BackgroundRepetitive transcranial magnetic stimulation (rTMS) is one of the high-potential non-pharmacological methods for migraine treatment. The purpose of this study is to define the neuroimaging markers associated with rTMS therapy in patients with migraine based on data from functional MRI (fMRI).Materials and MethodsA total of 19 patients with episodic migraine without aura underwent a 5-day course of rTMS of the fronto-temporo-parietal junction bilaterally, at 10 Hz frequency and 60% of motor threshold response of 900 pulses. Resting-state functional MRI (1.5 T) and a battery of tests were carried out for each patient to clarify their diagnosis, qualitative and quantitative characteristics of pain, and associated affective symptoms. Changes in functional connectivity (FC) in the brain's neural networks before and after the treatment were identified through independent components analysis.ResultsOver the course of therapy, we observed an increase in FC of the default mode network within it, with pain system components and with structures of the visual network. We also noted a decrease in FC of the salience network with sensorimotor and visual networks, as well as an increase in FC of the visual network. Besides, we identified 5 patients who did not have a positive response to one rTMS course after the first week of treatment according to the clinical scales results, presumably because of an increasing trend of depressive symptoms and neuroimaging criteria for depressive disorder.ConclusionsOur results show that a 5-day course of rTMS significantly alters the connectivity of brain networks associated with pain and antinociceptive brain systems in about 70% of cases, which may shed light on the neural mechanisms underlying migraine treatment with rTMS.
Background
Alterations in large‐scale functional connectivity have widely been used to understand migraine pathophysiology and to find any imaging markers. The successful use of the Triple Network Model for many mental and neurological diseases has prompted us to consider chronic migraine under the prism of this model for the first time in the literature.
Aim
To evaluate alterations in functional connectivity between large‐scale networks using resting‐state fMRI in chronic migraine patients and their correlation with clinical features within the boundaries of the Triple Network Model.
Methods
Twenty‐five chronic migraine patients underwent 1,5T resting‐state functional magnetic resonance imaging (RS‐fMRI) scanning during the interictal phase and were compared to a group of 25 healthy controls. Functional connectivity was assessed using region‐of‐interest to region‐of‐interest (ROI‐to‐ROI) analysis between 8 networks and 15 subcortical areas, conventionally assigned to salience network.
Results
Compare to healthy controls, patients had increased functional connectivity between salience network (SN) and sensorimotor network (SMN) and dorsal attention network (DAN), between nucleus accumbens and default mode network (DMN) and within DMN and also between thalamus and DAN. Decreased functional connectivity was registered between nucleus accumbens and DAN, and also within DAN. A higher depression scale score was positively correlated with an increase in FC within DMN.
Conclusion
Taken together, our results show that patients with chronic migraine could be characterized by specific dysfunctional interactions between the SN, SMN, DAN, and DMN during resting state.
Magnetic stimulation is a noninvasive technique that allows you to directly stimulate the neurons of the cerebral cortex. Currently, transcranial magnetic stimulation is used as informative diagnostic and effective therapeutic techniques for the treatment of diseases and injuries of the nervous system. The article discusses the indications, contraindications and the recommended protocols for the use of transcranial magnetic stimulation in certain diseases and consequences of traumas of the nervous system (bibliography: 37 refs).
Introduction. In the context of the search for new migraine therapy options, strict control of their eff ectiveness by means of objective examination methods is required.Objective. Objective assessment of the eff ectiveness of TMS in patients with migraine on the basis of functional magnetic resonance imaging (fMRI) data.Material and methods. Resting-state fMRI before and after a fi ve-day course of TMS of the junction of the inferior frontal and temporal lobes bilaterally was performed in 19 patients with migraine. Changes in functional connectivity (FC) of the main neuronal networks of the brain, as well as clinical parameters of pain and quality of life of the patients were assessed before and after the course of TMS.Results. A decrease in pain intensity and anxiety scores, as well as a decrease in the number of acute pain medications taken, was observed against the background of the therapy. Changes in FC aff ected three main networks: the default mode network, the salience and visual networks. At the same time, decreased effi cacy of therapy was noted in patients with higher severity of depressive symptoms and presence of neuroimaging criteria of depression.Conclusion. The study suggests the effi cacy of TMS in patients with migraine based on neuroimaging criteria. It is worth paying special attention to the presence of depressive symptoms in migraine patients.
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