Functional Connectivity Features of Resting-State Functional Magnetic Resonance Imaging May Distinguish Migraine From Tension-Type Headache

Abstract

BackgroundMigraineurs often exhibited abnormalities in cognition, emotion, and resting-state functional connectivity (rsFC), whereas patients with tension-type headache (TTH) rarely exhibited these abnormalities. The aim of this study is to explore whether rsFC alterations in brain regions related to cognition and emotion could be used to distinguish patients with migraine from patients with TTH.MethodsIn this study, Montreal Cognitive Assessment (MoCA), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and rsFC analyses were used to assess the cognition, anxiety, and depression of 24 healthy controls (HCs), 24 migraineurs, and 24 patients with TTH. Due to their important roles in neuropsychological functions, the bilateral amygdala and hippocampus were chosen as seed regions for rsFC analyses. We further assessed the accuracy of the potential rsFC alterations for distinguishing migraineurs from non-migraineurs (including HCs and patients with TTH) by the receiver operating characteristic (ROC) analysis. Associations between headache characteristics and rsFC features were calculated using a multi-linear regression model. This clinical trial protocol has been registered in the Chinese Clinical Trial Registry (registry number: ChiCTR1900024307, Registered: 5 July 2019-Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=40817).ResultsMigraineurs showed lower MoCA scores (p = 0.010) and higher SAS scores (p = 0.017) than HCs. Migraineurs also showed decreased rsFC in the bilateral calcarine/cuneus, lingual gyrus (seed: left amygdala), and bilateral calcarine/cuneus (seed: left hippocampus) in comparison to HCs and patients with TTH. These rsFC features demonstrated significant distinguishing capabilities and got a sensitivity of 82.6% and specificity of 81.8% with an area under the curve (AUC) of 0.868. rsFC alterations showed a significant correlation with headache frequency in migraineurs (p = 0.001, Pc = 0.020).ConclusionThe rsFC of amygdala and hippocampus with occipital lobe can be used to distinguish patients with migraine from patients with TTH.Clinical Trial Registration[http://www.chictr.org.cn/showproj.aspx?proj=40817], identifier [ChiCTR1900024307].

Brain structural and functional abnormalities in patients with tension‐type headache: A systematic review of magnetic resonance imaging studies

“…Furthermore, four studies only included patients with bilateral headaches (Chen et al., 2018; Li et al., 2021; Schmidt‐Wilcke et al., 2005; Zhang et al., 2021), whereas other 10 other studies did not specify the laterality of headaches in their TTH population. To evaluate the headache severity in patients, five studies utilized the visual analog scale (VAS) (Chen et al., 2016; Li et al., 2021; Wang et al., 2014; Yang et al., 2023; Zhang et al., 2021), two used headache intensity scale (HIS) (Chen et al., 2018; Wang, Wang, et al., 2022), and one employed headache disability inventory (HDI) (Tremolizzo et al., 2015), whereas six studies did not assess the headache intensity in their TTH population (Honningsvag et al., 2016, 2018; Husoy, Haberg, et al., 2019; Husoy, Pintzka, et al., 2019; Schmidt‐Wilcke et al., 2005). Among the studies that assessed the headache severity in TTH patients, six included patients with mild to moderate intensity headache (Chen et al., 2016, 2018; Li et al., 2021; Wang et al., 2014; Yang et al., 2023; Zhang et al., 2021), one included patients with moderate intensity headache (Wang, Wang, et al., 2022), and one included patients with mild, moderate, and severe intensity headaches (Tremolizzo et al., 2015).…”

“…Furthermore, the fMRI study by Wang, Wang, et al. (2022) calculated the seed‐based rsFC within the whole brain of patients with TTH and identified no regions with significant differences in rsFC, when compared to HFCs.…”

A state-of-the-art review of functional magnetic resonance imaging technique integrated with advanced statistical modeling and machine learning for primary headache diagnosis

“… Wang Y. et al (2022) selected the bilateral amygdalae and left hippocampi as seed regions for rs-FC analysis, assessing their discriminative capacity for TTH sufferers compared to HC and migraineurs. According to the rs-FC between the left amygdala and bilateral corpus callosum/cuneus, the AUC, sensitivity, and specificity for discriminating migraines from TTH were 0.822, 78.3, and 81.8%.…”

Imaging Correlates between Headache and Breast Cancer: An [18F]FDG PET Study

“…Although headache imaging is mainly performed to exclude secondary forms [ 3 ], numerous studies have explored the pathological pathways and morphological changes associated with headache, mainly by means of magnetic resonance (MRI) [ 4 , 5 , 6 , 7 , 8 , 9 ]. Limited evidence of functional brain changes has been reported using [ 18 F]Fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography (PET) [ 3 , 4 , 10 , 11 , 12 , 13 ].…”