Brain Metabolism and Structure in Chronic Migraine

Lai, Kuo-Lung; Niddam, David M.

doi:10.1007/s11916-020-00903-6

Cited by 8 publications

(8 citation statements)

References 48 publications

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“…3) [20,28]. These hyper-and hypoperfusion brain areas results both identi ed in our study showed consistency to previous results demonstrating the co-existed increasing and decreasing brain perfusion that could even happen in the same brain region in migraine patients [11,25,34,35]. Combing our results with present studies, it comes to an agreement that there exists perfusion abnormality on ASL in migraine patients.…”

Section: Discussionsupporting

confidence: 92%

“…The volume alteration of thalamus and its sub-regions in migraine were controversial, most recent study reported no volume alteration in thalamus in female MwA patients [32][33][34]. Reduced total N-acetyl-aspartate and total creatine in thalamus of chronic migraine patients were reported previously [35]. In a molecular imaging study, increased [11C] PBR28 was detected in thalamus indicating neural neuroin ammation in MwA [36].…”

Section: Discussionmentioning

confidence: 99%

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Cerebral blood flow alterations in migraine patients with and without aura: an arterial spin labeling study

Huang

Zhang

et al. 2022

Preprint

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Background Migraine aura is a transient, fully reversible visual, sensory, or other central nervous system symptom that classically precedes migraine headache. This study aimed to investigate cerebral blood flow (CBF) alterations of migraine with aura patients (MwA) and without aura patients (MwoA) during inter-ictal periods, using arterial spin labeling (ASL). Methods We evaluated 88 migraine patients (32 MwA) and 44 healthy control subjects (HC) who underwent a three-dimensional pseudo-continuous ASL MRI scanning. Voxel-based comparison of normalized CBF was conducted between MwA and MwoA. The relationship between CBF variation and clinical scale assessment was further analyzed. The mean CBF values in brain regions showed significant differences were calculated and considered as imaging features. Based on these features, support vector machine (SVM) models were established to differentiate MwA and MwoA under five-fold cross validation. The predictive ability of the SVM models was further tested in an independent sample of 30 migraine patients (10 MwA). Results In comparison to MwoA and HC, MwA exhibited higher CBF levels in the bilateral superior frontal gyrus, bilateral postcentral gyrus and cerebellum, and lower CBF levels in the bilateral middle frontal gyrus, thalamus and medioventral occipital cortex (all p values < 0.05). These variations were also significantly correlated with multiple clinical rating scales about headache severity, quality of life and emotion. On basis of these CBF features, the accuracies and areas under curve of the SVM models in the training and testing samples were 84.3% and 0.872, 83.3% and 0.860 in discriminating patients with and without aura, respectively. Conclusions In this study, CBF abnormalities of MwA were identified in multiple brain regions, which might help better understand migraine-stroke connection mechanisms and provide evidence for choosing optimal migraine-specific treatment to avoid aura-associated stroke.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Cerebral blood flow alterations in migraine patients with and without aura: an arterial spin labeling study

Huang

Zhang

et al. 2022

Preprint

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“…-all but one of the studies we found in international literature reported a significant association with insulin resistance for CM subjects, but not EM subjects (a summary of the studies investigating insulin sensitivity in migraine is provided in Table 5). Noteworthy is the study by Cavestro et al, 2007, as it demonstrated that migraineurs with an average of 12.1 attacks per month, i.e., on the borderline between EM and CM, had a higher incidence of both increased sensitivity to insulin and insulin resistance than the control group [32]; brain mitochondrial dysfunction [77,179], decrease in grey matter volume in specific -areas [117,225,236,39], impaired brain glucose metabolism [143] and neuroinflammation are main features of chronic migraine which could be caused, at least in part, by brain insulin resistance [210,10,234,155]; -insulin resistance may well be a pivotal pathophysiological feature, linking migraine with its major comorbidities: obesity, depression and cerebrovascular diseases; -brain insulin resistance may be a pathophysiological mechanism behind migraineurs' increased risk of developing dementia, especially those with aura (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Migraine, Brain Glucose Metabolism and the “Neuroenergetic” Hypothesis: A Scoping Review

Moro¹,

Rota

Pirovano³

et al. 2022

The Journal of Pain

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“…Several magnetic resonance spectroscopy studies highlight that the brains of migraine subjects are consistently in an energy deficit compared with those of healthy subjects [ 57 , 58 ].…”

Section: Mechanisms Of Action Of Kd In Treating Headachementioning

confidence: 99%

Applications of Ketogenic Diets in Patients with Headache: Clinical Recommendations

et al. 2021

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Headaches are among the most prevalent and disabling neurologic disorders and there are several unmet needs as current pharmacological options are inadequate in treating patients with chronic headache, and a growing interest focuses on nutritional approaches as non-pharmacological treatments. Among these, the largest body of evidence supports the use of the ketogenic diet (KD). Exactly 100 years ago, KD was first used to treat drug-resistant epilepsy, but subsequent applications of this diet also involved other neurological disorders. Evidence of KD effectiveness in migraine emerged in 1928, but in the last several year’s different groups of researchers and clinicians began utilizing this therapeutic option to treat patients with drug-resistant migraine, cluster headache, and/or headache comorbid with metabolic syndrome. Here we describe the existing evidence supporting the potential benefits of KDs in the management of headaches, explore the potential mechanisms of action involved in the efficacy in-depth, and synthesize results of working meetings of an Italian panel of experts on this topic. The aim of the working group was to create a clinical recommendation on indications and optimal clinical practice to treat patients with headaches using KDs. The results we present here are designed to advance the knowledge and application of KDs in the treatment of headaches.

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Brain Metabolism and Structure in Chronic Migraine

Cited by 8 publications

References 48 publications

Cerebral blood flow alterations in migraine patients with and without aura: an arterial spin labeling study

Cerebral blood flow alterations in migraine patients with and without aura: an arterial spin labeling study

Migraine, Brain Glucose Metabolism and the “Neuroenergetic” Hypothesis: A Scoping Review

Applications of Ketogenic Diets in Patients with Headache: Clinical Recommendations

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