Predicting response to tVNS in patients with migraine using functional MRI: A voxels-based machine learning analysis

Fu, Chengwei; Zhang, Yue; Ye, Yongsong; Hou, Xiaoyan; Wen, Zeying; Yan, Zhaoxian; Luo, Wenting; Feng, Meng; Liu, Bo

doi:10.3389/fnins.2022.937453

Cited by 13 publications

(12 citation statements)

References 87 publications

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“…A voxel-based machine learning analysis used fMRI to identify biomarkers to discriminate migraineurs as well as select patients suitable for transcutaneous vagus nerve stimulation (tVNS) treatment. By machine learning, two potential biomarkers were identified with an accuracy of 79.3%, sensitivity of 78.6%, and specificity of 80.0% (Fu et al, 2022).…”

Section: Machine Learning and Deep Learningmentioning

confidence: 99%

Application of EEG in migraine

Zhang

Pan

Chen

et al. 2023

Front. Hum. Neurosci.

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Migraine is a common disease of the nervous system that seriously affects the quality of life of patients and constitutes a growing global health crisis. However, many limitations and challenges exist in migraine research, including the unclear etiology and the lack of specific biomarkers for diagnosis and treatment. Electroencephalography (EEG) is a neurophysiological technique for measuring brain activity. With the updating of data processing and analysis methods in recent years, EEG offers the possibility to explore altered brain functional patterns and brain network characteristics of migraines in depth. In this paper, we provide an overview of the methodology that can be applied to EEG data processing and analysis and a narrative review of EEG-based migraine-related research. To better understand the neural changes of migraine or to provide a new idea for the clinical diagnosis and treatment of migraine in the future, we discussed the study of EEG and evoked potential in migraine, compared the relevant research methods, and put forwards suggestions for future migraine EEG studies.

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Section: Machine Learning and Deep Learningmentioning

confidence: 99%

Application of EEG in migraine

Zhang

Pan

Chen

et al. 2023

Front. Hum. Neurosci.

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“…Central effects of aVNS have also been investigated in a larger study [ 71 ] showing that the increased activity of the thalamus, frontal and parietal areas experienced by 60 migraine patients compared to controls could be reversed after 4 weeks of aVNS treatment. It has also been demonstrated that abnormal activity of the trigeminal cervical complex, insula, cingulate cortex, frontal and temporal gyrus could predict patients´ treatment response to 4-week treatment with aVNS [ 72 ].…”

Section: Resultsmentioning

confidence: 99%

Imaging the brain and vascular reactions to headache treatments: a systematic review

et al. 2023

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Background Neuroimaging studies have made an important contribution to our understanding of headache pathophysiology. This systematic review aims to provide a comprehensive overview and critical appraisal of mechanisms of actions of headache treatments and potential biomarkers of treatment response disclosed by imaging studies. Main body We performed a systematic literature search on PubMed and Embase databases for imaging studies investigating central and vascular effects of pharmacological and non-pharmacological treatments used to abort and prevent headache attacks. Sixty-three studies were included in the final qualitative analysis. Of these, 54 investigated migraine patients, 4 cluster headache patients and 5 patients with medication overuse headache. Most studies used functional magnetic resonance imaging (MRI) (n = 33) or molecular imaging (n = 14). Eleven studies employed structural MRI and a few used arterial spin labeling (n = 3), magnetic resonance spectroscopy (n = 3) or magnetic resonance angiography (n = 2). Different imaging modalities were combined in eight studies. Despite of the variety of imaging approaches and results, some findings were consistent. This systematic review suggests that triptans may cross the blood–brain barrier to some extent, though perhaps not sufficiently to alter the intracranial cerebral blood flow. Acupuncture in migraine, neuromodulation in migraine and cluster headache patients, and medication withdrawal in patients with medication overuse headache could promote headache improvement by reverting headache-affected pain processing brain areas. Yet, there is currently no clear evidence for where each treatment acts, and no firm imaging predictors of efficacy. This is mainly due to a scarcity of studies and heterogeneous treatment schemes, study designs, subjects, and imaging techniques. In addition, most studies used small sample sizes and inadequate statistical approaches, which precludes generalizable conclusions. Conclusion Several aspects of headache treatments remain to be elucidated using imaging approaches, such as how pharmacological preventive therapies work, whether treatment-related brain changes may influence therapy effectiveness, and imaging biomarkers of clinical response. In the future, well-designed studies with homogeneous study populations, adequate sample sizes and statistical approaches are needed.

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“…Fu et al [8 ▪▪ ] attempted to develop a predictive model for responders of 1 Hz transauricular VNS through a functional Magnetic Resonance Imaging (fMRI) study. Predictive features were noted in trigeminal cervical complex/rostral ventromedial medulla (TCC/RVM), thalamus, bilateral medial Prefrontal cortex, and temporal gyrus.…”

Section: Evidence From Neuroimaging Studiesmentioning

confidence: 99%

Vagal nerve stimulation for headache

Venkatakrishnan,

Thomas

2023

Current Opinion in Neurology

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Purpose of review Vagal nerve stimulation (VNS) is emerging as a probable therapeutic option for headache. Several questions remain on the mechanism of action, device parameters, efficacy, duration of treatment and long-term safety. This review aims at describing findings of recent literature pertaining to VNS for headache, to put these findings into the perspective of our current fund of knowledge and future scope of work on the topic. Recent findings Several studies on functional magnetic resonance imaging patterns following VNS in patients with headache have been published, revealing potential biomarkers of headache and possible treatment effects. A study on post-COVID-19 headache and its management with noninvasive cervical VNS adds to the body of original studies. Meta-analyses and systematic reviews outlining previous work have been published. The collection of these studies adds some data to mechanisms of VNS without adding much insight to differential effects of sub-types of VNS and possible device settings that could prove to be beneficial for headache management. Summary Well designed studies are needed to identify mechanisms of action, elicit differential effects of various stimulation parameters, and to demonstrate long-term therapeutic effects and safety of VNS in headache.

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Predicting response to tVNS in patients with migraine using functional MRI: A voxels-based machine learning analysis

Cited by 13 publications

References 87 publications

Application of EEG in migraine

Application of EEG in migraine

Imaging the brain and vascular reactions to headache treatments: a systematic review

Vagal nerve stimulation for headache

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