Common hippocampal structural and functional changes in migraine

Abstract

The hippocampus is classically involved in memory consolidation, spatial navigation and is involved in the stress response. Migraine is an episodic disorder characterized by intermittent attacks with a number of physiological and emotional stressors associated with or provoking each attack. Given that migraine attacks can be viewed as repeated stressors, alterations in hippocampal function and structure may play an important role in migraine pathophysiology. Using high-resolution magnetic resonance imaging, hippocampal morphometric and functional differences (in response to noxious heat stimulation) were compared in age and gender-matched acute episodic migraineurs with high (HF) versus low (LF) frequency of migraine attacks. Morphometric results were compared with age and gender-matched healthy control (HC) cohort. Significant larger bilateral hippocampal volume was found in LF group relative to the HF and HC groups suggestive of an initial adaptive plasticity that may then become dysfunctional with increased frequency. Functional correlates of greater deactivation (LF > HF) in the same hippocampal regions in response to noxious stimulation was also accompanied by overall reduction in functional connectivity of the hippocampus with other brain regions involved in pain processing in the HF group. The results implicate involvement of hippocampus in the pathophysiology of the migraine.

Reorganization of hippocampal functional connectivity with transition to chronic back pain

“…A myriad of behavioral changes observed in chronic pain patients, including elevated anxiety and depression (Gore et al 2012), problems in emotional decision making (Apkarian et al 2004;Gupta et al 2009), spatial working memory deficits (Abrahams et al 1999;Dick and Rashiq 2007;Kim et al 2012), and difficulty in classical conditioning tasks (Flor et al 2002), suggest abnormal hippocampal physiology in chronic pain. Indeed, some hippocampal functional changes have recently been identified in migraine pain (Maleki et al 2013), but investigations of hippocampal functional properties in the transition to chronic pain are completely absent.…”

Effects of long-term acupuncture treatment on resting-state brain activity in migraine patients: A randomized controlled trial on active acupoints and inactive acupoints

“…Based on our results, we detected that a long course of acupuncture treatment on active acupoints affected the hippocampus, which is associated with cognitive components of pain processing, as well as a major component of the human brain that links affective states with memory processing. The hippocampus was described as having increased gray matter volume in patients suffering chronic pain in a meta-analysis [47], and this was confirmed in a recent migraine study [6]. It seems to frequently participate in the central effects of acupuncture.…”

“…Migraine has attracted more and more attention worldwide as a public health issue because of its high prevalence, frequent attack history, significant medical burden, and a serious reduction in quality of life (QOL) and productivity [2,3]. Although the exact mechanism of migraine is still unclear, there is plenty of neuroimaging evidence showing that migraine is a central nervous system disorder [4][5][6]. Our research group involving migraine without aura patients showed that abnormal structure and function was possibly associated with an impaired pain processing and modulatory process, such as in the anterior cingulate cortex (ACC), insula, basal ganglia, thalamus, supplementary motor area (SMA), prefrontal cortex, etc.…”

Low-to-Moderate Alcohol Consumption is Associated With Hippocampal Volume in Fibromyalgia and Insomnia

“…In addition, we recently reported results of a structural analysis indicating lower hippocampal volume bilaterally in a mixed cohort of patients with fibromyalgia and fibromyalgia with comorbid insomnia (McCrae et al, 2015). However, not all authors have replicated these results in insomnia (Winkelman et al, 2010) or other pain-related conditions such as frequent migraines (Maleki et al, 2013) and osteoarthritis (Mutso et al, 2012). Furthermore, to our knowledge, no studies have addressed the potential impact of comorbid insomnia on hippocampal structure in patients with chronic musculoskeletal pain.…”