggest that the aberrant assignment of salience to external and internal stimuli plays an important role in chronic migraine and chronic migraine with medication overuse headache interictally, mostly involving mesolimbic pathways (especially bilateral extended amygdala) in chronic migraine, and prefrontal-subcortical limbic pathways in chronic migraine with medication overuse headache.
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Affiliation(s)
| | - Chris Rorden
- 2 University of South Carolina, Department of Psychology, Columbia, SC, USA
| | - B Lee Peterlin
- 3 Johns Hopkins University, Department of Neurology, Baltimore, MD, USA
| | - Kaitlin Krebs
- 1 University of South Carolina, Department of Neurology, Columbia, SC, USA
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16
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Linnman C, Catana C, Petkov MP, Chonde DB, Becerra L, Hooker J, Borsook D. Molecular and functional PET-fMRI measures of placebo analgesia in episodic migraine: Preliminary findings. NEUROIMAGE-CLINICAL 2017; 17:680-690. [PMID: 29255671 PMCID: PMC5725156 DOI: 10.1016/j.nicl.2017.11.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/03/2017] [Accepted: 11/13/2017] [Indexed: 12/18/2022]
Abstract
Pain interventions with no active ingredient, placebo, are sometimes effective in treating chronic pain conditions. Prior studies on the neurobiological underpinnings of placebo analgesia indicate endogenous opioid release and changes in brain responses and functional connectivity during pain anticipation and pain experience in healthy subjects. Here, we investigated placebo analgesia in healthy subjects and in interictal migraine patients (n = 9) and matched healthy controls (n = 9) using 11C-diprenoprhine Positron Emission Tomography (PET) and simultaneous functional Magnetic Resonance Imaging (fMRI). Intravenous saline injections (the placebo) led to lower pain ratings, but we did not find evidence for an altered placebo response in interictal migraine subjects as compared to healthy subjects.
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Affiliation(s)
- Clas Linnman
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA.
| | - Ciprian Catana
- Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Mike P Petkov
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, USA; Center for Pain and the Brain, Boston Children's Hospital and Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA
| | - Daniel Burje Chonde
- Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Lino Becerra
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA; Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.; Center for Pain and the Brain, Boston Children's Hospital and Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA
| | - Jacob Hooker
- Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - David Borsook
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA; Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.; Center for Pain and the Brain, Boston Children's Hospital and Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA
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17
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de Tommaso M, Trotta G, Vecchio E, Ricci K, Siugzdaite R, Stramaglia S. Brain networking analysis in migraine with and without aura. J Headache Pain 2017; 18:98. [PMID: 28963615 PMCID: PMC5622013 DOI: 10.1186/s10194-017-0803-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/21/2017] [Indexed: 01/03/2023] Open
Abstract
Background To apply effective connectivity by means of nonlinear Granger Causality (GC) and brain networking analysis to basal EEG and under visual stimulation by checkerboard gratings with 0.5 and 2.0 cpd as spatial frequency in migraine with aura (MA) and without aura (MO), and to compare these findings with Blood Oxygen Level Dependent (BOLD) signal changes. Methods Nineteen asymptomatic MA and MO patients and 11 age and sex matched controls (C) were recorded by 65 EEG channels. The same visual stimulation was employed to evaluate BOLD signal changes in a subgroup of MA and MO. The GC and brain networking were applied to EEG signals. Results A different pattern of reduced vs increased GC respectively in MO and MA patients, emerged in resting state. During visual stimulation, both MA and MO showed increased information transfer toward the fronto-central regions, while MA patients showed a segregated cluster of connections in the posterior regions, and an increased bold signal in the visual cortex, more evident at 2 cpd spatial frequency. Conclusions The wealth of information exchange in the parietal-occipital regions indicates a peculiar excitability of the visual cortex, a pivotal condition for the manifestation of typical aura symptoms. Electronic supplementary material The online version of this article (10.1186/s10194-017-0803-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marina de Tommaso
- Applied Neurophysiology and Pain Unit, Basic Medical, Neuroscience and Sensory System -SMBNOS- Department, Bari Aldo Moro University, Giovanni XXIII Building, Policlinico General Hospital, Via Amendola 207 A, 70124, Bari, Italy.
| | | | - Eleonora Vecchio
- Applied Neurophysiology and Pain Unit, Basic Medical, Neuroscience and Sensory System -SMBNOS- Department, Bari Aldo Moro University, Giovanni XXIII Building, Policlinico General Hospital, Via Amendola 207 A, 70124, Bari, Italy
| | - Katia Ricci
- Applied Neurophysiology and Pain Unit, Basic Medical, Neuroscience and Sensory System -SMBNOS- Department, Bari Aldo Moro University, Giovanni XXIII Building, Policlinico General Hospital, Via Amendola 207 A, 70124, Bari, Italy
| | - R Siugzdaite
- Data Analysis Department, Faculty of Psychological and Pedagogical Sciences 1, Ghent University, Ghent, Belgium
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18
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Volume expansion of periaqueductal gray in episodic migraine: a pilot MRI structural imaging study. J Headache Pain 2017; 18:83. [PMID: 28808987 PMCID: PMC5555964 DOI: 10.1186/s10194-017-0797-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/08/2017] [Indexed: 12/28/2022] Open
Abstract
Background The periaqueductal gray (PAG) dysfunction was recognized in migraine, and the nonspecific PAG lesions were also observed in episodic migraine (EM) recently. However, the PAG volume change was not totally detected in EM up to now. Herein, the aim of this study was to investigate altered PAG volume in EM patients based on high resolution brain structural image. Methods The brain structural images were obtained from 18 normal controls (NC), 18 EM patients and 16 chronic migraine (CM) on 3.0 T MR system. PAG template was created based on the ICBM152 gray matter template using MRIcron, and the individual PAG was created by applying the deformation field to the PAG template after structural image segment. One-way analysis of covariance, partial correlation analysis and Receiver operating characteristics (ROC) curve were applied. Results EM had a larger PAG volume (0.35 ± 0.02 ml) than that (0.32 ± 0.02 ml) of NC (P = 0.017). The PAG volume of CM (0.33 ± 0.02 ml) was negatively related to the VAS score (P = 0.03). ROC analysis demonstrated that PAG volume has higher diagnostic efficacy (AUC, 0.731; Sensitivity, 0.556; Specificity, 0.889) for NC vs. EM compared with that NC vs. CM (AUC, 0.634; Sensitivity, 0.438; Specificity, 0.833) and EM vs. CM (AUC, 0.618; Sensitivity, 0.813; Specificity, 0.556). Conclusion PAG volume expansion may be the direct impairment evidence on the brain in EM, and could be considered as a diagnostic and evaluated imaging biomarker in migraine.
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19
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Chen Z, Chen X, Liu M, Dong Z, Ma L, Yu S. Altered functional connectivity architecture of the brain in medication overuse headache using resting state fMRI. J Headache Pain 2017; 18:25. [PMID: 28220377 PMCID: PMC5318354 DOI: 10.1186/s10194-017-0735-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 02/01/2017] [Indexed: 12/24/2022] Open
Abstract
Background Functional connectivity density (FCD) could identify the abnormal intrinsic and spontaneous activity over the whole brain, and a seed-based resting-state functional connectivity (RSFC) could further reveal the altered functional network with the identified brain regions. This may be an effective assessment strategy for headache research. This study is to investigate the RSFC architecture changes of the brain in the patients with medication overuse headache (MOH) using FCD and RSFC methods. Methods 3D structure images and resting-state functional MRI data were obtained from 37 MOH patients, 18 episodic migraine (EM) patients and 32 normal controls (NCs). FCD was calculated to detect the brain regions with abnormal functional activity over the whole brain, and the seed-based RSFC was performed to explore the functional network changes in MOH and EM. Results The decreased FCD located in right parahippocampal gyrus, and the increased FCD located in left inferior parietal gyrus and right supramarginal gyrus in MOH compared with NC, and in right caudate and left insula in MOH compared with EM. RSFC revealed that decreased functional connectivity of the brain regions with decreased FCD anchored in the right dorsal-lateral prefrontal cortex, right frontopolar cortex in MOH, and in left temporopolar cortex and bilateral visual cortices in EM compared with NC, and in frontal-temporal-parietal pattern in MOH compared with EM. Conclusions These results provided evidence that MOH and EM suffered from altered intrinsic functional connectivity architecture, and the current study presented a new perspective for understanding the neuromechanism of MOH and EM pathogenesis.
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Affiliation(s)
- Zhiye Chen
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.,Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China.,Department of Radiology, Hainan Branch of Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiaoyan Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Mengqi Liu
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.,Department of Radiology, Hainan Branch of Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhao Dong
- Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Lin Ma
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China.
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20
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Chen Z, Chen X, Liu M, Liu S, Ma L, Yu S. Nonspecific periaqueductal gray lesions on T2WI in episodic migraine. J Headache Pain 2016; 17:101. [PMID: 27796733 PMCID: PMC5085968 DOI: 10.1186/s10194-016-0695-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 10/20/2016] [Indexed: 12/28/2022] Open
Abstract
Background The specific periaqueductal gray (PAG) lesions with migraine-like headache were easily identified on conventional MR images in clinical practice, and the aim of this study is to investigate the nonspecific periaqueductal gray (PAG) lesions in episodic migraine (EM) patients based on T2 weighted imaging (T2WI). Methods T2WI images were obtained from 18 EM patients and 18 normal controls (NC) on 3.0 T MR system. The images were observed by two experienced radiologists, and the lesions were identified on T2WI by consensus by 2 experienced neuroradiologists blinded to the patient identity. Chi-Square test was performed for the significance test. Results Ring-like hyperintensity lesions (HILs) around the PAG region were observed in 14 EM patients and in 5 NCs on T2WI. Four EM patients and 13 NCs were normal in PAG region. The significance was revealed by Chi-Square test (P = 0.003). Conclusion HIL of PAG may be the direct evidence of the EM genesis, and the further structural and functional study should be performed to elucidate the neuromechanism of migraine pathogenesis.
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Affiliation(s)
- Zhiye Chen
- Department of Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Xiaoyan Chen
- Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Mengqi Liu
- Department of Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Shuangfeng Liu
- Department of Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Lin Ma
- Department of Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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