Functional imaging and migraine

Schwedt, Todd J.; Chong, Catherine D.

doi:10.1097/wco.0000000000000194

Cited by 29 publications

(20 citation statements)

References 63 publications

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“…However, the paucity of longitudinal data has precluded the inference of a causal relationship. 6 Since the current study describes intraindividual changes in connectivity from baseline to early-phase migraine, it arguably supports the brain trait model of connectivity abnormalities, in agreement with a previous study that reported progressive abnormalities in connectivity over 6 weeks in patients with worsening migraines. 7 Some limitations to the study include the following:…”

Section: Resultssupporting

confidence: 91%

Journal Club: Change in brain network connectivity during PACAP38-induced migraine attacks

et al. 2016

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Journal Club: Change in brain network connectivity during PACAP38-induced migraine attacksThere is evidence to suggest that migraine attacks involve changes in complex neuronal networks that can be measured using functional MRI (fMRI) methods including resting state functional connectivity (RSFC). Networks that have previously been shown to be involved in the sensory and affective aspects of pain perception include the default mode network (DMN), salience network (SN), and sensorimotor network (SMN) (figure).1 In a recent study, Amin et al. 2 examined the RSFC of these 3 networks at baseline and in the early phases of experimentally induced migraine in patients with migraine without aura. In order to capture the early phases of migraine, corresponding to the time closest to migraine attack onset, migraine attacks were induced using the potent vasodilator neuropeptide pituitary adenylate cyclase-activating polypeptide-38 (PACAP38). 3 Since vasodilators can alter hemodynamics and potentially confound the fMRI signal, another vasodilator, vasoactive intestinal peptide (VIP), was used as a control since it also acts on extracranial arteries, but is much less likely (,20%) to provoke migraine-like attacks. 3HYPOTHESIS AND DESIGN Amin et al. hypothesized that patients would have altered RSFC of the DMN, SN, and SMN during the early phases of migraine compared to baseline. Abnormalities in the connectivity and activity of these resting-state networks have previously been reported during the interictal phase of migraine. 4,5 Patients were recruited as part of a larger study investigating the migraine-inducing properties of PACAP38 and VIP and their effects on extracranial and intracranial arterial diameter among other factors. 3A double-blind randomized design was used to allocate 24 patients to receive an IV infusion of either PACAP38 (10 pmol/kg/min) or VIP (8 pmol/kg/min) over 20 minutes on the first study day. On the second study day, which occurred at least 1 week after the first, patients received an infusion of the alternate vasodilator (i.e., the one they did not receive on the first day). Resting-state fMRI scans were acquired at baseline and at fixed timepoints thereafter.METHODS Eligible female participants meeting the inclusion criteria were included in the study if they had a verified diagnosis of migraine without aura according to the International Classification of Headache Disorders II. Resting-state fMRI scans were acquired at baseline and at 3 fixed time points after the start of infusion: 30, 130, and 310 minutes. An exception was if patients reported a migraine-like attack, in which case they were scanned immediately. Patients were migraine-free for 5 days and headache-free for 48 hours prior to baseline scans. To examine the early phase of PACAP38-induced migraine, the preattack time point that was closest to the attack onset was used in the RSFC analyses. The PACAP38 group consisted of 16 patients who all experienced migraine attacks after PACAP38 infusion, and the VIP group comprised 15 patie...

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Section: Resultssupporting

confidence: 91%

Journal Club: Change in brain network connectivity during PACAP38-induced migraine attacks

et al. 2016

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“…Brain imaging studies of people with psychiatric disorders demonstrate atypical structure and function of similar regions as those identified as being atypical and important for affective-motivational processing of sensory stimuli in migraine studies 101–106. Similar to people with depression and other psychiatric disorders, people with migraine have atypical function and structure of brain regions that are important for determining affective-motivational responses to sensory stimuli and for determining mood 100. These regions are key components of brain networks implicated in emotion, such as the limbic system, the salience network, and the default mode network.…”

Section: Knowledge Learned From Imaging Studies: How Functional Imagimentioning

confidence: 99%

Migraine and its psychiatric comorbidities

Minen

Dhaem

Diest

et al. 2016

J Neurol Neurosurg Psychiatry

328

255

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Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. In this manuscript, we provide an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. We present data on psychiatric risk factors for migraine chronification. We discuss the evidence, theories and methods, such as brain functional imaging, to explain the pathophysiological links between migraine and psychiatric disorders. Finally, we provide an overview of the treatment considerations for treating migraine with psychiatric comorbidities. In conclusion, a review of the literature demonstrates the wide variety of psychiatric comorbidities with migraine. However, more research is needed to elucidate the neurocircuitry underlying the association between migraine and the comorbid psychiatric conditions and to determine the most effective treatment for migraine with psychiatric comorbidity.

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“…Previous fMRI studies consistently demonstrate that migraines exhibit an atypical brain activation in response to olfactory, painful, and visual stimuli 8 9 10 11 . Previous resting state fMRI studies have found many brain areas and networks with abnormal functional connectivity in migraine, which suggested long-term headache attacks would induce brain dysfunction and functional reorganization in migraine 12 13 .…”

mentioning

confidence: 98%

Visual cortex and cerebellum hyperactivation during negative emotion picture stimuli in migraine patients

Wang

Zhang

et al. 2017

Sci Rep

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Migraines are a common and undertreated disease and often have psychiatric comorbidities; however, the abnormal mechanism of emotional processing in migraine patients has not been well clarified. This study sought to investigate the different brain functional activation to neutral, positive and negative emotional stimuli between migraine and healthy subjects. Twenty-six adults with migraines and 26 healthy adults, group-matched for sex and age, participated in this experiment. Although there were no significant differences between two groups during the viewing of positive affective pictures vs. neutral affective pictures, there were different activation patterns during the viewing of negative to neutral affective pictures in the two groups; the control group showed both increased and decreased activation patterns, while the migraine subjects showed only increased activation. Negative affective pictures elicited stronger activation than neutral affective pictures in migraineurs, which included the bilateral cerebellum anterior lobe/culmen, the bilateral lingual gyri, the bilateral precuneus and the left cuneus. Our data indicated that migraine patients were hypersensitive to negative stimuli, which might provide clues to aid in the understanding of the pathophysiology and psychiatric comorbidities of migraines.

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Functional imaging and migraine

Cited by 29 publications

References 63 publications

Journal Club: Change in brain network connectivity during PACAP38-induced migraine attacks

Journal Club: Change in brain network connectivity during PACAP38-induced migraine attacks

Migraine and its psychiatric comorbidities

Visual cortex and cerebellum hyperactivation during negative emotion picture stimuli in migraine patients

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