Cerebellar involvement in migraine

Kros, Lieke; Angueyra, Chantal

doi:10.1177/0333102417752120

Cited by 36 publications

(32 citation statements)

References 123 publications

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“…In addition, cerebellum has been demonstrated to respond to noxious stimuli and involve pain processing [31][32][33][34], but the specific function of cerebellum during pain processing and its role in pain disorder is not clear. In migraine, cerebellar activation was demonstrated not only in trigeminal nociception but also during a migraine episode [35,36]. Additionally, more silent ischemic lesions have been found over the cerebellum in patients with migraine with or without aura [37,38].…”

Section: Discussionmentioning

confidence: 99%

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

Liu

Lee²,

Chou³

et al. 2020

J Headache Pain

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Background: The increase of headache frequency is associated with higher headache related disability and lower quality of life in patients with migraine. However, the pathophysiology of migraine progression, persistence, or remission is elusive. The purpose of this study is to identify the brain signatures that are predictive of the long-term outcomes among patients with high-frequency migraine (HFM: 10-30 headache days/month). Methods: We prospectively enrolled patients with HFM and healthy controls and collected their baseline clinical profiles and brain-MRI data at first visit. We longitudinally followed the patients and determined their outcomes at 2-year follow-up. Good outcome was defined as ≥50% reduction of baseline headache days and poor outcome was defined as reduction < 50% or frequency increase. Voxel-based morphometry was used to study gray matter volume (GMV), and structural covariance was used to investigate structural connectivity. Results: Among 56 patients with HFM, 37 had good outcome and 19 poor outcome. Compared to the healthy controls (n = 37), patients with poor outcome had decreased GMV over the left posterior cingulate gyrus, and increased GMV over the bilateral cerebellum and the right precentral gyrus. Further, patients with poor outcome had greater GMV over the right and the left cerebella compared to patients with good outcome, and the GMVs of the cerebella were correlated to 2-year headache frequencies (right: r = 0.38, P = 0.005; left: r = 0.35, P = 0.009). Structural connectivity were increased between the cerebellum and the cuneus, the calcarine cortex, and the temporal lobe, respectively, in patients with poor outcome, and was decreased between the cerebellum and the prefrontal cortex in patients with poor outcome. The structural covariance integrities between the right cerebellum and the right cuneus were correlated to 2-year headache frequencies (r = 0.36, P = 0.008). Conclusions: Structural volume and connectivity changes of the cerebellum may underlie headache persistence in patients with HFM.

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Section: Discussionmentioning

confidence: 99%

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

Liu

Lee²,

Chou³

et al. 2020

J Headache Pain

View full text Add to dashboard Cite

show abstract

“…In addition, cerebellum has been demonstrated to respond to noxious stimuli [31], but the specific function of cerebellum during pain processing and its role in pain disorder is not clear. In migraine, cerebellar activation was demonstrated not only in trigeminal nociception but also during a migraine episode [32,33]. Additionally, more silent ischemic lesions have been found over the cerebellum in patients with migraine with or without aura [34,35].…”

Section: Discussionmentioning

confidence: 99%

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

Liu

Lee

Chou

et al. 2020

Preprint

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Background: The increase of headache frequency is associated with higher headache related disability and lower quality of life in patients with migraine. However, the pathophysiology of migraine progression, persistence, or remission is elusive. The purpose of this study is to identify the brain signatures that are predictive of the long-term outcomes among patients with high-frequency migraine (HFM: 10–30 headache days/month). Methods: We prospectively enrolled patients with HFM and healthy controls and collected their baseline clinical profiles and brain-MRI data at first visit. We longitudinally followed the patients and determined their outcomes at 2-year follow-up. Good outcome was defined as ≥ 50% reduction of baseline headache days and poor outcome was defined as reduction < 50% or frequency increase. Voxel-based morphometry was used to study gray matter volume (GMV), and structural covariance was used to investigate structural connectivity. Results: Among 56 patients with HFM, 37 had good outcome and 19 poor outcome. Compared to the healthy controls (n = 37), patients with poor outcome had decreased GMV over the left posterior cingulate gyrus, and increased GMV over the bilateral cerebellum and the right precentral gyrus. Further, patients with poor outcome had greater GMV over the right and the left cerebella compared to patients with good outcome, and the GMVs of the cerebella were correlated to 2-year headache frequencies (right: r = 0.38, P = 0.005; left: r = 0.35, P = 0.009). Structural connectivity were increased between the cerebellum and the cuneus, the calcarine cortex, and the temporal lobe, respectively, in patients with poor outcome, and was decreased between the cerebellum and the prefrontal cortex in patients with poor outcome. The structural covariance integrities between the right cerebellum and the right cuneus were correlated to 2-year headache frequencies (r = 0.36, P = 0.008). Conclusions: Structural volume and connectivity changes of the cerebellum may underlie headache persistence in patients with HFM.

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“…Based on these observations, several structural and functional studies have been conducted in the attempt to clarify the putative role played by the cerebellum in migraine [30]. Among these, an increased activity of the cerebellar crus with a concomitant decreased functional connectivity with thalamus have been demonstrated during trigeminal stimulations.…”

Section: Discussionmentioning

confidence: 99%

Advanced visual network and cerebellar hyperresponsiveness to trigeminal nociception in migraine with aura

et al. 2019

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BackgroundDespite the growing body of advanced studies investigating the neuronal correlates of pain processing in patients with migraine without aura (MwoA), only few similar studies have been conducted in patients with migraine with aura (MwA). Therefore, we aimed to explore the functional brain response to trigeminal noxious heat stimulation in patients with MwA.MethodsSeventeen patients with MwA and 15 age- and sex-matched healthy controls (HC) underwent whole-brain blood oxygen level–dependent (BOLD) fMRI during trigeminal noxious heat stimulation. To examine the specificity of any observed differences between patients with MwA and HC, the functional response of neural pathways to trigeminal noxious heat stimulation in patients with MwA was compared with 18 patients with MwoA. Secondary analyses investigated the correlations between BOLD signal changes and clinical parameters of migraine severity.ResultsWe observed a robust cortical and subcortical pattern of BOLD response to trigeminal noxious heat stimulation across all participants. Patients with MwA showed a significantly increased activity in higher cortical areas known to be part of a distributed network involved in advanced visual processing, including lingual gyrus, inferior parietal lobule, inferior frontal gyrus and medial frontal gyrus. Moreover, a significantly greater cerebellar activation was observed in patients with MwA when compared with both patients with MwA and HC. Interestingly, no correlations were found between migraine severity parameters and magnitude of BOLD response in patients with MwA.ConclusionOur findings, characterized by abnormal visual pathway response to trigeminal noxious heat stimulation, support the role of a functional integration between visual and trigeminal pain networks in the pathophysiological mechanisms underlying migraine with aura. Moreover, they expand the concept of “neurolimbic-pain network” as a model of MwoA including both limbic dysfunction and cortical dys-excitability. Indeed, we suggest a model of “neurolimbic-visual-pain network” in MwA patients, characterized by dysfunctional correlations between pain-modulating circuits not only with the cortical limbic areas but with advanced visual areas as well. Furthermore, the abnormal cerebellar response to trigeminal noxious heat stimulation may suggest a dysfunctional cerebellar inhibitory control on thalamic sensory gating, impinging on the advanced visual processing cortical areas in patients with MwA.Electronic supplementary materialThe online version of this article (10.1186/s10194-019-1002-3) contains supplementary material, which is available to authorized users.

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Cerebellar involvement in migraine

Cited by 36 publications

References 123 publications

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

Advanced visual network and cerebellar hyperresponsiveness to trigeminal nociception in migraine with aura

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