1
|
Fu T, Gao Y, Huang X, Zhang D, Liu L, Wang P, Yin X, Lin H, Yuan J, Ai S, Wu X. Brain connectome-based imaging markers for identifiable signature of migraine with and without aura. Quant Imaging Med Surg 2024; 14:194-207. [PMID: 38223049 PMCID: PMC10784058 DOI: 10.21037/qims-23-827] [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: 06/08/2023] [Accepted: 10/07/2023] [Indexed: 01/16/2024]
Abstract
Background Cortical spreading depression (CSD) has been considered the prominent theory for migraine with aura (MwA). However, it is also argued that CSD can exist in patients in a silent state, and not manifest as aura. Thus, the MwA classification based on aura may be questionable. This study aimed to capture whole-brain connectome-based imaging markers with identifiable signatures for MwA and migraine without aura (MwoA). Methods A total of 88 migraine patients (32 MwA) and 49 healthy controls (HC) underwent a diffusion tensor imaging and resting-state functional magnetic resonance imaging scan. The whole-brain structural connectivity (SC) and functional connectivity (FC) analysis was employed to extract imaging features. The extracted features were subjected to an all-relevant feature selection process within cross-validation loops to pinpoint attributes demonstrating substantial efficacy for patient categorization. Based on the identified features, the predictive ability of the random forest classifiers constructed with the 88 migraine patients' sample was tested using an independent sample of 32 migraine patients (eight MwA). Results Compared to MwoA and HC, MwA showed two reduced SC and six FC (five increased and one reduced) features [all P<0.01, after false discovery rate (FDR) correction], involving frontal areas, temporal areas, visual areas, amygdala, and thalamus. A total of four imaging features were significantly correlated with clinical rating scales in all patients (r=-0.38 to 0.47, P<0.01, after FDR correction). The predictive ability of the random forest classifiers achieved an accuracy of 78.1% in the external sample to identify MwA. Conclusions The whole-brain connectivity features in our results may serve as connectome-based imaging markers for MwA identification. The alterations of SC and FC strength provide possible evidence in further understanding the heterogeneity and mechanism of MwA which may help for patient-specific decision-making.
Collapse
Affiliation(s)
- Tong Fu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yujia Gao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaobin Huang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Di Zhang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lindong Liu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Peng Wang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Hai Lin
- Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Jianmin Yuan
- Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Shuyue Ai
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xinying Wu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| |
Collapse
|
2
|
Hougaard A, Gaist D, Garde E, Iversen P, Madsen CG, Kyvik KO, Ashina M, Siebner HR, Madsen KH. Lack of reproducibility of resting-state functional MRI findings in migraine with aura. Cephalalgia 2023; 43:3331024231212574. [PMID: 37950678 DOI: 10.1177/03331024231212574] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2023]
Abstract
BACKGROUND Several studies have applied resting-state functional MRI to examine whether functional brain connectivity is altered in migraine with aura patients. These studies had multiple limitations, including small sample sizes, and reported conflicting results. Here, we performed a large, cross-sectional brain imaging study to reproduce previous findings. METHODS We recruited women aged 30-60 years from the nationwide Danish Twin Registry. Resting-state functional MRI of women with migraine with aura, their co-twins, and unrelated migraine-free twins was performed at a single centre. We carried out an extensive series of brain connectivity data analyses. Patients were compared to migraine-free controls and to co-twins. RESULTS Comparisons were based on data from 160 patients, 30 co-twins, and 136 controls. Patients were similar to controls with regard to age, and several lifestyle characteristics. We replicated clear effects of age on resting-state networks. In contrast, we failed to detect any differences, and to replicate previously reported differences, in functional connectivity between migraine patients with aura and non-migraine controls or their co-twins in any of the analyses. CONCLUSION Given the large sample size and the unbiased population-based design of our study, we conclude that women with migraine with aura have normal resting-state brain connectivity outside of migraine attacks.
Collapse
Affiliation(s)
- Anders Hougaard
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Neurology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - David Gaist
- Research Unit for Neurology, Odense University Hospital, Odense, Denmark; University of Southern Denmark, Odense, Denmark
| | - Ellen Garde
- Department of Public Health, Section of Environmental Health, University of Copenhagen, Copenhagen, Denmark
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
| | - Pernille Iversen
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
| | - Camilla G Madsen
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
- Department of Radiology, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
| | - Kirsten O Kyvik
- Department of Public Health, Section of Environmental Health, University of Copenhagen, Copenhagen, Denmark
- The Danish Twin Registry, Epidemiology, Biostatistics and Biodemography, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hartwig R Siebner
- Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
- Department of Neurology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Kristoffer H Madsen
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
| |
Collapse
|
3
|
Chou BC, Lerner A, Barisano G, Phung D, Xu W, Pinto SN, Sheikh-Bahaei N. Functional MRI and Diffusion Tensor Imaging in Migraine: A Review of Migraine Functional and White Matter Microstructural Changes. J Cent Nerv Syst Dis 2023; 15:11795735231205413. [PMID: 37900908 PMCID: PMC10612465 DOI: 10.1177/11795735231205413] [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: 01/21/2023] [Accepted: 09/14/2023] [Indexed: 10/31/2023] Open
Abstract
Migraine is a complex and heterogenous disorder whose disease mechanisms remain disputed. This narrative review summarizes functional MRI (fMRI) and diffusion tensor imaging (DTI) findings and interprets their association with migraine symptoms and subtype to support and expand our current understanding of migraine pathophysiology. Our PubMed search evaluated and included fMRI and DTI studies involving comparisons between migraineurs vs healthy controls, migraineurs with vs without aura, and episodic vs chronic migraineurs. Migraineurs demonstrate changes in functional connectivity (FC) and regional activation in numerous pain-related networks depending on migraine phase, presence of aura, and chronicity. Changes to diffusion indices are observed in major cortical white matter tracts extending to the brainstem and cerebellum, more prominent in chronic migraine and associated with FC changes. Reported changes in FC and regional activation likely relate to pain processing and sensory hypersensitivities. Diffuse white matter microstructural changes in dysfunctional cortical pain and sensory pathways complement these functional differences. Interpretations of reported fMRI and DTI measure trends have not achieved a clear consensus due to inconsistencies in the migraine neuroimaging literature. Future fMRI and DTI studies should establish and implement a uniform methodology that reproduces existing results and directly compares migraineurs with different subtypes. Combined fMRI and DTI imaging may provide better pathophysiological explanations for nonspecific FC and white matter microstructural differences.
Collapse
Affiliation(s)
- Brendon C. Chou
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alexander Lerner
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Daniel Phung
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Wilson Xu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Soniya N. Pinto
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Nasim Sheikh-Bahaei
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
4
|
Li ML, Zhang F, Chen YY, Luo HY, Quan ZW, Wang YF, Huang LT, Wang JH. A state-of-the-art review of functional magnetic resonance imaging technique integrated with advanced statistical modeling and machine learning for primary headache diagnosis. Front Hum Neurosci 2023; 17:1256415. [PMID: 37746052 PMCID: PMC10513061 DOI: 10.3389/fnhum.2023.1256415] [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: 07/10/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023] Open
Abstract
Primary headache is a very common and burdensome functional headache worldwide, which can be classified as migraine, tension-type headache (TTH), trigeminal autonomic cephalalgia (TAC), and other primary headaches. Managing and treating these different categories require distinct approaches, and accurate diagnosis is crucial. Functional magnetic resonance imaging (fMRI) has become a research hotspot to explore primary headache. By examining the interrelationships between activated brain regions and improving temporal and spatial resolution, fMRI can distinguish between primary headaches and their subtypes. Currently the most commonly used is the cortical brain mapping technique, which is based on blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI). This review sheds light on the state-of-the-art advancements in data analysis based on fMRI technology for primary headaches along with their subtypes. It encompasses not only the conventional analysis methodologies employed to unravel pathophysiological mechanisms, but also deep-learning approaches that integrate these techniques with advanced statistical modeling and machine learning. The aim is to highlight cutting-edge fMRI technologies and provide new insights into the diagnosis of primary headaches.
Collapse
Affiliation(s)
- Ming-Lin Li
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Fei Zhang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yi-Yang Chen
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
- Department of Family Medicine, Liaoning Health Industry Group Fukuang General Hospital, Fushun, Liaoning, China
| | - Han-Yong Luo
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zi-Wei Quan
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yi-Fei Wang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Le-Tian Huang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jia-He Wang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
5
|
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: 0] [Impact Index Per Article: 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.
Collapse
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
| |
Collapse
|
6
|
Lozano-Soto E, Cruz-Gómez ÁJ, Rashid-López R, Sanmartino F, Espinosa-Rosso R, Forero L, González-Rosa JJ. Neuropsychological and Neuropsychiatric Features of Chronic Migraine Patients during the Interictal Phase. J Clin Med 2023; 12:jcm12020523. [PMID: 36675452 PMCID: PMC9864628 DOI: 10.3390/jcm12020523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
This study aimed to examine the presence of neuropsychological deficits and their relationships with clinical, pharmacological, and neuropsychiatric characteristics in chronic migraine (CM) patients assessed during a headache-free period. We enrolled 39 CM patients (mean age: 45.4 years; male/female ratio: 3/36) and 20 age-, sex-, and education-matched healthy controls (HCs, mean age: 45.5 years; male/female ratio: 2/18) in a case-control study. All CM patients underwent a full and extensive clinical, neuropsychiatric, and neuropsychological evaluation to evaluate cognitive domains, including sustained attention (SA), information processing speed (IPS), visuospatial episodic memory, working memory (WM), and verbal fluency (VF), as well as depressive and anxiety symptoms. CM patients exhibited higher scores than HCs for all clinical and neuropsychiatric measures, but no differences were found in personality characteristics. Although more than half of the CM patients (54%) showed mild-to-severe neuropsychological impairment (NI), with the most frequent impairments occurring in short- and long-term verbal episodic memory and inhibitory control (in approximately 90% of these patients), almost half of the patients (46%) showed no NI. Moreover, the severity of NI was positively associated with the number of pharmacological treatments received. Remarkably, disease-related symptom severity and headache-related disability explained global neuropsychological performance in CM patients. The presence of cognitive and neuropsychiatric dysfunction during the interictal phase occurred in more than half of CM patients, increasing migraine-related disability and possibly exerting a negative impact on health-related quality of life and treatment adherence.
Collapse
Affiliation(s)
- Elena Lozano-Soto
- Department of Psychology, University of Cadiz, 11003 Cadiz, Spain
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
| | - Álvaro Javier Cruz-Gómez
- Department of Psychology, University of Cadiz, 11003 Cadiz, Spain
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
| | - Raúl Rashid-López
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
- Department of Neurology, Puerta del Mar Universitary Hospital, 11009 Cadiz, Spain
| | - Florencia Sanmartino
- Department of Psychology, University of Cadiz, 11003 Cadiz, Spain
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
| | - Raúl Espinosa-Rosso
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
- Department of Neurology, Jerez de la Frontera University Hospital, 11407 Jerez de la Frontera, Spain
| | - Lucía Forero
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
- Department of Neurology, Puerta del Mar Universitary Hospital, 11009 Cadiz, Spain
| | - Javier J. González-Rosa
- Department of Psychology, University of Cadiz, 11003 Cadiz, Spain
- Institute of Research and Biomedical Innovation of Cadiz (INiBICA), 11009 Cadiz, Spain
- Correspondence:
| |
Collapse
|
7
|
Hu S, Hao Z, Li M, Zhao M, Wen J, Gao Y, Wang Q, Xi H, Antwi CO, Jia X, Ren J. Resting-state abnormalities in functional connectivity of the default mode network in migraine: A meta-analysis. Front Neurosci 2023; 17:1136790. [PMID: 36937687 PMCID: PMC10014826 DOI: 10.3389/fnins.2023.1136790] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/15/2023] [Indexed: 03/05/2023] Open
Abstract
Migraine-a disabling neurological disorder, imposes a tremendous burden on societies. To reduce the economic and health toll of the disease, insight into its pathophysiological mechanism is key to improving treatment and prevention. Resting-state functional magnetic resonance imaging (rs-fMRI) studies suggest abnormal functional connectivity (FC) within the default mode network (DMN) in migraine patients. This implies that DMN connectivity change may represent a biomarker for migraine. However, the FC abnormalities appear inconsistent which hinders our understanding of the potential neuropathology. Therefore, we performed a meta-analysis of the FC within the DMN in migraine patients in the resting state to identify the common FC abnormalities. With efficient search and selection strategies, nine studies (published before July, 2022) were retrieved, containing 204 migraine patients and 199 healthy subjects. We meta-analyzed the data using the Anisotropic Effect Size version of Signed Differential Mapping (AES-SDM) method. Compared with healthy subjects, migraine patients showed increased connectivity in the right calcarine gyrus, left inferior occipital gyrus, left postcentral gyrus, right cerebellum, right parahippocampal gyrus, and right posterior cingulate gyrus, while decreased connectivity in the right postcentral gyrus, left superior frontal gyrus, right superior occipital gyrus, right orbital inferior frontal gyrus, left middle occipital gyrus, left middle frontal gyrus and left inferior frontal gyrus. These results provide a new perspective for the study of the pathophysiology of migraine and facilitate a more targeted treatment of migraine in the future.
Collapse
Affiliation(s)
- Su Hu
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Zeqi Hao
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Mengting Li
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Mengqi Zhao
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Jianjie Wen
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Yanyan Gao
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Qing Wang
- Department of Radiology, Changshu No.2 People’s Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Hongyu Xi
- School of Western Languages, Heilongjiang University, Harbin, China
| | - Collins Opoku Antwi
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Xize Jia
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Jun Ren
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
- *Correspondence: Jun Ren,
| |
Collapse
|
8
|
Karsan N, Silva E, Goadsby PJ. Evaluating migraine with typical aura with neuroimaging. Front Hum Neurosci 2023; 17:1112790. [PMID: 37025972 PMCID: PMC10070832 DOI: 10.3389/fnhum.2023.1112790] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/01/2023] [Indexed: 04/08/2023] Open
Abstract
Objective To provide an up-to-date narrative literature review of imaging in migraine with typical aura, as a means to understand better migraine subtypes and aura biology. Background Characterizing subtypes of migraine with typical aura and appreciating possible biological differences between migraine with and without aura, are important to understanding the neurobiology of aura and trying to advance personalized therapeutics in this area through imaging biomarkers. One means of doing this over recent years has been the use of increasingly advanced neuroimaging techniques. Methods We conducted a literature review of neuroimaging studies in migraine with aura, using a PubMed search for terms 'imaging migraine', 'aura imaging', 'migraine with aura imaging', 'migraine functional imaging' and 'migraine structural imaging'. We collated the findings of the main studies, excluding small case reports and series with n < 6, and have summarized these and their implications for better understanding of aura mechanisms. Results Aura is likely mediated by widespread brain dysfunction in areas involving, but not limited to, visual cortex, somatosensory and insular cortex, and thalamus. Higher brain excitability in response to sensory stimulation and altered resting-state functional connectivity in migraine sufferers with aura could have a genetic component. Pure visual aura compared to visual aura with other sensory or speech symptoms as well, may involve different functional reorganization of brain networks and additional mitochondrial dysfunction mediating more aura symptoms. Conclusion There is a suggestion of at least some distinct neurobiological differences between migraine with and without aura, despite the shared phenotypic similarity in headache and other migraine-associated symptoms. It is clear from the vast majority of aura phenotypes being visual that there is a particular predisposition of the occipital cortex to aura mechanisms. Why this is the case, along with the relationships between cortical spreading depression and headache, and the reasons why aura does not consistently present in affected individuals, are all important research questions for the future.
Collapse
Affiliation(s)
- Nazia Karsan
- Headache Group, School of Neuroscience, Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- NIHR King’s Clinical Research Facility, King’s College London, London, United Kingdom
- *Correspondence: Nazia Karsan,
| | - Elisa Silva
- Headache Group, School of Neuroscience, Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Peter J. Goadsby
- Headache Group, School of Neuroscience, Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- NIHR King’s Clinical Research Facility, King’s College London, London, United Kingdom
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
9
|
Kaiser Pinotti L, Castro ADS, de Oliveira Garcia GH, Alvim PHP, Roza TH, Andrade FA, Kowacs PA, Massuda R. Executive functions in migraine patients: a systematic review with meta-analysis. Cogn Neuropsychiatry 2023; 28:52-66. [PMID: 36420996 DOI: 10.1080/13546805.2022.2149390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction: Migraine, a common neurological disease, is known to impact the quality of life of individuals with this condition.Methods: We performed a systematic review with meta-analysis to investigate the abnormalities associated with executive functions of migraineurs as compared with healthy controls. In addition, we investigated the differences between patients with and without aura.Results: A total of 25 studies were included in the systematic review and 19 in the meta-analysis. Meta-analysis was conducted using random effects models, with the unit of analysis as the standardised mean difference (calculated as Hedges'g). Patients with migraine had worse performance in the trail making test A (g = 0.40; 95% confidence interval [CI] 0.05-0.74; p = 0.0271) and B (g = 0.40; 95% CI 0.16-0.64; p = 0.0026), and digit span backward test (g = -0.20; 95% CI - 0.31, - 0.09; p = 0.0105). Subgroup analysis revealed no difference between migraine with and without aura.Conclusion: These results suggest that migraine patients may present worse performance for specific executive functional domains, including attention, working memory, and mental flexibility.
Collapse
Affiliation(s)
- Luciane Kaiser Pinotti
- Postgraduate Program in Internal Medicine and Health Sciences (PPGMICS), Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Anderson da Silva Castro
- Complexo Hospital de Cllínicas do Paraná (CHC), Neurology Service, Federal University of Paraná (UFPR), Curitiba, Brazil
| | | | - Pedro Henrique Pereira Alvim
- Postgraduate Program in Internal Medicine and Health Sciences (PPGMICS), Federal University of Paraná (UFPR), Curitiba, Brazil.,Department of Psychiatry, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Thiago Henrique Roza
- Department of Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Fabiana Antunes Andrade
- Laboratory of Molecular Immunopathology, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Pedro André Kowacs
- Postgraduate Program in Internal Medicine and Health Sciences (PPGMICS), Federal University of Paraná (UFPR), Curitiba, Brazil.,Complexo Hospital de Cllínicas do Paraná (CHC), Neurology Service, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Raffael Massuda
- Postgraduate Program in Internal Medicine and Health Sciences (PPGMICS), Federal University of Paraná (UFPR), Curitiba, Brazil.,Department of Psychiatry, Federal University of Paraná (UFPR), Curitiba, Brazil
| |
Collapse
|
10
|
Piervincenzi C, Petsas N, Viganò A, Mancini V, Mastria G, Puma M, Giannì C, Di Piero V, Pantano P. Functional connectivity alterations in migraineurs with Alice in Wonderland syndrome. Neurol Sci 2023; 44:305-317. [PMID: 36114397 DOI: 10.1007/s10072-022-06404-1] [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: 06/10/2022] [Accepted: 09/09/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND PURPOSE Alice in Wonderland syndrome (AIWS) is a neurological disorder characterized by erroneous perception of the body schema or surrounding space. Migraine is the primary cause of AIWS in adults. The pathophysiology of AIWS is largely unknown, especially regarding functional abnormalities. In this study, we compared resting-state functional connectivity (FC) of migraine patients experiencing AIWS, migraine patients with typical aura (MA) and healthy controls (HCs). METHODS Twelve AIWS, 12 MA, and 24 HCs were enrolled and underwent 3 T MRI scanning. Independent component analysis was used to identify RSNs thought to be relevant for AIWS: visual, salience, basal ganglia, default mode, and executive control networks. Dual regression technique was used to detect between-group differences in RSNs. Finally, AIWS-specific FC alterations were correlated with clinical measures. RESULTS With respect to HCs, AIWS and MA patients both showed significantly lower (p < 0.05, FDR corrected) FC in lateral and medial visual networks and higher FC in salience and default mode networks. AIWS patients alone showed higher FC in basal ganglia and executive control networks than HCs. When directly compared, AIWS patients showed lower FC in visual networks and higher FC in all other investigated RSNs than MA patients. Lastly, AIWS-specific FC alterations in the executive control network positively correlated with migraine frequency. CONCLUSIONS AIWS and MA patients showed similar FC alterations in several RSNs, although to a different extent, suggesting common pathophysiological underpinnings. However, AIWS patients showed additional FC alterations, likely due to the complexity of AIWS symptoms involving high-order associative cortical areas.
Collapse
Affiliation(s)
| | | | | | - Valentina Mancini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Giulio Mastria
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,My Space Lab, Department of Clinical Neuroscience, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Marta Puma
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Costanza Giannì
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Vittorio Di Piero
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Patrizia Pantano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS NEUROMED, Pozzilli, IS, Italy
| |
Collapse
|
11
|
Fu T, Liu L, Huang X, Zhang D, Gao Y, Yin X, Lin H, Dai Y, Wu X. Cerebral blood flow alterations in migraine patients with and without aura: An arterial spin labeling study. J Headache Pain 2022; 23:131. [PMID: 36195842 PMCID: PMC9531478 DOI: 10.1186/s10194-022-01501-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/20/2022] [Indexed: 11/15/2022] Open
Abstract
Background
Migraine aura is a transient, fully reversible visual, sensory, or other central nervous system symptom that classically precedes migraine headache. This study aimed to investigate cerebral blood flow (CBF) alterations of migraine with aura patients (MwA) and without aura patients (MwoA) during inter-ictal periods, using arterial spin labeling (ASL). Methods We evaluated 88 migraine patients (32 MwA) and 44 healthy control subjects (HC) who underwent a three-dimensional pseudo-continuous ASL MRI scanning. Voxel-based comparison of normalized CBF was conducted between MwA and MwoA. The relationship between CBF variation and clinical scale assessment was further analyzed. The mean CBF values in brain regions showed significant differences were calculated and considered as imaging features. Based on these features, different machine learning–based models were established to differentiate MwA and MwoA under five-fold cross validation. The predictive ability of the optimal model was further tested in an independent sample of 30 migraine patients (10 MwA). Results
In comparison to MwoA and HC, MwA exhibited higher CBF levels in the bilateral superior frontal gyrus, bilateral postcentral gyrus and cerebellum, and lower CBF levels in the bilateral middle frontal gyrus, thalamus and medioventral occipital cortex (all p values < 0.05). These variations were also significantly correlated with multiple clinical rating scales about headache severity, quality of life and emotion. On basis of these CBF features, the accuracies and areas under curve of the final model in the training and testing samples were 84.3% and 0.872, 83.3% and 0.860 in discriminating patients with and without aura, respectively. Conclusion In this study, CBF abnormalities of MwA were identified in multiple brain regions, which might help better understand migraine-stroke connection mechanisms and may guide patient-specific decision-making.
Collapse
Affiliation(s)
- Tong Fu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China
| | - Lindong Liu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China
| | - Xiaobin Huang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China
| | - Di Zhang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China
| | - Yujia Gao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China
| | - Hai Lin
- Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Yongming Dai
- Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Xinying Wu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China.
| |
Collapse
|
12
|
Cai M, Liu J, Wang X, Ma J, Ma L, Liu M, Zhao Y, Wang H, Fu D, Wang W, Xu Q, Guo L, Liu F. Spontaneous brain activity abnormalities in migraine: A meta-analysis of functional neuroimaging. Hum Brain Mapp 2022; 44:571-584. [PMID: 36129066 PMCID: PMC9842892 DOI: 10.1002/hbm.26085] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/21/2022] [Accepted: 09/02/2022] [Indexed: 01/25/2023] Open
Abstract
Neuroimaging studies have demonstrated that migraine is accompanied by spontaneous brain activity alterations in specific regions. However, these findings are inconsistent, thus hindering our understanding of the potential neuropathology. Hence, we performed a quantitative whole-brain meta-analysis of relevant resting-state functional imaging studies to identify brain regions consistently involved in migraine. A systematic search of studies that investigated the differences in spontaneous brain activity patterns between migraineurs and healthy controls up to April 2022 was conducted. We then performed a whole-brain voxel-wise meta-analysis using the anisotropic effect size version of seed-based d mapping software. Complementary analyses including jackknife sensitivity analysis, heterogeneity test, publication bias test, subgroup analysis, and meta-regression analysis were conducted as well. In total, 24 studies that reported 31 datasets were finally eligible for our meta-analysis, including 748 patients and 690 controls. In contrast to healthy controls, migraineurs demonstrated consistent and robust decreased spontaneous brain activity in the angular gyrus, visual cortex, and cerebellum, while increased activity in the caudate, thalamus, pons, and prefrontal cortex. Results were robust and highly replicable in the following jackknife sensitivity analysis and subgroup analysis. Meta-regression analyses revealed that a higher visual analog scale score in the patient sample was associated with increased spontaneous brain activity in the left thalamus. These findings provided not only a comprehensive overview of spontaneous brain activity patterns impairments, but also useful insights into the pathophysiology of dysfunction in migraine.
Collapse
Affiliation(s)
- Mengjing Cai
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Jiawei Liu
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Xuexiang Wang
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina,Department of RadiologyTianjin Hongqiao HospitalTianjinChina
| | - Juanwei Ma
- Department of RadiologyTianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for CancerTianjinChina
| | - Lin Ma
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Mengge Liu
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Yao Zhao
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - He Wang
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Dianxun Fu
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Wenqin Wang
- School of Mathematical SciencesTiangong UniversityTianjinChina
| | - Qiang Xu
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Lining Guo
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Feng Liu
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| |
Collapse
|
13
|
Wei HL, Yang WJ, Zhou GP, Chen YC, Yu YS, Yin X, Li J, Zhang H. Altered static functional network connectivity predicts the efficacy of non-steroidal anti-inflammatory drugs in migraineurs without aura. Front Mol Neurosci 2022; 15:956797. [PMID: 36176962 PMCID: PMC9513180 DOI: 10.3389/fnmol.2022.956797] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022] Open
Abstract
Brain networks have significant implications for the understanding of migraine pathophysiology and prognosis. This study aimed to investigate whether large-scale network dysfunction in patients with migraine without aura (MwoA) could predict the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs). Seventy patients with episodic MwoA and 33 healthy controls (HCs) were recruited. Patients were divided into MwoA with effective NSAIDs (M-eNSAIDs) and with ineffective NSAIDs (M-ieNSAIDs). Group-level independent component analysis and functional network connectivity (FNC) analysis were used to extract intrinsic networks and detect dysfunction among these networks. The clinical characteristics and FNC abnormalities were considered as features, and a support vector machine (SVM) model with fivefold cross-validation was applied to distinguish the subjects at an individual level. Dysfunctional connections within seven networks were observed, including default mode network (DMN), executive control network (ECN), salience network (SN), sensorimotor network (SMN), dorsal attention network (DAN), visual network (VN), and auditory network (AN). Compared with M-ieNSAIDs and HCs, patients with M-eNSAIDs displayed reduced DMN-VN and SMN-VN, and enhanced VN-AN connections. Moreover, patients with M-eNSAIDs showed increased FNC patterns within ECN, DAN, and SN, relative to HCs. Higher ECN-SN connections than HCs were revealed in patients with M-ieNSAIDs. The SVM model demonstrated that the area under the curve, sensitivity, and specificity were 0.93, 0.88, and 0.89, respectively. The widespread FNC impairment existing in the modulation of medical treatment suggested FNC disruption as a biomarker for advancing the understanding of neurophysiological mechanisms and improving the decision-making of therapeutic strategy.
Collapse
Affiliation(s)
- Heng-Le Wei
- Department of Radiology, Nanjing Jiangning Hospital, Nanjing, China
| | - Wen-Juan Yang
- Department of Neurology, Nanjing Jiangning Hospital, Nanjing, China
| | - Gang-Ping Zhou
- Department of Radiology, Nanjing Jiangning Hospital, Nanjing, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yu-Sheng Yu
- Department of Radiology, Nanjing Jiangning Hospital, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Junrong Li
- Department of Neurology, Nanjing Jiangning Hospital, Nanjing, China
| | - Hong Zhang
- Department of Radiology, Nanjing Jiangning Hospital, Nanjing, China
| |
Collapse
|
14
|
Gu L, Wang Y, Shu H. Association between migraine and cognitive impairment. J Headache Pain 2022; 23:88. [PMID: 35883043 PMCID: PMC9317452 DOI: 10.1186/s10194-022-01462-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/16/2022] [Indexed: 11/20/2022] Open
Abstract
Background Previous studies revealed inconsistent results regarding association between migraine and cognitive impairment. In addition, previous studies found inconsistent results regarding the association between migraine and risk of dementia. Thus, the study aimed to make a meta-analysis exploring comparison result in different types of cognitive function between migraine patients and non-migraine subjects. In addition, meta-analysis was made to explore the association between migraine and risk of dementia. Methods Articles published before June 2022 were searched in the following databases: PubMed, Web of Science, SCOPUS, EMBASE, EBSCO, PROQUEST, ScienceDirect and Cochrane Database of Systematic Reviews. Results were computed using STATA 12.0 software. Results Meta-analysis showed lower general cognitive function and language function in migraine group, compared to no migraine group (general cognitive function: standard mean difference (SMD) = − 0.40, 95% CI = − 0.66 to − 0.15; language: SMD = − 0.14, 95% confidence interval (CI) = − 0.27 to − 0.00), whereas the study showed no significant difference in visuospatial function, attention, executive function and memory between migraine group and no migraine group (visuospatial function: SMD = − 0.23, 95% CI = − 0.53 to 0.08; attention: SMD = − 0.01, 95% CI = − 0.10 to 0.08; executive function: SMD = − 0.05, 95% CI = − 0.16 to 0.05; memory: SMD = − 0.14, 95% CI = − 0.30 to 0.03). In addition, the meta-analysis showed a significant association between migraine and risk of dementia (odds ratio (OR)/relative risk (RR) = 1.30, 95% CI = 1.11 to 1.52). Conclusions In conclusion, the meta-analysis demonstrated lower general cognitive function and language function in migraine. In addition, migraine is associated with an increased risk of all-cause dementia, VaD and AD. These results suggest a significant association between migraine and cognitive impairment. Because of the association between migraine and cognitive impairment, neurological physician should be vigilant and effectively intervene in migraineurs with high risk factors of cognitive impairment to prevent the development of cognitive impairment. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01462-4.
Collapse
Affiliation(s)
- Lihua Gu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China. .,Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.
| | - Yanjuan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
| | - Hao Shu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
| |
Collapse
|
15
|
Resting-state occipital alpha power is associated with treatment outcome in patients with chronic migraine. Pain 2022; 163:1324-1334. [PMID: 35708466 DOI: 10.1097/j.pain.0000000000002516] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/05/2021] [Indexed: 01/03/2023]
Abstract
ABSTRACT Preventive treatment is crucial for patients with chronic migraine (CM). This study explored the association between resting-state cortical oscillations and 3-month treatment outcome in patients with CM. Treatment-naïve patients with CM were recruited with their demographic data, psychosocial data, and headache profiles as well as the healthy controls (HCs). Resting-state cortical activities were recorded using an electroencephalogram and analysed using source-based and electrode-based spectral power method. The regions of interest were the bilateral primary somatosensory (S1) and visual (V1) cortices. After 3-month treatment with flunarizine, patients with CM were categorized into responders and nonresponders. Demographic, clinical, and electroencephalogram data from 72 patients with CM and 50 HCs were analysed. Elevated anxiety, depression, and stress were observed in patients with CM. Theta power in bilateral S1 and alpha and gamma powers in the right S1 increased in patients with CM. Nonresponders (n = 34) exhibited larger alpha powers in bilateral V1 than those in responders (n = 38). Alpha powers also exhibited significant correlations with changes of monthly headache days. Notably, in responders and nonresponders, occipital alpha powers did not differ at baseline and in the third month. In conclusion, patients with CM who were not responsive to preventive treatment were associated with augmented resting-state occipital alpha activity. Moreover, changes in migraine attack frequency were associated with baseline occipital alpha power. However, the prognostic feature of visual alpha oscillation seems to be inherent because it is not altered by flunarizine treatment. These findings may be useful for developing personalised migraine treatment plans.
Collapse
|
16
|
Wei XY, Luo SL, Chen H, Liu SS, Gong ZG, Zhan SH. Functional connectivity changes during migraine treatment with electroacupuncture at Shuaigu (GB8). JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:237-243. [PMID: 35219625 DOI: 10.1016/j.joim.2022.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the changes in the functional connectivity (FC) in the right insula between migraine without aura (MWoA) and healthy controls by using resting-state functional magnetic resonance imaging (rs-fMRI), and to observe the instant alteration of FC in MWoA during electroacupuncture (EA) stimulation at Shuaigu (GB8). METHODS A total of 30 patients with MWoA (PM group) and 30 healthy controls (HC group) underwent rs-fMRI scans. The PM group underwent a second rs-fMRI scan while receiving EA at GB8. The right insula subregions, including the ventral anterior insula (vAI), dorsal anterior insula (dAI) and posterior insula (PI), were selected as the seed points for FC analysis. RESULTS Aberrant FC, including dAI with right postcentral gyrus, PI with left precuneus, was found among PM before EA (PMa), PM during EA (PMb) and HC. Meanwhile, decreased FC between dAI and the right postcentral gyrus was found in the PMa compared to the HC and PMb. Increased FC between the PI and left precuneus was found in the PMa compared to the HC and PMb. Correlation analysis showed that the FC value of the right postcentral gyrus in PMa was negatively correlated with the scores of Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety. The FC value of the left precuneus in PMa was positively correlated with the visual analogue scale score. CONCLUSION The alteration of FC between the right insula subregions and multiple brain regions may be an important index for MWoA. EA at GB8 was able to adjust the FC between the right insula subregions and parietal lobe, namely, the right dAI and right postcentral gyrus, and the right PI and left precuneus, thereby rendering an instant effect in the management of MWoA.
Collapse
Affiliation(s)
- Xiang-Yu Wei
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Shi-Lei Luo
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Hui Chen
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Shan-Shan Liu
- Department of Acupuncture & Moxibustion, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Zhi-Gang Gong
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Song-Hua Zhan
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
| |
Collapse
|
17
|
Petrusic I, Jovanovic V, Kovic V, Savic AM. P3 latency as a biomarker for the complexity of migraine with aura: Event-related potential study. Cephalalgia 2022; 42:1022-1030. [PMID: 35332814 DOI: 10.1177/03331024221090204] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study aimed to compare the P3 component between patients who have migraines with aura and healthy subjects, and to compare different subtypes of migraine with aura relative to the complexity of migraine aura. METHODS Average Migraine Aura Complexity Score was calculated for each MwA patient. Visual oddball paradigm was used to elicit the P3 component. P3 amplitudes and latencies elicited from frequent and rare stimuli, as well as from difference wave, were compared with healthy subjects. Subsequently, subtypes of migraine with aura were compared and Average Migraine Aura Complexity Score was used to explore the connection between features of the P3 and complexity of migraine with aura. RESULTS 37 patients who have migraine with aura (16 with simple aura and 21 with complex aura) patients and 28 healthy subjects were studied. Patients who have migraine with aura had significantly prolonged latencies compared to healthy subjects (411 ± 39 ms vs 372 ± 34 ms, p < 0.001) relative to a rare condition. Patients who have complex aura significantly differs from patients who have simple aura (427 ± 34 ms vs 389 ± 35 ms, p = 0.004) and healthy subjects (372 ± 34 ms, p < 0.001) relative to P3 latency in a rare condition and the patients who have complex aura significantly differs from healthy subjects (442 ± 37 ms vs 394 ± 33 ms, p < 0.001) relative to P3 latency in difference wave. P3 latency from rare condition positively correlated with the Average Migraine Aura Complexity Score (p < 0.001). CONCLUSIONS Visual oddball paradigm, particularly rare stimuli, could serve as a potential new tool for deep profiling of different clinical complexities among patients who have migraine with aura. Also, the present pattern of P3 components provided new evidence for the cognitive dysfunctions in patients who have migraine with aura.
Collapse
Affiliation(s)
- Igor Petrusic
- University of Belgrade, Faculty of Physical Chemistry, Laboratory for Advanced Analysis of Neuroimages, Belgrade, Serbia
| | - Vojislav Jovanovic
- University of Belgrade, Faculty of Philosophy, Department of Psychology, Laboratory for Neurocognition and Applied Cognition, Belgrade, Serbia
| | - Vanja Kovic
- University of Belgrade, Faculty of Philosophy, Department of Psychology, Laboratory for Neurocognition and Applied Cognition, Belgrade, Serbia
| | - Andrej M Savic
- University of Belgrade, School of Electrical Engineering, Science and Research Centre, Belgrade, Serbia
| |
Collapse
|
18
|
Alhajri N, Boudreau SA, Graven-Nielsen T. Angular gyrus connectivity at alpha and beta oscillations is reduced during tonic pain - Differential effect of eye state. Neuroimage Clin 2022; 33:102907. [PMID: 34915329 PMCID: PMC8683773 DOI: 10.1016/j.nicl.2021.102907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
Tonic pain differentially altered AG connectivity during eyes closed and eyes open. Negative mood and/or sleep quality can influence pain-related connectivity. Eyes closed baseline may allow for a reliable detection of pain-related changes. Eyes-closed-eyes-open sequence is crucial for assessing pain-related connectivity.
The angular gyrus (AG) is a common hub in the pain networks. The role of the AG during pain perception, however, is still unclear. This crossover study examined the effect of tonic pain on resting state functional connectivity (rsFC) of the AG under eyes closed (EC) and eyes open (EO). It included two sessions (placebo/pain) separated by 24 hours. Pain was induced using topical capsaicin (or placebo as control) on the right forearm. Electroencephalographic rsFC assessed by Granger causality was acquired from 28 healthy participants (14 women) before (baseline) and 1-hour following the application of placebo/capsaicin. Subjects were randomly assigned and balanced to groups of recording sequence (EC-EO, EO-EC). Decreased rsFC at alpha-1 and beta, but not alpha-2, oscillations was found during pain compared to baseline during EC only. For alpha-1, EC-EO group showed a pain-induced decrease only among connections between the right AG and each of the posterior cingulate cortex (PCC, P = 0.002), medial prefrontal cortex (mPFC, P = 0.005), and the left AG (P = 0.023). For beta rsFC, the EC-EO group showed a bilateral decrease in rsFC spanning the connections between the right AG and mPFC (P = 0.015) and between the left AG and each of PCC (P = 0.004) and mPFC (P = 0.026). In contrast, the EO-EC group showed an increase in beta rsFC only among connections between the left AG and each of PCC (P = 0.012) and mPFC (P = 0.036). No significant change in the AG rsFC was found during EO. These results provide insight into the involvement of the AG in pain perception and reveal methodological considerations when assessing rsFC during EO and EC.
Collapse
Affiliation(s)
- Najah Alhajri
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Shellie Ann Boudreau
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| |
Collapse
|
19
|
Begasse de Dhaem O, Robbins MS. Cognitive Impairment in Primary and Secondary Headache Disorders. Curr Pain Headache Rep 2022; 26:391-404. [PMID: 35239156 PMCID: PMC8891733 DOI: 10.1007/s11916-022-01039-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 11/28/2022]
Abstract
Purpose of Review To critically evaluate the recent literature on cognitive impairment and headache. Recent Findings Neurocognitive symptoms are prevalent, debilitating, and occur often with both primary and secondary headache disorders. Summary This is a “narrative review of the current literature in PubMed on cognitive function and headache.” Migraine is associated with cognitive impairment years before a migraine diagnosis. In young and middle-aged adults, migraine is associated with deficits in attention, executive function, processing speed, and memory. It is unlikely that migraine is associated with dementia. Although methodologically difficult to assess, there does not seem to be an association between tension-type headache and cognitive dysfunction. In early to midlife, cluster headache seems to be associated with executive dysfunction. Several secondary headache syndromes relevant to clinicians managing headache disorders are associated with poorer cognitive performance or distinctive cognitive patterns, including those attributed to chronic cerebral or systemic vascular disorders, trauma, and derangements of intracranial pressure and volume, including frontotemporal brain sagging syndrome.
Collapse
Affiliation(s)
| | - Matthew S Robbins
- Department of Neurology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA
| |
Collapse
|
20
|
Disrupted Dynamic Functional Connectivity of the Visual Network in Episodic Patients with Migraine without Aura. Neural Plast 2022; 2022:9941832. [PMID: 35035474 PMCID: PMC8754605 DOI: 10.1155/2022/9941832] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 12/01/2021] [Accepted: 12/16/2021] [Indexed: 12/28/2022] Open
Abstract
Background Visual symptoms are common in patients with migraine, even in interictal periods. The purpose was to assess the association between dynamic functional connectivity (dFC) of the visual cortex and clinical characteristics in migraine without aura (MwoA) patients. Methods We enrolled fifty-five MwoA patients as well as fifty gender- and age-matched healthy controls. Regional visual cortex alterations were investigated using regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF). Then, significant regions were selected as seeds for conducting dFC between the visual cortex and the whole brain. Results Relative to healthy controls, MwoA patients exhibited decreased ReHo and ALFF values in the right lingual gyrus (LG) and increased ALFF values in the prefrontal cortex. The right LG showed abnormal dFC within the visual cortex and with other core brain networks. Additionally, ReHo values for the right LG were correlated with duration of disease and ALFF values of the right inferior frontal gyrus and middle frontal gyrus were correlated with headache frequency and anxiety scores, respectively. Moreover, the abnormal dFC of the right LG with bilateral cuneus was positively correlated with anxiety scores. Conclusions The dFC abnormalities of the visual cortex may be involved in pain integration with multinetworks and associated with anxiety disorder in episodic MwoA patients.
Collapse
|
21
|
OUP accepted manuscript. PAIN MEDICINE 2022; 23:1560-1569. [DOI: 10.1093/pm/pnac048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/04/2022] [Accepted: 03/17/2022] [Indexed: 11/13/2022]
|
22
|
Petrusic I, Jovanovic V, Kovic V, Savic A. Characteristics of N400 component elicited in patients who have migraine with aura. J Headache Pain 2021; 22:157. [PMID: 34961473 PMCID: PMC8903587 DOI: 10.1186/s10194-021-01375-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/15/2021] [Indexed: 12/01/2022] Open
Abstract
Background This study aimed to examine the N400 effect and event-related potentials (ERPs) elicited from congruent and incongruent stimuli in patients who have migraines with aura (MwA). Methods A total of 33 MwA patients and 20 healthy controls (HCs) were studied. They were balanced in age (35.12 ± 8.94 vs 34.70 ± 9.59 years, p = 0.872) and sex (69.7 vs 75.0% females, p = 0.761). ERPs were measured in response to both stimuli, where pictures were preceded with an object name that either matched or mismatched with the object. Averaged amplitudes, peaks, peak latencies, difference waves and topography were compared between MwA and HCs. Results MwA patients had significantly lower averaged amplitudes at the Fz and F4 sites during incongruent stimuli, as well as reduced peaks at the C3 and Pz sites. Topography showed a more widespread N400 effect over scalp relative to HCs. The difference ERP waveforms did not differ in the N400 effect between groups, but the P600 effect was significantly stronger in the HCs group relative to the MwA group at the Pz (6.52 ± 2.57 vs. 3.50 ± 3.15, p = 0.001) and P4 (5.86 ± 2.79 vs. 3.95 ± 3.64, p = 0.040) sites. Conclusions Picture-word matching tasks could serve as a potential new method for the investigation of semantic processing in MwA patients.
Collapse
Affiliation(s)
- Igor Petrusic
- Laboratory for Advanced Analysis of Neuroimages, Faculty of Physical Chemistry, University of Belgrade, 12-16 Studentski Trg Street, Belgrade, 11000, Serbia.
| | - Vojislav Jovanovic
- Laboratory for Neurocognition and Applied Cognition, Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Vanja Kovic
- Laboratory for Neurocognition and Applied Cognition, Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Andrej Savic
- Science and Research Centre, School of Electrical Engineering, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
23
|
Schading S, Pohl H, Gantenbein A, Luechinger R, Sandor P, Riederer F, Freund P, Michels L. Tracking tDCS induced grey matter changes in episodic migraine: a randomized controlled trial. J Headache Pain 2021; 22:139. [PMID: 34800989 PMCID: PMC8605508 DOI: 10.1186/s10194-021-01347-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/27/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Occipital transcranial direct current stimulation (tDCS) is an effective and safe treatment for migraine attack prevention. Structural brain alterations have been found in migraineurs in regions related to pain modulation and perception, including occipital areas. However, whether these structural alterations can be dynamically modulated through tDCS treatment is understudied. OBJECTIVE To track longitudinally grey matter volume changes in occipital areas in episodic migraineurs during and up to five months after occipital tDCS treatment in a single-blind, and sham-controlled study. METHODS 24 episodic migraineurs were randomized to either receive verum or sham occipital tDCS treatment for 28 days. To investigate dynamic grey matter volume changes patients underwent structural MRI at baseline (prior to treatment), 1.5 months and 5.5 months (after completion of treatment). 31 healthy controls were scanned with the same MRI protocol. Morphometry measures assessed rate of changes over time and between groups by means of tensor-based morphometry. RESULTS Before treatment, migraineurs reported 5.6 monthly migraine days on average. A cross-sectional analysis revealed grey matter volume increases in the left lingual gyrus in migraineurs compared to controls. Four weeks of tDCS application led to a reduction of 1.9 migraine days/month and was paralleled by grey matter volume decreases in the left lingual gyrus in the treatment group; its extent overlapping with that seen at baseline. CONCLUSION This study shows that migraineurs have increased grey matter volume in the lingual gyrus, which can be modified by tDCS. Tracking structural plasticity in migraineurs provides a potential neuroimaging biomarker for treatment monitoring. TRIAL REGISTRATION ClinicalTrials.gov , NCT03237754 . Registered 03 August 2017 - retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03237754 .
Collapse
Affiliation(s)
- Simon Schading
- Spinal Cord Injury Centre Balgrist, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Heiko Pohl
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Andreas Gantenbein
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland.,ZURZACH Care, Bad Zurzach, Switzerland
| | - Roger Luechinger
- Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Peter Sandor
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland.,ZURZACH Care, Bad Zurzach, Switzerland
| | - Franz Riederer
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland.,Neurological Center Rosenhügel and Karl Landsteiner Institute for Epilepsy Research and Cognitive Neurology, Vienna, Austria
| | - Patrick Freund
- Spinal Cord Injury Centre Balgrist, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, UK.,Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Lars Michels
- Department of Neuroradiology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
| |
Collapse
|
24
|
Braganza DL, Fitzpatrick LE, Nguyen ML, Crowe SF. Interictal Cognitive Deficits in Migraine Sufferers: A Meta-Analysis. Neuropsychol Rev 2021; 32:736-757. [PMID: 34398435 DOI: 10.1007/s11065-021-09516-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/20/2021] [Indexed: 11/26/2022]
Abstract
While a significant proportion of the population suffer from migraine, the existing research literature does not provide a clear indication as to whether migraineurs experience objective cognitive deficits outside of acute migraine attacks. This meta-analysis was conducted to investigate which cognitive domains if any were affected by migraine, by synthesising the existing research quantitatively. The meta-analysis was prospectively registered with the PROSPERO International prospective register of systematic reviews (registration no.: CRD42019134138). A search of the electronic databases PubMed, Ovid MEDLINE, and PsycINFO was conducted for journal articles published between January 1980 and January 2020. Seventeen studies met the inclusion criteria, allowing for the calculation of pooled effect sizes between migraineurs (with and without aura) and healthy controls in the several cognitive domains. During the interictal period, migraineurs demonstrated a moderate, negative effect on complex attention immediate and delayed memory, spatial cognition, and executive functioning. This effect was not attributable to migraine history, attack frequency, or participant age. However, the lack of performance validity testing, and limited data on mood symptomatology and migraine medication use in the included studies may be confounds potentially overestimating the magnitude of effect. Comparison with a clinical control group, which may have accounted for some these extraneous variables, was unable to be conducted. Recommendations for comprehensive future neuropsychological research are provided.
Collapse
Affiliation(s)
- Dion L Braganza
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Lauren E Fitzpatrick
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Mai L Nguyen
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Simon F Crowe
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia.
| |
Collapse
|
25
|
Zhang D, Huang X, Mao C, Chen Y, Miao Z, Liu C, Xu C, Wu X, Yin X. Assessment of normalized cerebral blood flow and its connectivity with migraines without aura during interictal periods by arterial spin labeling. J Headache Pain 2021; 22:72. [PMID: 34261444 PMCID: PMC8278584 DOI: 10.1186/s10194-021-01282-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migraine constitutes a global health burden, and its pathophysiology is not well-understood; research evaluating cerebral perfusion and altered blood flow between brain areas using non-invasive imaging techniques, such as arterial spin labeling, have been scarce. This study aimed to assess cerebral blood flow (CBF) and its connectivity of migraine. METHODS This study enrolled 40 patients with episodic migraine without aura (MwoA), as well as 42 healthy patients as control (HC). Two groups of normalized CBF and CBF connectivity were compared, and the relationship between CBF variation and clinical scale assessment was further evaluated. RESULTS In comparison to HC subjects, MwoA patients exhibited higher CBF in the right middle frontal orbital gyrus (ORBmid.R) and the right middle frontal gyrus, while that in Vermis_6 declined. The increased CBF of ORBmid.R was positively correlated with both the Visual Light Sensitivity Questionnaire-8 (VLSQ-8) and the monthly attack frequency score. In MwoA, significantly decreased CBF connectivity was detected between ORBmid.R and the left superior frontal gyrus, the right putamen, the right caudate, as well as the right angular gyrus. In addition, increased CBF connectivity was observed between the left calcarine cortex and ORBmid.R. CONCLUSIONS Our results indicate that migraine patients exhibit abnormalities in regional CBF and feature CBF connection defects at the resting state. The affected areas involve information perception, information integration, and emotional, pain and visual processing. Our findings might provide important clues for the pathophysiology of migraine.
Collapse
Affiliation(s)
- Di Zhang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Xiaobin Huang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Cunnan Mao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Yuchen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Zhengfei Miao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Chunmei Liu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Chenjie Xu
- Department of Pain Treatment, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Xinying Wu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China.
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China.
| |
Collapse
|
26
|
Pozhidaev KA, Parfenov VA. [Cognitive and emotional disorders in patients with migraine and signs of leukoencephalopathy]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:7-12. [PMID: 33834711 DOI: 10.17116/jnevro20211210317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify cognitive and emotional disorders and their correlation with neuroimaging parameters in patients with chronic migraine. MATERIAL AND METHODS We examined 50 patients (8 men and 42 women, mean age 41.9±11.9 years) with migraine, including 31 with chronic migraine, and signs of leukoencephalopathy according to magnetic resonance imaging (MRI). A control group comprised 40 healthy individuals (13 men and 27 women) aged 20 to 64 years (mean 42.6±12.0 years). A number of tests for neuropsychological examination and assessment of the emotional state, including a 12-word test, literal and categorical associations, Benton Test, the Montreal cognitive scale (MOCA), the Hospital Depression Scale, the Beck Depression Scale, the Center for Epidemiological Research scale, the Hospital Anxiety Scale and the Spielberger-Khanin scale, were administered at baseline and after 3 and 6 month of preventive therapy. RESULTS Patients with migraine had lower scores (p=0.004) on MOCA, memorization of 12 words (p=0.0003), test for literal (p=0.001) and categorical associations (p=0.0002) compared with the control group. No significant correlations were found between the volume of white matter lesions according to MRI and the severity of cognitive impairment. An inverse correlation of average strength was noted (correlation coefficient R=-0.41) between the number of days with headache per month and the MOCA score (p<0.05). In patients with migraine, signs of depression were found on the Hospital Depression Scale (p=0.04), Beck Depression Scale (p=0.003), the Center for Epidemiological Research scale (p=0.0001), and increased anxiety on the Hospital Anxiety Scale (p=0.0001) and the Spielberger-Khanin scale (p=0.0001). A significant relationship was found between the degree of depression and the MOCA score (p=0.007). The frequency of headaches decreased from 19.4±2.9 to 12.6±4.4 days per month (p<0.05). CONCLUSION There were a significant decrease of emotional disorders and improvement of cognitive functions compared with baseline scores during the 6 month therapy. Preventive treatment of migraine and concomitant emotional disorders seems to be the most effective way to improve cognitive functions.
Collapse
Affiliation(s)
- K A Pozhidaev
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - V A Parfenov
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| |
Collapse
|
27
|
Kim DJ, Jassar H, Lim M, Nascimento TD, DaSilva AF. Dopaminergic Regulation of Reward System Connectivity Underpins Pain and Emotional Suffering in Migraine. J Pain Res 2021; 14:631-643. [PMID: 33727857 PMCID: PMC7955762 DOI: 10.2147/jpr.s296540] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/17/2021] [Indexed: 12/31/2022] Open
Abstract
Purpose It has been suggested that reward system dysfunction may account for emotion and pain suffering in migraine. However, there is a lack of evidence whether the altered reward system connectivity is directly associated with clinical manifestations, including negative affect and ictal pain severity and, at the molecular level, the dopamine (DA) D2/D3 receptors (D2/3Rs) signaling implicated in encoding motivational and emotional cues. Patients and Methods We acquired resting-state functional MRI from interictal episodic migraine (EM) patients and age-matched healthy controls, as well as positron emission tomography (PET) with [11C]raclopride, a selective radiotracer for DA D2/3Rs, from a subset of these participants. The nucleus accumbens (NAc) was seeded to measure functional connectivity (FC) and DA D2/3Rs availability based on its essential involvement in pain-related aversive/reward functions. Associations of the brain measures with positive/negative affect and ictal pain severity were also assessed. Results Compared with controls, the EM group showed weaker right NAc connectivity with areas implicated in pain and emotional regulation, such as the amygdala, rostral anterior cingulate cortex, hippocampus, and thalamus; but showed stronger left NAc connectivity with the dorsolateral prefrontal cortex and lingual gyrus. Moreover, among the altered NAc connectivities, only right NAc-amygdala connectivity was inversely correlated with DA D2/3Rs availability in migraine patients (diagnostic group-by-D2/3Rs interaction p < 0.007). At a clinical level, such weaker NAc-amygdala connectivity was associated with lower interictal positive affect and greater ictal pain severity over the head and facial extension area (pain area and intensity number summation, PAINS). Conclusion Together, our findings suggest that altered reward system connectivity, specifically between the NAc and amygdala, might be affected by endogenous DA D2/3Rs signaling, and such process might be a neural mechanism that underlies emotional and pain suffering in episodic migraineurs.
Collapse
Affiliation(s)
- Dajung J Kim
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Hassan Jassar
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Manyoel Lim
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Thiago D Nascimento
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Alexandre F DaSilva
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| |
Collapse
|
28
|
Sharif S, Saleem A, Koumadoraki E, Jarvis S, Madouros N, Khan S. Headache - A Window to Dementia: An Unexpected Twist. Cureus 2021; 13:e13398. [PMID: 33758699 PMCID: PMC7978388 DOI: 10.7759/cureus.13398] [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] [Indexed: 11/29/2022] Open
Abstract
Migraine and other types of headaches have several symptoms associated with them. The association between migraine and dementia has been considered. It is a topic of discussion and appears to be multifactorial. Dementia is a cluster of symptoms, with memory loss and cognitive dysfunction being the prominent symptoms. In this review, we discussed the association of headache and cognitive dysfunction in a broader context and how the practiced treatment of headaches may silently lead to dementia. We conducted a thorough literature search using PubMed as our main database. The articles exploring the association between headache (both migraine and non-migraine) and dementia were included. Some risk factors like migraine-induced stroke and inherent vascular diseases in migraine patients channeling to stroke and dementia were not considered. A total of 28 studies were included for review. All the reviewed studies put together showed an association between headache and cognitive dysfunction of any form. They showed that the frequency and duration of headache is a determinant for dementia. Few studies also focused on how treating headaches with certain drugs can lead to dementia. The reviewed published literature showed that headaches of any sort and their treatment are potentially linked to dementia. Not all headache patients will require medical treatment, as the benefit might outweigh the risk sometimes. It is interim to understand these facts and formulate a better protocol for treating headache patients. However, due to some discordant results, further studies are needed.
Collapse
Affiliation(s)
- Shayka Sharif
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Amber Saleem
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Evgenia Koumadoraki
- Pathology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sommer Jarvis
- Anatomy/Cell Biology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Nikolaos Madouros
- Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
29
|
Wei HL, Chen YC, Yu YS, Guo X, Zhou GP, Zhou QQ, Qu LJ, Yin X, Li J, Zhang H. Aberrant activity within auditory network is associated with psychiatric comorbidities in interictal migraineurs without aura. Brain Imaging Behav 2021; 15:2464-2471. [PMID: 33479923 DOI: 10.1007/s11682-020-00446-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 12/20/2022]
Abstract
The present study aimed to explore associations between brain activity in the auditory cortex and clinical and psychiatric characteristics in patients with migraine without aura (MwoA) during interictal periods. Resting-state data were acquired from patients with episodic MwoA (n = 34) and healthy controls (n = 30). Independent component analysis was used to extract and calculate the resting-state auditory network. Subsequently, we analyzed the correlations between spontaneous activity in the auditory cortex and clinical and psychiatric features in interictal MwoA. Compared with healthy controls, patients with MwoA showed increased activity in the left superior temporal gyrus (STG), postcentral gyrus (PoCG) and insula. Brain activity in the left STG was positively correlated with anxiety scores, and activity in the left PoCG was negatively correlated with anxiety and depression scores. No significant differences were found in intracranial volume between the two groups. This study indicated that functional impairment and altered integration linked to the auditory cortex existed in patients with MwoA in the interictal period, suggesting that auditory-associated cortex disruption as a biomarker may be implemented for the early diagnosis and prediction of neuropsychiatric impairment in interictal MwoA patients.
Collapse
Affiliation(s)
- Heng-Le Wei
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu Province, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Xi Guo
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Gang-Ping Zhou
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Qing-Qing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Li-Jie Qu
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu Province, China
| | - Junrong Li
- Department of Neurology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
| |
Collapse
|
30
|
Ke J, Yu Y, Zhang X, Su Y, Wang X, Hu S, Dai H, Hu C, Zhao H, Dai L. Functional Alterations in the Posterior Insula and Cerebellum in Migraine Without Aura: A Resting-State MRI Study. Front Behav Neurosci 2020; 14:567588. [PMID: 33132860 PMCID: PMC7573354 DOI: 10.3389/fnbeh.2020.567588] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/19/2020] [Indexed: 01/03/2023] Open
Abstract
Background: Hypothesis-driven functional connectivity (FC) analyses have revealed abnormal functional interaction of regions or networks involved in pain processing in episodic migraine patients. We aimed to investigate the resting-state FC patterns in episodic migraine by combining data-driven voxel-wise degree centrality (DC) calculation and seed-based FC analysis. Methods: Thirty-nine patients suffering from episodic migraine without aura and 35 healthy controls underwent clinical assessment and functional MRI. DC was analyzed voxel-wise and compared between groups, and FC of regions with DC differences were further examined using a seed-based approach. Results: Compared with the control group, the migraine group showed increased and decreased DC in the right posterior insula and left crus I, respectively. Seed-based FC analyses revealed that migraine patients demonstrated increased right posterior insula connections with the postcentral gyrus, supplementary motor area/paracentral lobule, fusiform gyrus and temporal pole. The left crus I showed decreased FC with regions of the default mode network (DMN), including the medial prefrontal cortex (mPFC), angular gyrus, medial and lateral temporal cortex in patients with migraine. Furthermore, pain intensity positively correlated with DC in the right amygdala/parahippocampal gyrus, and migraine frequency negatively correlated with FC between the left crus I and mPFC. Conclusion: Patients with episodic migraine without aura have increased FC with the right posterior insula and decreased FC within the DMN, which may underlie disturbed sensory integration and cognitive processing of pain. The left crus I-mPFC connectivity may be a useful biomarker for assessing migraine frequency.
Collapse
Affiliation(s)
- Jun Ke
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Yang Yu
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Xiaodong Zhang
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Yunyan Su
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Ximing Wang
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Su Hu
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Hui Dai
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Chunhong Hu
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| | - Hongru Zhao
- Department of Neurology, the First Affiliated Hospital of Soochow University, Soochow, China
| | - Lingling Dai
- Department of Radiology, the First Affiliated Hospital of Soochow University, Soochow, China.,Institute of Medical Imaging, Soochow University, Soochow, China
| |
Collapse
|
31
|
Wei HL, Chen J, Chen YC, Yu YS, Guo X, Zhou GP, Zhou QQ, He ZZ, Yang L, Yin X, Li J, Zhang H. Impaired effective functional connectivity of the sensorimotor network in interictal episodic migraineurs without aura. J Headache Pain 2020; 21:111. [PMID: 32928098 PMCID: PMC7489040 DOI: 10.1186/s10194-020-01176-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/18/2020] [Indexed: 01/03/2023] Open
Abstract
Background Resting-state functional magnetic resonance imaging (Rs-fMRI) has confirmed sensorimotor network (SMN) dysfunction in migraine without aura (MwoA). However, the underlying mechanisms of SMN effective functional connectivity in MwoA remain unclear. We aimed to explore the association between clinical characteristics and effective functional connectivity in SMN, in interictal patients who have MwoA. Methods We used Rs-fMRI to acquire imaging data in 40 episodic patients with MwoA in the interictal phase and 34 healthy controls (HCs). Independent component analysis was used to profile the distribution of SMN and calculate the different SMN activity between the two groups. Subsequently, Granger causality analysis was used to analyze the effective functional connectivity between the SMN and other brain regions. Results Compared to the HCs, MwoA patients showed higher activity in the bilateral postcentral gyri (PoCG), but lower activity in the left midcingulate cortex (MCC). Moreover, MwoA patients showed decreased effective functional connectivity from the SMN to left middle temporal gyrus, right putamen, left insula and bilateral precuneus, but increased effective functional connectivity to the right paracentral lobule. There was also significant effective functional connectivity from the primary visual cortex, right cuneus and right putamen to the SMN. In the interictal period, there was positive correlation between the activity of the right PoCG and the frequency of headache. The disease duration was positively correlated with abnormal effective functional connectivity from the left PoCG to right precuneus. In addition, the headache impact scores were negatively correlated with abnormal effective functional connectivity from the left MCC to right paracentral lobule, as well as from the right precuneus to left PoCG. Conclusions These differential, resting-state functional activities of the SMN in episodic MwoA may contribute to the understanding of migraine-related intra- and internetwork imbalances associated with nociceptive regulation and chronification.
Collapse
Affiliation(s)
- Heng-Le Wei
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Jing Chen
- Department of Neurology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Xi Guo
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Gang-Ping Zhou
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Qing-Qing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Zhen-Zhen He
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Lian Yang
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Junrong Li
- Department of Neurology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.
| |
Collapse
|
32
|
Ayas S, Kızıltan ME, Karaali-Savrun F, Gündüz A. Modulation of the Somatosensory Blink Reflex in the Peripersonal Space Is Defective in Episodic Migraine. PAIN MEDICINE 2020; 21:1663-1667. [PMID: 31958117 DOI: 10.1093/pm/pnz328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In migraine, there is an altered behavior of patients during the attack and an altered connectivity in the cortical structures modulating and encoding the sensation and pain. Thus, we hypothesized that the extent of the peripersonal space (PPS) and the responses in the PPS may change during a migraine attack. For this reason, we analyzed the modulation of somatosensory blink reflex (SBR) in the PPS during episodic migraine. DESIGN Cross-sectional assessment of modulation of SBR in patients with migraine. SETTING Headache outpatient clinic of a tertiary referral center. SUBJECTS We included 22 patients with episodic migraine, of whom 13 individuals were in the interictal period and nine were experiencing a headache episode. We also included 14 healthy individuals. The three groups were similar in age and gender. METHODS SBR was recorded when the participants were sitting with their forearm in the extrapersonal space and also when their hands were in the PPS surrounding the face. Latency, amplitude, and area under the curve (AUC) were measured and compared. RESULTS The amplitude and AUC of the SBR were significantly higher in patients during the attack compared with healthy subjects. The magnitude of the SBR was increased in the PPS in healthy subjects, whereas the increase was not significant in patients during the attack or in the interictal period. CONCLUSIONS We think that the modulation in the PPS is defective in patients with migraine both during the acute attack and in the interictal phase, suggesting diminished top-down modulation of the SBR.
Collapse
Affiliation(s)
- Selahattin Ayas
- Department of Neurology, Cerrahpasa Medical Faculty, IUC, Istanbul, Turkey
| | - Meral E Kızıltan
- Department of Neurology, Cerrahpasa Medical Faculty, IUC, Istanbul, Turkey
| | | | - Ayşegül Gündüz
- Department of Neurology, Cerrahpasa Medical Faculty, IUC, Istanbul, Turkey
| |
Collapse
|
33
|
Vallesi A. On the utility of the trail making test in migraine with and without aura: a meta-analysis. J Headache Pain 2020; 21:63. [PMID: 32493204 PMCID: PMC7271430 DOI: 10.1186/s10194-020-01137-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/27/2020] [Indexed: 01/18/2023] Open
Abstract
This meta-analytical review assesses the utility of the Trail Making Test (TMT), versions A and B, in detecting migraine-related cognitive deficits. A comprehensive literature search was performed in two electronic databases and other sources to obtain relevant studies administering TMT to migraine patients. Search terms included “migraine” and “Trail Making”. Only studies in which the TMT-A, TMT-B or both were administered to adult patients suffering from migraine with and without aura were included. All pooled meta-analyses were based on random effects models. A total of 14 studies for TMT-A and 15 for TMT-B met inclusion criteria and were subjected to meta-analyses. Results showed that performance is worse in migraine patients than in controls for both the TMT-A (Hedges’ g = −.28) and TMT-B (g = −.37), with no difference between migraine with and without aura. This study demonstrates the sensitivity of the TMT in detecting cognitive alterations in migraine. This test should be considered for inclusion in cognitive batteries assessing patients with migraine.
Collapse
Affiliation(s)
- Antonino Vallesi
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Via Giustiniani, 5, Padova, 35128, Italy. .,Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, 30126, Italy.
| |
Collapse
|
34
|
Bonanno L, Lo Buono V, De Salvo S, Ruvolo C, Torre V, Bramanti P, Marino S, Corallo F. Brain morphologic abnormalities in migraine patients: an observational study. J Headache Pain 2020; 21:39. [PMID: 32334532 PMCID: PMC7183590 DOI: 10.1186/s10194-020-01109-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/13/2020] [Indexed: 01/03/2023] Open
Abstract
Background Migraine is a common neurological disorder characterized by a complex physiopathology. We assessed brain morphologic differences in migraine and the possible pathogenetic mechanism underlying this disease. Methods We analyzed brain morphologic images of migraine patients, 14 with aura (MwA) [the mean (SD) age was 42.36 (2.95) years (range, 37–47)] and 14 without aura (MwoA) [the mean (SD) age was 43.5 (3.25) years (range, 39–50)] during episodic attack compared with health subjects balanced (HS) [the mean (SD) age was 42.5 (5.17) years (range, 34–51)]. All subjects underwent a Magnetic Resonance Imaging (MRI) examination with a scanner operating at 3.0 T and voxel based morphometry (VBM) approach was used to examine the gray matter volume (GMV). The statistical analysis to compare clinicl characteristics was performed using unpaired t-test an one-way Anova. Results: Total cerebral GMV showed a significant difference between MwA and HS (p = 0.02), and between MwoA and HS (p = 0.003). In addition, not significative differences were found between MwA and MwoA groups (p = 0.17). We found three clusters of regions which showed significant GMV reduction in MwA compared with MwoA. MwA subjects showed a less of GMV in 4 clusters if compared with HS, and MwoA subjects showed a less of GMV in 3 clusters if compared with HS. We observed that MwA and MwoA patients had a significant reduction of GMV in the frontal and temporal lobe and the cerebellum, if compared to HS. The bilateral fusiform gyrus and the cingulate gyrus were increase in MwoA patients compared with HS. Conclusion Our findings could provide a approach to understand possible differences in the pathogenesis of two type of migraine.
Collapse
Affiliation(s)
- Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, C. da Casazza, 98124, Messina, Italy
| | - Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, C. da Casazza, 98124, Messina, Italy.
| | - Simona De Salvo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, C. da Casazza, 98124, Messina, Italy
| | - Claudio Ruvolo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, C. da Casazza, 98124, Messina, Italy
| | - Viviana Torre
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, C. da Casazza, 98124, Messina, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, C. da Casazza, 98124, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, C. da Casazza, 98124, Messina, Italy
| | - Francesco Corallo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Via Palermo, C. da Casazza, 98124, Messina, Italy
| |
Collapse
|
35
|
Lévêque Y, Masson R, Fornoni L, Moulin A, Bidet-Caulet A, Caclin A, Demarquay G. Self-perceived attention difficulties are associated with sensory hypersensitivity in migraine. Rev Neurol (Paris) 2020; 176:829-838. [PMID: 32312498 DOI: 10.1016/j.neurol.2020.01.360] [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: 10/08/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Attention is the process which enables to preferentially select salient or relevant stimuli and to attenuate the response to irrelevant incoming stimuli. Migraine is characterized by both attentional alterations and an abnormal sensory processing to external stimulations. The aim of the study was to investigate potential interactions between self-perceived attentional difficulties and sensory hypersensitivity in migraine patients. METHODS Forty-six episodic migraineurs without aura and 46 healthy controls filled out questionnaires on self-perceived attention difficulties and self-reported sensitivity to visual, auditory and olfactory stimulations. RESULTS Compared to controls, migraineurs reported significantly higher levels of attention difficulty and sensory sensitivity. Sensory hypersensitivity correlated significantly with self-perceived attentional difficulties in migraineurs (P=0.002), but not with migraine disability or levels of anxiety or depression. Ictal and interictal sensory sensitivities were significantly correlated in migraineurs within visual (P<0.001), auditory (P<0.001) and olfactory (P=0.001) modalities. CONCLUSION This study shows for the first time an association between self-reported attentional difficulties and multimodal sensory hypersensitivity. Studies combining behavioral and physiological measures of sensory processing and attention processes are necessary to further understand the peculiar vulnerability of migraineurs to sensory stimuli.
Collapse
Affiliation(s)
- Y Lévêque
- Inserm UMRS 1028, CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
| | - R Masson
- Inserm UMRS 1028, CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - L Fornoni
- Inserm UMRS 1028, CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - A Moulin
- Inserm UMRS 1028, CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - A Bidet-Caulet
- Inserm UMRS 1028, CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - A Caclin
- Inserm UMRS 1028, CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - G Demarquay
- Inserm UMRS 1028, CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France; Functional Neurology and Epilepsy Department, Université Claude Bernard Lyon 1, Université de Lyon, Hospices Civils de Lyon, Neurological Hospital Pierre Wertheimer, Lyon, France
| |
Collapse
|
36
|
Zhang D, Huang X, Su W, Chen Y, Wang P, Mao C, Miao Z, Liu C, Xu C, Yin X, Wu X. Altered lateral geniculate nucleus functional connectivity in migraine without aura: a resting-state functional MRI study. J Headache Pain 2020; 21:17. [PMID: 32066379 PMCID: PMC7025412 DOI: 10.1186/s10194-020-01086-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/07/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES To investigate the structural and functional connectivity changes of lateral geniculate nucleus (LGN) and their relationships with clinical characteristics in patients without aura. METHODS Conventional MRI, 3D structure images and resting state functional MRI were performed in 30 migraine patients without aura (MwoA) and 22 healthy controls (HC). The lateral geniculate nucleus volumes and the functional connectivity (FC) of bilateral lateral geniculate nucleus were computed and compared between groups. RESULTS The lateral geniculate nucleus volumes in patient groups did not differ from the controls. The brain regions with increased FC of the left LGN mainly located in the left cerebellum and right lingual gyrus in MwoA compared with HC. The increased FC of right LGN located in left inferior frontal gyrus in MwoA compared with HC. The correlation analysis showed a positive correlation between VLSQ-8 score and the increased FC of left cerebellum and right lingual gyrus. CONCLUSIONS Photophobia in MwoA could be mediated by abnormal resting state functional connectivity in visual processing regions, the pain perception regulatory network and emotion regulation network. This result is valuable to further understanding about the clinical manifestation and pathogenesis of migraine.
Collapse
Affiliation(s)
- Di Zhang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Xiaobin Huang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Wen Su
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Yuchen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Peng Wang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Cunnan Mao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Zhengfei Miao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Chunmei Liu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Chenjie Xu
- Department of Pain Treatment, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China.
| | - Xinying Wu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu Province, China.
| |
Collapse
|
37
|
Argaman Y, Kisler LB, Granovsky Y, Coghill RC, Sprecher E, Manor D, Weissman-Fogel I. The Endogenous Analgesia Signature in the Resting Brain of Healthy Adults and Migraineurs. THE JOURNAL OF PAIN 2020; 21:905-918. [PMID: 31904502 DOI: 10.1016/j.jpain.2019.12.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/19/2019] [Indexed: 12/15/2022]
Abstract
Altered pain modulation and resting state functional connectivity (rsFC) were found to be related to migraine pathology and clinical manifestation. We examined how pain modulation psychophysical measures are related to resting-state networks and rsFC between bottom-up and top-down pain modulation areas. Thirty-two episodic migraineurs and 23 age-matched healthy individuals underwent temporal summation of pain (TSOP) and conditioned pain modulation (CPM) tests, followed by a resting-state imaging scan. No differences in temporal summation of pain and CPM were found between groups. However, in healthy individuals, more efficient CPM was correlated with 1) stronger rsFCs of the posterior cingulate cortex, with the ventromedial prefrontal cortex and with the pregenual anterior cingulate cortex; 2) weaker rsFC of the anterior insula with the angular gyrus. Conversely, in migraineurs, the association between CPM and rsFC was altered. Our results suggest that the functional connectivity within the default mode network (DMN) components and the functional coupling between the DMN and pain inhibitory brain areas is linked with pain inhibition efficiency. In migraineurs, this interplay is changed, yet enables normal pain inhibition. Our findings shed light on potential functional adaptation of the DMN and its role in pain inhibition in health and migraine. PERSPECTIVE: This article establishes evidence for the relationship between the resting-state brain and individual responses in psychophysical pain modulation tests, in both migraine and healthy individuals. The results emphasize the significant role of the default mode network in maintaining pain inhibition efficiency in health and in the presence of chronic pain.
Collapse
Affiliation(s)
- Yuval Argaman
- Laboratory of Clinical Neurophysiology, Technion Faculty of Medicine, Haifa, Israel
| | - Lee B Kisler
- Laboratory of Clinical Neurophysiology, Technion Faculty of Medicine, Haifa, Israel
| | - Yelena Granovsky
- Laboratory of Clinical Neurophysiology, Technion Faculty of Medicine, Haifa, Israel; Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Robert C Coghill
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Elliot Sprecher
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - David Manor
- MRI Unit, Rambam Health Care Campus, Haifa, Israel; Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Irit Weissman-Fogel
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
| |
Collapse
|
38
|
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] [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.
Collapse
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.
| | | |
Collapse
|
39
|
Michels L, Villanueva J, O'Gorman R, Muthuraman M, Koirala N, Büchler R, Gantenbein AR, Sandor PS, Luechinger R, Kollias S, Riederer F. Interictal Hyperperfusion in the Higher Visual Cortex in Patients With Episodic Migraine. Headache 2019; 59:1808-1820. [PMID: 31680242 DOI: 10.1111/head.13646] [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] [Accepted: 08/06/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Migraine pathophysiology is complex and probably involves cortical and subcortical alterations. Structural and functional brain imaging studies indicate alterations in the higher order visual cortex in patients with migraine. Arterial spin labeling magnetic resonance imaging (ASL-MRI) is a non-invasive imaging method for assessing changes in cerebral blood flow (CBF) in vivo. OBJECTIVE To examine if interictal CBF differs between patients with episodic migraine (EM) with or without aura and healthy controls (HC). METHODS We assessed interictal CBF using 2D pseudo-continuous ASL-MRI on a 3 Tesla Philips scanner (University Hospital Zurich, Switzerland) in EM (N = 17, mean age 32.7 ± 9.9, 13 females) and HC (N = 19, mean age 31.0 ± 9.3, 11 females). RESULTS Compared to HC, EM showed exclusively hyperperfusion in the right MT+ and Cohen's d effect size was 0.99 (HC mean CBF ± SD: 33.1 ± 5.9 mL/100 g/minutes; EM mean CBF: 40.9 ± 9.4 mL/100 g/minutes). EM with aura (N = 13, MwA) revealed hyperperfusion compared to HC in the right MT+ and superior temporal gyrus. For MT, Cohen's d effect size was 1.34 (HC mean CBF ± SD: 33.1 ± 5.9 mL/100 g/minutes; MwA mean CBF: 43.3 ± 8.6 mL/100 g/minutes). For the superior temporal gyrus, Cohen's d effect size was 1.28 (HC mean CBF ± SD: 40.1 ± 4.9 mL/100 g/minutes; MwA mean CBF: 47.4 ± 6.4 mL/100 g/minutes). In EM, anxiety was positively associated with CBF in the parietal operculum and angular gyrus. CONCLUSIONS Our results suggest that extrastriate brain regions probably involved in cortical spreading depression are associated with CBF changes in the interictal state. We conclude that ASL-MRI is a sensitive method to identify local neuro-functional abnormalities in CBF in patients with EM in the interictal state.
Collapse
Affiliation(s)
- Lars Michels
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.,Center for MR-Research, University Children's Hospital Zurich, Zurich, Switzerland
| | - Jeanette Villanueva
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Ruth O'Gorman
- Center for MR-Research, University Children's Hospital Zurich, Zurich, Switzerland
| | - Muthuraman Muthuraman
- Biomedical Statistics and Multimodal Signal Processing Unit, Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), Johannes-Gutenberg-University Hospital, Mainz, Germany
| | - Nabin Koirala
- Biomedical Statistics and Multimodal Signal Processing Unit, Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), Johannes-Gutenberg-University Hospital, Mainz, Germany
| | - Roman Büchler
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Andreas R Gantenbein
- University of Zurich, Zurich, Switzerland.,RehaClinic Bad Zurzach, Bad Zurzach, Switzerland
| | - Peter S Sandor
- University of Zurich, Zurich, Switzerland.,RehaClinic Bad Zurzach, Bad Zurzach, Switzerland
| | - Roger Luechinger
- Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Franz Riederer
- University of Zurich, Zurich, Switzerland.,Neurological Center Rosenhuegel and Karl Landsteiner Institute for Epilepsy Research and Cognitive Neurology, Vienna, Austria
| |
Collapse
|
40
|
Kincses ZT, Veréb D, Faragó P, Tóth E, Kocsis K, Kincses B, Király A, Bozsik B, Párdutz Á, Szok D, Tajti J, Vécsei L, Tuka B, Szabó N. Are Migraine With and Without Aura Really Different Entities? Front Neurol 2019; 10:982. [PMID: 31632329 PMCID: PMC6783501 DOI: 10.3389/fneur.2019.00982] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/28/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Migraine research is booming with the rapidly developing neuroimaging tools. Structural and functional alterations of the migrainous brain were detected with MRI. The outcome of a research study largely depends on the working hypothesis, on the chosen measurement approach and also on the subject selection. Against all evidence from the literature that migraine subtypes are different, most of the studies handle migraine with and without aura as one disease. Methods: Publications from PubMed database were searched for terms of "migraine with aura," "migraine without aura," "interictal," "MRI," "diffusion weighted MRI," "functional MRI," "compared to," "atrophy" alone and in combination. Conclusion: Only a few imaging studies compared the two subforms of the disease, migraine with aura, and without aura, directly. Functional imaging investigations largely agree that there is an increased activity/activation of the brain in migraine with aura as compared to migraine without aura. We propose that this might be the signature of cortical hyperexcitability. However, structural investigations are not equivocal. We propose that variable contribution of parallel, competing mechanisms of maladaptive plasticity and neurodegeneration might be the reason behind the variable results.
Collapse
Affiliation(s)
- Zsigmond Tamás Kincses
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
- Department of Radiology, University of Szeged, Szeged, Hungary
| | - Dániel Veréb
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Péter Faragó
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - 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
| | - András Király
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
- Brain and Mind Research, Central European Institute of Technology, Brno, Czechia
| | - Bence Bozsik
- 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
| | - János Tajti
- 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
| | - Bernadett Tuka
- 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
- Brain and Mind Research, Central European Institute of Technology, Brno, Czechia
| |
Collapse
|
41
|
Frid A, Shor M, Shifrin A, Yarnitsky D, Granovsky Y. A Biomarker for Discriminating Between Migraine With and Without Aura: Machine Learning on Functional Connectivity on Resting-State EEGs. Ann Biomed Eng 2019; 48:403-412. [DOI: 10.1007/s10439-019-02357-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/05/2019] [Indexed: 11/29/2022]
|
42
|
Allone C, Corallo F, Scarlata F, Formica C, Cartella E, Lo Buono V, Todaro A, Logiudice AL, Alagna A, Bramanti P, Marino S. Mindfulness interventions and pain management in a patient with encephalomyelitis. Complement Ther Clin Pract 2019; 36:69-71. [PMID: 31383446 DOI: 10.1016/j.ctcp.2019.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/16/2019] [Accepted: 06/01/2019] [Indexed: 11/30/2022]
Abstract
Chronic pain is considered a common disabling disease, frequently related to a high comorbidity with anxiety and depression. Several psychological techniques have demonstrated to be effective in the treatment of chronic pain, in particular, mindfulness-based interventions (MBIs) seem to reduce pain acting on self-regulatory individual's ability. In addition, this approach could develop cognitive strategies to decrease impulsivity. We selected a case of a patient with encephalomyelitis and spastic tetraparesis to assess the application and effectiveness of MBIs to reduce pain perception, improve anxiety and depressive symptoms. Our treatment showed a reduction in pain perception, and an improvement in anxious and depressive symptoms. In conclusion, MBIs could be useful to relieve disorders related to pain in neurological patients.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy; Department of Biomedical Sciences and Morphological and Fuctional Imaging, University of Messina, Messina, Italy
| |
Collapse
|
43
|
Wang Q, Liu ZY, Zhou J. Ultrasonic assessment of carotid intima-media thickness in migraine: a meta-analysis. J Int Med Res 2019; 47:2848-2855. [PMID: 31272253 PMCID: PMC6683931 DOI: 10.1177/0300060519851354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/26/2019] [Indexed: 12/13/2022] Open
Abstract
Objective Migraine is believed to be a risk factor for cerebrovascular diseases, and previous studies have indicated an association between migraine and cerebral atherosclerosis. Carotid artery intima-media thickness (IMT) is considered to be a biomarker of atherosclerosis pathology. This study aimed to investigate the relationship between carotid IMT and migraine by conducting a meta-analysis. Methods We searched Web of Science, PubMed, and the Cochrane Library for eligible studies assessing carotid IMT in patients with migraine and controls. Data were extracted independently by two reviewers and analyzed using Review Manager 5.3 software. Results The meta-analysis included seven articles with 555 subjects (279 migraine patients, 276 controls). Carotid IMT was significantly greater in patients with migraine compared with controls. However, there were no significant differences in IMT between patients with migraine with aura (MA) and controls, migraine without aura (MO) and controls, and patients with MA and MO. Conclusion Patients with migraine have greater carotid IMT than individuals without migraine, suggesting an association between atherosclerosis and migraine. However, further studies with more samples are needed to confirm this finding.
Collapse
Affiliation(s)
- Qiao Wang
- Department of Ultrasound, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Zhen-Yu Liu
- Department of Ultrasound, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Jia Zhou
- Department of Ultrasound, The First Affiliated Hospital of University of South China, Hengyang, China
| |
Collapse
|
44
|
Soheili-Nezhad S, Sedghi A, Schweser F, Eslami Shahr Babaki A, Jahanshad N, Thompson PM, Beckmann CF, Sprooten E, Toghae M. Structural and Functional Reorganization of the Brain in Migraine Without Aura. Front Neurol 2019; 10:442. [PMID: 31133962 PMCID: PMC6515892 DOI: 10.3389/fneur.2019.00442] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/10/2019] [Indexed: 01/27/2023] Open
Abstract
It remains unknown whether migraine headache has a progressive component in its pathophysiology. Quantitative MRI may provide valuable insight into abnormal changes in the migraine interictum and assist in identifying disrupted brain networks. We carried out a data-driven study of structural integrity and functional connectivity of the resting brain in migraine without aura. MRI scanning was performed in 36 patients suffering from episodic migraine without aura and 33 age-matched healthy subjects. Voxel-wise analysis of regional brain volume was performed by registration of the T1-weighted MRI scans into a common study brain template using the tensor-based morphometry (TBM) method. Changes in functional synchronicity of the brain networks were assessed using probabilistic independent component analysis (ICA). TBM revealed that migraine is associated with reduced volume of the medial prefrontal cortex (mPFC). Among 375 functional brain networks, resting-state connectivity was decreased between two components spanning the visual cortex, posterior insula, and parietal somatosensory cortex. Our study reveals structural and functional alterations of the brain in the migraine interictum that may stem from underlying disease risk factors and the "silent" aura phenomenon. Longitudinal studies will be needed to investigate whether interictal brain changes are progressive and associated with clinical disease trajectories.
Collapse
Affiliation(s)
- Sourena Soheili-Nezhad
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands.,Donders Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, Netherlands
| | - Alireza Sedghi
- Medical Informatics Laboratory, Queen's University, Kingston, ON, Canada
| | - Ferdinand Schweser
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, University at Buffalo, Buffalo, NY, United States.,Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, Buffalo, NY, United States
| | | | - Neda Jahanshad
- Keck School of Medicine of USC, Imaging Genetics Center, USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, United States
| | - Paul M Thompson
- Keck School of Medicine of USC, Imaging Genetics Center, USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, United States
| | - Christian F Beckmann
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands.,Donders Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, Netherlands.,John Radcliffe Hospital, Oxford Centre for Functional MRI of the Brain, Oxford, United Kingdom
| | - Emma Sprooten
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands.,Donders Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, Netherlands
| | - Mansoureh Toghae
- Headache Department, Iranian Center of Neurological Research, Neuroscience Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
45
|
|
46
|
Lo Buono V, Bonanno L, Corallo F, Palmeri R, Allone C, Lo Presti R, Grugno R, Di Lorenzo G, Bramanti P, Marino S. Cognitive functions and psychological symptoms in migraine: a study on patients with and without aura. Int J Neurosci 2018; 129:588-592. [DOI: 10.1080/00207454.2018.1554658] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
| | - Lilla Bonanno
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | | | | | | | | | | | | | | | - Silvia Marino
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| |
Collapse
|
47
|
Vuralli D, Ayata C, Bolay H. Cognitive dysfunction and migraine. J Headache Pain 2018; 19:109. [PMID: 30442090 PMCID: PMC6755588 DOI: 10.1186/s10194-018-0933-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 10/16/2018] [Indexed: 12/11/2022] Open
Abstract
Cognitive dysfunction has recently gained attention as a significant problem among migraine sufferers. All of the clinical studies show poor cognitive performance during migraine attacks, though, the interictal data are conflicting. Migraineurs show impaired cognitive function interictally in most of the clinic-based studies. Population-based studies did not reveal a difference in cognitive functions between migraineurs and controls. The specific cognitive domains involved are information processing speed, basic attention, executive functions, verbal and non-verbal memory and verbal skills. Neurophysiological, imaging and pharmacological studies support clinical symptoms of cognitive impairment in migraine. Longitudinal studies do not suggest progressive cognitive decline over time in migraine patients. Preventive medications and comorbid disorders such as depression and anxiety can impact cognitive function, but cannot fully explain the cognitive impairment in migraine. In contrast to migraine, tension type or cluster headache are not associated with cognitive impairment, at least during headache-free periods.
Collapse
Affiliation(s)
- Doga Vuralli
- Department of Neurology and Algology, Gazi University Faculty of Medicine, Besevler, 06510, Ankara, Turkey.,Neuropsychiatry Center, Gazi University, Besevler, 06510, Ankara, Turkey
| | - Cenk Ayata
- Neurovascular Research Lab, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Stroke Service, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Hayrunnisa Bolay
- Department of Neurology and Algology, Gazi University Faculty of Medicine, Besevler, 06510, Ankara, Turkey. .,Neuropsychiatry Center, Gazi University, Besevler, 06510, Ankara, Turkey.
| |
Collapse
|
48
|
Russo A, Silvestro M, Tessitore A, Tedeschi G. Advances in migraine neuroimaging and clinical utility: from the MRI to the bedside. Expert Rev Neurother 2018; 18:533-544. [PMID: 29883214 DOI: 10.1080/14737175.2018.1486708] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION In current migraine clinical practice, no specific diagnostic investigations are available and therefore the diagnosis is an eminently clinical process where instrumental examinations may have a part to exclude possible causes of secondary headaches. While migraine clinical phenotype has been widely characterized, migraine pathophysiology has still a gap that might be partly bridged by structural and functional neuroimaging investigations. Areas covered: This article aims to review the recent advances in functional neuroimaging, the consequent progress in the knowledge of migraine pathophysiology and their putative application and impact in the clinical setting. A comprehensive review was conducted of PubMed citations by entering the key word 'MRI' combined with 'migraine' AND/OR 'headache.' Other key words included 'gray matter' OR 'white matter,' 'structural' OR 'functional.' The only restriction was English-language publication. The abstracts of all articles meeting these criteria were reviewed, and full texts were examined for relevant references. Expert commentary: Advanced magnetic resonance imaging (MRI) techniques are tremendously improving our knowledge about brain abnormalities in migraine patients. However, advanced MRI could nowadays overcome the limits linked to the clinicians' judgment through the identification of objectively measurable neuroimaging findings (quantitative biomarkers) concerning the diagnosis, the prognosis and 'tailored' therapeutic-care pathways.
Collapse
Affiliation(s)
- Antonio Russo
- a Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy.,b MRI Research Center SUN-FISM , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Marcello Silvestro
- a Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Alessandro Tessitore
- a Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy.,b MRI Research Center SUN-FISM , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Gioacchino Tedeschi
- a Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy.,b MRI Research Center SUN-FISM , University of Campania "Luigi Vanvitelli" , Naples , Italy.,c Institute for Diagnosis and Care ''Hermitage Capodimonte'', Neurology Department , Naples , Italy
| |
Collapse
|