Interictal brain activity differs in migraine with and without aura: resting state fMRI study

Abstract

BackgroundMigraine is one of the most severe primary headache disorders. The nature of the headache and the associated symptoms during the attack suggest underlying functional alterations in the brain. In this study, we examined amplitude, the resting state fMRI fluctuation in migraineurs with and without aura (MWA, MWoA respectively) and healthy controls.MethodsResting state functional MRI images and T1 high-resolution images were acquired from all participants. For data analysis we compared the groups (MWA-Control, MWA-MWoA, MWoA-Control). The resting state networks were identified by MELODIC. The mean time courses of the networks were identified for each participant for all networks. The time-courses were decomposed into five frequency bands by discrete wavelet decomposition. The amplitude of the frequency-specific activity was compared between groups. Furthermore, the preprocessed resting state images were decomposed by wavelet analysis into five specific frequency bands voxel-wise. The voxel-wise amplitudes were compared between groups by non-parametric permutation test.ResultsIn the MWA-Control comparison the discrete wavelet decomposition found alterations in the lateral visual network. Higher activity was measured in the MWA group in the highest frequency band (0.16–0.08 Hz).In case of the MWA-MWoA comparison all networks showed higher activity in the 0.08–0.04 Hz frequency range in MWA, and the lateral visual network in in higher frequencies.In MWoA-Control comparison only the default mode network revealed decreased activity in MWoA group in the 0.08–0.04 Hz band.The voxel-wise frequency specific analysis of the amplitudes found higher amplitudes in MWA as compared to MWoA in the in fronto-parietal regions, anterior cingulate cortex and cerebellum.DiscussionThe amplitude of the resting state fMRI activity fluctuation is higher in MWA than in MWoA. These results are in concordance with former studies, which found cortical hyperexcitability in MWA.

Evaluation of Electroencephalogram Using Exact Low-Resolution Electromagnetic Tomography During Photic Driving Response in Patients with Migraine

“…In our study, we analyzed the interictal phase of cortical activities of migraine patients with photic stimulation by using EEG-source localization analysis (eLORETA) and found different cortical responses to photic stimulation between MWOA and MWA, supporting that neuronal excitability may play an important role in the predisposition to develop different forms of migraine [20]. A study using resting state functional MRI images revealed that interictal cortical activity was higher in MWA patients compared to MWOA patients [23]. Visual cortex hyperexcitability in migraine in response to sound-induced flash illusions, especially MWA, has been described [24].…”

Evaluation of oxidative stress in migraine patients with visual aura - the experience of an Rehabilitation Hospital

“…In our study the increased oxidative stress and endothelial dysfunction found both group can contribute to migraine pathophysiology due to triggering the cortical spreading depression. By fMRI study was demonstrated that interictal brain activity is more intense in patients with migraine with aura compare with patients with migraine without aura that demonstrated that there is and increased brain hyperexcitability in patients with migraine with aura [36]. Datta et al found that despite similar interictal symptoms of visual discomfort, only migraine with aura subjects have cortical hyperresponsiveness to visual stimulus, suggesting a direct connection between cortical hyperresponsiveness and aura itself [37].…”

Lamotrigine in the Prevention of Migraine With Aura: A Narrative Review

“…Hyperexcitability has been also reported at the neuromuscular junction level in migraineurs . This is detected in cases of migraine with isolated visual aura and seems further increased in patients having migraine with prolonged or complex auras . Accumulating evidence suggests that CSD, a wave of depolarization that propagates slowly across the brain surface is the main physiological substrate of MA .…”

“…There is also accumulating evidence suggesting that MA patients present with neuronal hyperexcitability. At cortical level, an increased interictal excitability has been repeatedly observed in patients with visual aura that is further amplified in patients with multiple aura symptoms . Hyperexcitability has been also reported at the neuromuscular junction level in migraineurs .…”