Resting State Functional Connectivity After Sphenopalatine Ganglion Blocks in Chronic Migraine With Medication Overuse Headache: A Pilot Longitudinal fMRI Study

Krebs, Kaitlin; Rorden, Chris

doi:10.1111/head.13318

Cited by 19 publications

(18 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Migraineurs with more frequent migraine attacks had greater or more “hyper-reactive” pre- and post-treatment activations of the anterior cingulate. A MRI functional connectivity study of CM with MO demonstrated improvement in interregional intra-network connectivity of salience and executive networks following a series of treatments with sphenopalatine ganglion blocks (23). Brain imaging biomarkers for treatment response that could be used early after the initiation of treatment, prior to being able to determine response on clinical grounds alone, could help to increase the efficiency of screening new migraine therapies during their development.…”

Section: Brain Imaging: Structural and Functional Chronic Migraine Bimentioning

confidence: 99%

How does the brain change in chronic migraine? Developing disease biomarkers

2020

View full text Add to dashboard Cite

Background Validated chronic migraine biomarkers could improve diagnostic, prognostic, and predictive abilities for clinicians and researchers, as well as increase knowledge on migraine pathophysiology. Objective The objective of this narrative review is to summarise and interpret the published literature regarding the current state of development of chronic migraine biomarkers. Findings Data from functional and structural imaging, neurophysiological, and biochemical studies have been utilised towards the development of chronic migraine biomarkers. These biomarkers could contribute to chronic migraine classification/diagnosis, prognosticating patient outcomes, predicting response to treatment, and measuring treatment responses early after initiation. Results show promise for using measures of brain structure and function, evoked potentials, and sensory neuropeptide concentrations for the development of chronic migraine biomarkers, yet further optimisation and validation are still required. Conclusions Imaging, neurophysiological, and biochemical changes that occur with the progression from episodic to chronic migraine could be utilised for developing chronic migraine biomarkers that might assist with diagnosis, prognosticating individual patient outcomes, and predicting responses to migraine therapies. Ultimately, validated biomarkers could move us closer to being able to practice precision medicine in the field and thus improve patient care.

show abstract

Section: Brain Imaging: Structural and Functional Chronic Migraine Bimentioning

confidence: 99%

How does the brain change in chronic migraine? Developing disease biomarkers

2020

View full text Add to dashboard Cite

show abstract

“…Patients reported using nifedipine (N = 1), metoprolol (N = 1), amitriptyline (N = 1), topiramate (N = 5). Some patients in this cohort also participated a previously published functional MRI study in which we examined 10 individuals with CM w/MOH [21].…”

Section: Participantsmentioning

confidence: 99%

“…While several studies hint at potential relationships between brain structures and various aspects of migraine (such as severity and frequency) [9][10][11][12][13][14][15][16][17][18][19][20], little is known about the potential effects of SPG treatment on brain structure and function. Recently, our lab conducted a pilot longitudinal fMRI study on the use of repetitive SPG blockades for chronic migraine with medication overuse headache (CM w/MOH) , which demonstrated improved overall central executive network connectivity and intra-network connectivity within salience network [21]. Here, we evaluated whether this treatment is associated with any changes in brain morphometry.…”

Section: Introductionmentioning

confidence: 99%

Cortical and subcortical changes following sphenopalatine ganglion blocks in chronic migraine with medication overuse headache: a preliminary longitudinal study

Newman‐Norlund

Rorden

Maleki

et al. 2020

womens midlife health

Self Cite

View full text Add to dashboard Cite

Objective: The purpose of this pilot study was to investigate potential changes in brain morphology (cortical thickness and cortical/subcortical volume) accompanying a series of sphenopalatine ganglion (SPG) blockade treatments in chronic migraine with medication overuse headaches (CM w/MOH). Background: Local anesthetization of the SPG via intranasal application is used for the treatment for multiple types of headache disorders, including CM. Our previous longitudinal fMRI study revealed improved network connectivity after such treatment. However, the impact of SPG blocks on cortical, subcortical gray matter volume and cortical thickness has yet to be assessed. Methods: Using magnetic resonance imaging (MRI), cortical/subcortical volume were measured in 12 chronic migraine patients before and after a series of 12 SPG blocks administered over a 6-week period (2 per week). The average time between MRI assessments was 6 weeks. Targeted, within-subjects t-tests comparing pre-treatment and post-treatment values in specific apriori brain regions of interest, including the hippocampus, amygdala, basal ganglia, somatosensory cortex, temporal cortex and occipital cortex, were used to estimate the impact of repetitive SPG blocks treatment on brain morphology in CM w/MOH. Results: Compared to baseline values, the number of moderate/severe headache days per month, HIT-6, PHQ-9 scores and allodynia scores were all significantly improved at the end of treatment. Analysis of MRI data revealed that the volume of the right hippocampus and the right palladium significantly decreased following SPG block treatment, while the volume of the left nucleus accumbens significantly increased following treatment. Cortical thickness in the left temporal pole and left lateral occipito-temporal gyrus significantly decreased following SPG block treatment. Conclusion: Our results suggest SPG block treatment is associated with significant symptom improvement as well as significant structural brain changes in regions known to be associated with migraine and chronic pain processing in CM w/MOH .

show abstract

“…Multiple time-point studies in individual patients before and after withdrawal are undoubtedly the most informative for investigating how the brain changes or recovers subsequent to medication withdrawal and/or effective treatment. Krebs et al (22) found improved functional connectivity within the salience and central executive networks after successful treatment using sphenopalatine ganglion (SPG) blocks in patients with MOH. SPG treatment in these patients resulted in decreased number of moderate to severe headache days per month, thus indicating that imbalance within both networks can be restored following successful treatment.…”

Section: Functional Imaging: Before and After Medication Withdrawalmentioning

confidence: 99%

Brain Structural and Functional Imaging Findings in Medication-Overuse Headache

Chong

2020

Front. Neurol.

View full text Add to dashboard Cite

This chapter overviews research neuroimaging findings of patients with medication-overuse headache (MOH). Results indicate; (i) correlations between neuropathology and medication-overuse; (ii) changes in brain morphology and cortical function; and (iii) brain recovery subsequent to withdrawal of medication that was overused. Results of this narrative review indicate exacerbated brain structural and functional changes in regions of the pain-matrix and in regions of the mesocortical-limbic circuit in patients with MOH compared to patients with migraine or compared to healthy controls. Modification of brain morphology as well as an association between brain recovery and medication withdrawal suggest that the MOH disease process involves state (brain modification) and trait-like (brain adaptation and recovery) neuromechanisms.

show abstract

Resting State Functional Connectivity After Sphenopalatine Ganglion Blocks in Chronic Migraine With Medication Overuse Headache: A Pilot Longitudinal fMRI Study

Cited by 19 publications

References 34 publications

How does the brain change in chronic migraine? Developing disease biomarkers

How does the brain change in chronic migraine? Developing disease biomarkers

Cortical and subcortical changes following sphenopalatine ganglion blocks in chronic migraine with medication overuse headache: a preliminary longitudinal study

Brain Structural and Functional Imaging Findings in Medication-Overuse Headache

Contact Info

Product

Resources

About