Altered thalamic connectivity during spontaneous attacks of migraine without aura: A resting-state fMRI study

Abstract

Background Functional connectivity of brain networks may be altered in migraine without aura patients. Functional magnetic resonance imaging (fMRI) studies have demonstrated changed activity in the thalamus, pons and cerebellum in migraineurs. Here, we investigated the thalamic, pontine and cerebellar network connectivity during spontaneous migraine attacks. Methods Seventeen patients with episodic migraine without aura underwent resting-state fMRI scan during and outside of a spontaneous migraine attack. Primary endpoint was a difference in functional connectivity between the attack and the headache-free days. Functional connectivity was assessed in four different networks using seed-based analysis. The chosen seeds were in the thalamus (MNI coordinates x,y,z: right, 22,-24,0 and left, -22,-28,6), pons (right, 8,-24,-32 and left, -8,-24,-32), cerebellum crus I (right, 46,-58,-30 and left, -46,-58,-30) and cerebellum lobule VI (right, 34,-42,-36 and left, -32,-42,-36). Results We found increased functional connectivity between the right thalamus and several contralateral brain regions (superior parietal lobule, insular cortex, primary motor cortex, supplementary motor area and orbitofrontal cortex). There was decreased functional connectivity between the right thalamus and three ipsilateral brain areas (primary somatosensory cortex and premotor cortex). We found no change in functional connectivity in the pontine or the cerebellar networks. Conclusions The study indicates that network connectivity between thalamus and pain modulating as well as pain encoding cortical areas are affected during spontaneous migraine attacks.

Brain Diffusion Abnormalities in Children with Tension-Type and Migraine-Type Headaches

“…21,22 The thalamus seemed to be only significantly altered in patients with MTH in this study, though recently published reports have identified the significance of this brain region as a functional pain-signaling relay. 23,24 Additionally, the thalamus volume has been found to be altered in patients with medication overuse headache and MTH with and without aura. [23][24][25] The amygdala has also been demonstrated to have volumetric decreases in patients with chronic MTH, demonstrating an inverse relationship to the frequency of migraine.…”

“…23,24 Additionally, the thalamus volume has been found to be altered in patients with medication overuse headache and MTH with and without aura. [23][24][25] The amygdala has also been demonstrated to have volumetric decreases in patients with chronic MTH, demonstrating an inverse relationship to the frequency of migraine. 26 These structures are more prominently implicated in the limbic circuitry, which is presumed to be more related to pain perception than pain sensation.…”

Why is the therapeutic effect of acute antimigraine drugs delayed? A review of controlled trials and hypotheses about the delay of effect

“…The thalamus has been described as being most likely to be involved in dysfunctional pain modulation and processing in migraine . In addition, during migraine attacks, the network connectivity of the right thalamus with pain‐modulating and pain‐encoding cortical areas is affected . In 1 study in rats, intravenous or microiontophoretically naratriptan potently and reversibly modulated trigemino‐vascular thalamic neuronal firing triggered by electrical stimulation of the superior sagittal sinus .…”

“…100 In addition, during migraine attacks, the network connectivity of the right thalamus with pain-modulating and painencoding cortical areas is affected. 101 In 1 study in rats, intravenous or microiontophoretically naratriptan potently and reversibly modulated trigemino-vascular thalamic neuronal firing triggered by electrical stimulation of the superior sagittal sinus. 102 The peak inhibition was observed between 5 and 10 minutes after intravenous administration; 102 however, the blood-brain barrier was…”

Çocukluk Çağı Migreni ile Subkortikal Gri Madde Yapılarının İlişkisi

“…Çalışmalar, ağrı-nosiseptif ve görsel uyaranlara aşırı duyarlılık gibi tipik migren semptomlarının, anormal aktivasyon ve trigeminovasküler ve talamik yolların duyarlılığı sonucunda ortaya çıktığını göstermiştir (20). Talamustaki değişiklikler migrenli hastalarda daha önceki çalışmalarda gösterilmiştir (5,(21)(22)(23). Bizim çalışmamızda seyrek ağrı sıklığı olan grupta talamus volümü artmış olarak bulundu.…”