Thalamo-cortical network activity during spontaneous migraine attacks

Coppola, Gianluca; Renzo, Antonio Di; Tinelli, Emanuele; Lorenzo, Cherubino Di; Lorenzo, Giorgio Di; Parisi, Vincenzo; Serrao, Mariano; Schoenen, Jean; Pierelli, Francesco

doi:10.1212/wnl.0000000000003327

Cited by 86 publications

(87 citation statements)

References 41 publications

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“…Our findings are particularly interesting in this population, 23,24 since thalamocortical network dysfunction, 25,26 thalamic microstructural changes, 27,28 and thalamic morphological abnormalities 29 have been recently demonstrated in individuals with migraine. Migraine is a disorder that is frequently clinically and radiographically mistaken for MS, 5,6 and previous studies have also suggested an increased risk of migraine in patients with MS. 30 In our MS + c cohort, 6/10 participants had migraine.…”

Section: Discussionmentioning

confidence: 62%

MRI evaluation of thalamic volume differentiates MS from common mimics

Solomon

Watts

Reich

2017

Neurol Neuroimmunol Neuroinflamm

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Objective:To determine whether MRI evaluation of thalamic volume differentiates MS from other disorders that cause MRI white matter abnormalities.Methods:There were 40 study participants: 10 participants with MS without additional comorbidities for white matter abnormalities (MS − c); 10 participants with MS with additional comorbidities for white matter abnormalities (MS + c); 10 participants with migraine, MRI white matter abnormalities, and no additional comorbidities for white matter abnormalities (Mig − c); and 10 participants previously incorrectly diagnosed with MS (Misdx). T1-magnetization-prepared rapid gradient-echo and T2-weighted three-dimensional fluid attenuation inversion recovery sequences were acquired on a Phillips Achieva d-Stream 3T MRI, and scans were randomly ordered and de-identified for a blinded reviewer who performed MRI segmentation using LesionTOADS.Results:Mean normalized thalamic volume differed among the 4 cohorts (analysis of variance, p = 0.005) and was smaller in the 20 MS participants compared with the 20 non-MS participants (p < 0.001), smaller in MS − c compared with Mig − c (p = 0.03), and smaller in MS + c compared with Misdx (p = 0.006). The sensitivity and specificity were both 0.75 for diagnosis of MS with a thalamic volume <0.0077.Conclusions:MRI volumetric evaluation of the thalamus, but not other deep gray-matter structures, differentiated MS from other diseases that cause white matter abnormalities and are often mistaken for MS. Evaluation for thalamic atrophy may improve accuracy for diagnosis of MS as an adjunct to additional radiologic criteria. Thalamic volumetric assessment by MRI in larger cohorts of patients undergoing evaluation for MS is needed, along with the development of automated and easily applied volumetric assessment tools for future clinical application.Classification of evidence:This study provides Class III evidence that MRI evaluation of thalamic volume differentiates MS from other diseases that cause white matter abnormalities.

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Section: Discussionmentioning

confidence: 62%

MRI evaluation of thalamic volume differentiates MS from common mimics

Solomon

Watts

Reich

2017

Neurol Neuroimmunol Neuroinflamm

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“…There are also studies that found no differences between migraine patients and healthy controls. These studies employed methods whole-brain such as TBSS [22,56], ROI-based analysis (ictal migraine) [57] and voxel-based whole brain comparison [58]. Interestingly, the trend when comparing AD values between EM and healthy controls is inverted when comparing CM and healthy controls or CM with respect to EM (Additional file 1: Figures S4 and S5).…”

Section: Discussionmentioning

confidence: 99%

White matter changes in chronic and episodic migraine: a diffusion tensor imaging study

et al. 2020

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Background: White matter alterations have been observed in patients with migraine. However, no microstructural white matter alterations have been found particularly in episodic or chronic migraine patients, and there is limited research focused on the comparison between these two groups of migraine patients. Methods: Fifty-one healthy controls, 55 episodic migraine patients and 57 chronic migraine patients were recruited and underwent brain T1-weighted and diffusion-weighted MRI acquisition. Using Tract-Based Spatial Statistics (TBSS), fractional anisotropy, mean diffusivity, radial diffusivity and axial diffusivity were compared between the different groups. On the one hand, all migraine patients were compared against healthy controls. On the other hand, patients from each migraine group were compared between them and also against healthy controls. Correlation analysis between clinical features (duration of migraine in years, time from onset of chronic migraine in months, where applicable, and headache and migraine frequency, where applicable) and Diffusion Tensor Imaging measures was performed. Results: Fifty healthy controls, 54 episodic migraine and 56 chronic migraine patients were finally included in the analysis. Significant decreased axial diffusivity (p < .05 false discovery rate and by number of contrasts corrected) was found in chronic migraine compared to episodic migraine in 38 white matter regions from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas. Significant positive correlation was found between time from onset of chronic migraine and mean fractional anisotropy in the bilateral external capsule, and negative correlation between time from onset of chronic migraine and mean radial diffusivity in the bilateral external capsule. Conclusions: These findings suggest global white matter structural differences between episodic migraine and chronic migraine. Patients with chronic migraine could present axonal integrity impairment in the first months of chronic migraine with respect to episodic migraine patients. White matter changes after the onset of chronic migraine might reflect a set of maladaptive plastic changes.

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“…The increased sensitivity is consistent with the reports of the cortex being hyperexcitable in migraine. [6][7][8][9][10] Further evidence of cortical hyper-excitability in migraine is based on the reduced thresholds for inducing phosphenes with stimulation methods, 29,30 the co-morbidity of migraine and epilepsy, and the use of anti-seizure medication 31 ). The increased ERP amplitude in migraine, however, was not consistently larger across the visual cortex compared to controls.…”

Section: Large and Large Chromaticity Separations For Individuals Wimentioning

confidence: 99%

Cortical Hyper‐Excitability in Migraine in Response to Chromatic Patterns

et al. 2019

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Objective Individuals with migraine exhibit heightened sensitivity to visual input that continues beyond their migraine episodes. However, the contribution of color to visual sensitivity, and how it relates to neural activity, has largely been unexplored in these individuals. Background Previously, it has been shown that, in non‐migraine individuals, patterns with greater chromaticity separation evoked greater cortical activity, regardless of hue, even when colors were isoluminant. Therefore, to investigate whether individuals with migraine experienced increased visual sensitivity, we compared the behavioral and neural responses to chromatic patterns of increasing separation in migraine and non‐migraine individuals. Methods Seventeen individuals with migraine (12 with aura) and 18 headache‐free controls viewed pairs of colored horizontal grating patterns that varied in chromaticity separation. Color pairs were either blue‐green, red‐green, or red‐blue. Participants rated the discomfort of the gratings and electroencephalogram was recorded simultaneously. Results Both groups showed increased discomfort ratings and larger N1/N2 event‐related potentials (ERPs) with greater chromaticity separation, which is consistent with increased cortical excitability. However, individuals with migraine rated gratings as being disproportionately uncomfortable and exhibited greater effects of chromaticity separation in ERP amplitude across occipital and parietal electrodes. Ratings of discomfort and ERPs were smaller in response to the blue‐green color pairs than the red‐green and red‐blue gratings, but this was to an equivalent degree across the 2 groups. Conclusions Together, these findings indicate that greater chromaticity separation increases neural excitation, and that this effect is heightened in migraine, consistent with the theory that hyper‐excitability of the visual system is a key signature of migraine.

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Thalamo-cortical network activity during spontaneous migraine attacks

Cited by 86 publications

References 41 publications

MRI evaluation of thalamic volume differentiates MS from common mimics

MRI evaluation of thalamic volume differentiates MS from common mimics

White matter changes in chronic and episodic migraine: a diffusion tensor imaging study

Cortical Hyper‐Excitability in Migraine in Response to Chromatic Patterns

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