Resting state connectivity between default mode network and insula encodes acute migraine headache

Abstract

Background: Previous functional MRI studies have revealed that ongoing clinical pain in different chronic pain syndromes is directly correlated to the connectivity strength of the resting default mode network (DMN) with the insula. Here, we investigated seed-based resting state DMN-insula connectivity during acute migraine headaches. Methods: Thirteen migraine without aura patients (MI) underwent 3 T MRI scans during the initial six hours of a spontaneous migraine attack, and were compared to a group of 19 healthy volunteers (HV). We evaluated headache intensity with a visual analogue scale and collected seed-based MRI resting state data in the four core regions of the DMN: Medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC), and left and right inferior parietal lobules (IPLs), as well as in bilateral insula. Results: Compared to HV, MI patients showed stronger functional connectivity between MPFC and PCC, and between MPFC and bilateral insula. During migraine attacks, the strength of MPFC-to-insula connectivity was negatively correlated with pain intensity. Conclusion: We show that greater subjective intensity of pain during a migraine attack is associated with proportionally weaker DMN-insula connectivity. This is at variance with other chronic extra-cephalic pain disorders where the opposite was found, and may thus be a hallmark of acute migraine head pain.

Neurobiologic Features of Fibromyalgia Are Also Present Among Rheumatoid Arthritis Patients

“…Although no other study has applied neuroimaging to characterize FM in a coexisting disorder, dysfunctional DMN–insula functional connectivity has been observed in irritable bowel syndrome , chronic back pain , and migraine , all of which are pain conditions in which central sensitization has been implicated . Interestingly, these conditions are also associated with somatic symptoms , which is consistent with our post hoc analysis indicating that the DMN–insula functional connection relates not only to pain but also to symptoms such as fatigue and cognitive dysfunction (as measured by the Symptom Severity Index ).…”

Changes in resting‐state functional connectivity in nonacute sciatica with acupuncture modulation: A preliminary study

“…2014;Stevens, Hurley, Hurley, & Taber, 2011). Stronger interregional FC between DMN and mPFC was observed in primary dysmenorrhea and migraine patients compared to controls(Coppola et al, 2018;Wu et al, 2016). Similar findings were observed in our study based on visual inspection(Figure 3a).…”

“…In addition to bilateral TA B L E 3 Analysis of effects of between-group and within-group differences in regional homogeneity (ReHo) seed-based functional connectivity insula and bilateral IPL, the patients receiving acupuncture had greater PCC-seeded FC to the right OFC and dACC, implicating that the analgesic effect of acupuncture may involve emotion, cognition, and reward circuits of the brain (Kringelbach, 2005;Navratilova & Porreca, 2014;Stevens, Hurley, Hurley, & Taber, 2011). Stronger interregional FC between DMN and mPFC was observed in primary dysmenorrhea and migraine patients compared to controls (Coppola et al, 2018;Wu et al, 2016). Similar findings were observed in our study based on visual inspection (Figure 3a Figure 3b,d,e).…”

Interictal Hyperperfusion in the Higher Visual Cortex in Patients With Episodic Migraine

“…The angular gyrus is part of the default mode network, one of the main networks that are consistently identified when an individual is at wakeful rest and not performing an attention-demanding task. It has been reported that ictal 61 and interictal 62,63 resting-state fMRI connectivity is disturbed in the default mode network in migraine. However, the functional meaning of the observed correlation between anxiety and components of the default mode network or the parietal operculum needs to be explored in future studies.…”