Static and dynamic functional connectivity differences between migraine and persistent post-traumatic headache: A resting-state magnetic resonance imaging study

Abstract

Introduction Although migraine and persistent post-traumatic headache often share phenotypic characteristics, few studies have interrogated the pathophysiological differences underlying these headache types. While there is now some indication of differences in brain structure between migraine and persistent post-traumatic headache, differences in brain function have not been adequately investigated. The objective of this study was to compare static and dynamic functional connectivity patterns in migraine versus persistent post-traumatic headache using resting-state magnetic resonance imaging. Methods This case-control study interrogated the static functional connectivity and dynamic functional connectivity patterns of 59 a priori selected regions of interest involved in pain processing. Pairwise connectivity (region of interest to region of interest) differences between migraine (n = 33) and persistent post-traumatic headache (n = 44) were determined and compared to healthy controls (n = 36) with ANOVA and subsequent t-tests. Pearson partial correlations were used to explore the relationship between headache burden (headache frequency; years lived with headache) and functional connectivity and between pain intensity at the time of imaging and functional connectivity for migraine and persistent post-traumatic headache groups, separately. Results Significant differences in static functional connectivity between migraine and persistent post-traumatic headache were found for 17 region pairs that included the following regions of interest: Primary somatosensory, secondary somatosensory, posterior insula, hypothalamus, anterior cingulate, middle cingulate, temporal pole, supramarginal gyrus, superior parietal, middle occipital, lingual gyrus, pulvinar, precuneus, cuneus, somatomotor, ventromedial prefrontal cortex, and dorsolateral prefrontal cortex. Significant differences in dynamic functional connectivity between migraine and persistent post-traumatic headache were found for 10 region pairs that included the following regions of interest: Secondary somatosensory, hypothalamus, middle cingulate, temporal pole, supramarginal gyrus, superior parietal, lingual gyrus, somatomotor, precentral, posterior cingulate, middle frontal, fusiform gyrus, parieto-occiptal, and amygdala. Although there was overlap among the regions demonstrating static functional connectivity differences and those showing dynamic functional connectivity differences between persistent post-traumatic headache and migraine, there was no overlap in the region pair functional connections. After controlling for sex and age, there were significant correlations between years lived with headache with static functional connectivity of the right dorsolateral prefrontal cortex with the right ventromedial prefrontal cortex in the migraine group and with static functional connectivity of right primary somatosensory with left supramarginal gyrus in the persistent post-traumatic headache group. There were significant correlations between headache frequency with static functional connectivity of left secondary somatosensory with right cuneus in the migraine group and with static functional connectivity of left middle cingulate with right pulvinar and right posterior insula with left hypothalamus in the persistent post-traumatic headache group. Dynamic functional connectivity was significantly correlated with headache frequency, after controlling for sex and age, in the persistent post-traumatic headache group for one region pair (right middle cingulate with right supramarginal gyrus). Dynamic functional connectivity was correlated with pain intensity at the time of imaging for the migraine cohort for one region pair (right posterior cingulate with right amygdala). Conclusions Resting-state functional imaging revealed static functional connectivity and dynamic functional connectivity differences between migraine and persistent post-traumatic headache for regions involved in pain processing. These differences in functional connectivity might be indicative of distinctive pathophysiology associated with migraine versus persistent post-traumatic headache.

Altered Hypothalamic Region Covariance in Migraine and Cluster Headache: A Structural MRI Study

“…Migraine patients had significantly weaker hypothalamic‐frontal region covariance relative to HC, specifically between the left hypothalamic region and left rostral frontal region, and right hypothalamic region with the right lateral orbitofrontal and right rostral anterior cingulate region. Our previous results using functional connectivity resting‐state analyses also demonstrated altered connectivity patterns of the hypothalamus to frontal regions in migraine . Using a similar migraine cohort, our previous results indicated altered dynamic functional connectivity in migraine patients (relative to patients with post‐traumatic headache) between the right hypothalamus and bilateral precentral nodes, as well as altered static functional connectivity of the left hypothalamus with right insula nodes.…”

“…Our previous results using functional connectivity resting-state analyses also demonstrated altered connectivity patterns of the hypothalamus to frontal regions in migraine. 35 Using a similar migraine cohort, our previous results indicated altered dynamic functional connectivity in migraine patients (relative to patients with post-traumatic headache) between the right hypothalamus and bilateral precentral nodes, as well as altered static functional connectivity of the left hypothalamus with right insula nodes.…”

Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine

“…This was a cross-sectional cohort study in which participants were prospectively enrolled from November 2015 until February 2018. The data reported within this manuscript were collected as part of a United States Department of Defense funded study that aimed to compare clinical characteristics and brain imaging findings amongst those with PPTH vs. migraine [25][26][27] .…”

Persistent Post-Traumatic Headache and Migraine: Pre-Clinical Comparisons

“…Dumkrieger et al focused their attention on the differences in brain structure of patients suffering from migraine and PPTH through a magnetic resonance imaging analysis. They analyzed the static functional connectivity (sFC), the correlation between two signals in the region of interest (ROI), the dynamic functional connectivity (dFC) or a connectivity/correlation that varies with time [15]. Significant differences in sFC and dFC have been found between migraine and PPTH for the regions that participate in the elaboration of pain, including the somatosensory region and the hypothalamus.…”