Functional and structural alterations in the migraine cerebellum

Mehnert, Jan; May, Arne

doi:10.1177/0271678x17722109

Cited by 105 publications

(117 citation statements)

References 60 publications

Supporting

Mentioning

107

Contrasting

Order By: Relevance

“…Furthermore, activity in the posterior part of the cerebellum, namely crus I and II, has also shown a sensitive dependence on the phase of the migraine cycle, i.e. on the proximity to a migraine attack . Those authors postulated an abnormally decreased inhibitory involvement of the cerebellum on gating and evaluation of trigeminal nociception in the migrainous brain, a hypothesis which is in line with previous findings from transcranial magnetic stimulation experiments .…”

Section: Discussionsupporting

confidence: 75%

Postural instability during attacks of migraine without aura

Anagnostou

Gerakoulis

Voskou

et al. 2018

Euro J of Neurology

View full text Add to dashboard Cite

Background and purpose Migraine has long been associated with unsteadiness and dizziness but postural control has not been studied in the ictal state. Here, the stability of upright stance during migraine attacks was measured. Methods Static balance was assessed prospectively in migraine patients (n = 30) during quiet stance for 40 s on a posturographic force platform. Recordings were performed both ictally and in the pain‐free interval. Subjects were assessed under four different conditions yielding different visual and proprioceptive feedback environments. Both ictal and interictal data were compared with age‐matched healthy controls (n = 30). Results Postural instability increased significantly under all experimental conditions during migraine attacks. Whilst standing on a foam pad with eyes closed, median sway area was 353 mm2 in control subjects, 318 mm2 in migraineurs in the pain‐free period and 618 mm2 in the ictal state. However, Romberg and vestibular Romberg quotients were not altered during migraine attacks. Spectral analyses of postural sway also showed similar profiles in migraineurs and controls. The severity of headache was inversely correlated to Romberg quotients. Conclusions The demonstrated pattern of balance disorder during migraine attacks suggests a transient cerebellar dysfunction. Our findings also indicate that intense headache induces a re‐weighting of sensory processing toward less dependence on visual and proprioceptive information.

show abstract

Section: Discussionsupporting

confidence: 75%

Postural instability during attacks of migraine without aura

Anagnostou

Gerakoulis

Voskou

et al. 2018

Euro J of Neurology

View full text Add to dashboard Cite

show abstract

“…Functional connectivity was decreased between the cerebellum and the thalamus, occipital areas, and fusiformis gyrus, respectively, during trigeminal nociception in patients with migraine. The authors thus suggested a decreased inhibitory control of cerebellum on gating and nociceptive processing [37].…”

Section: Discussionmentioning

confidence: 97%

“…One study showed decreased cerebellar volume in patients with low frequency episodic migraine (mean monthly headache days = 4.7) [36]. Another study enrolled most patients with CM (episodic/chronic migraine: 8/46) showed increased GMV of the right cerebellar hemisphere, and the GMV increase was associated with a lower headache frequency and a shorter disease duration [37]. Our study in patients with HFM, in accordance with the latter one, also demonstrated a volume increase of the right cerebellar hemisphere, which correlated with higher disability (the MIDAS score).…”

Section: Discussionmentioning

confidence: 99%

The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine

Liu

Lee

Chou

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The increase of headache frequency is associated with higher headache related disability and lower quality of life in patients with migraine. However, the pathophysiology of migraine progression, persistence, or remission is elusive. The purpose of this study is to identify the brain signatures that are predictive of the long-term outcomes among patients with high-frequency migraine (HFM: 10–30 headache days/month). Methods: We prospectively enrolled patients with HFM and healthy controls and collected their baseline clinical profiles and brain-MRI data at first visit. We longitudinally followed the patients and determined their outcomes at 2-year follow-up. Good outcome was defined as ≥ 50% reduction of baseline headache days and poor outcome was defined as reduction < 50% or frequency increase. Voxel-based morphometry was used to study gray matter volume (GMV), and structural covariance was used to investigate structural connectivity. Results: Among 56 patients with HFM, 37 had good outcome and 19 poor outcome. Compared to the healthy controls (n = 37), patients with poor outcome had decreased GMV over the left posterior cingulate gyrus, and increased GMV over the bilateral cerebellum and the right precentral gyrus. Further, patients with poor outcome had greater GMV over the right and the left cerebella compared to patients with good outcome, and the GMVs of the cerebella were correlated to 2-year headache frequencies (right: r = 0.38, P = 0.005; left: r = 0.35, P = 0.009). Structural connectivity were increased between the cerebellum and the cuneus, the calcarine cortex, and the temporal lobe, respectively, in patients with poor outcome, and was decreased between the cerebellum and the prefrontal cortex in patients with poor outcome. The structural covariance integrities between the right cerebellum and the right cuneus were correlated to 2-year headache frequencies (r = 0.36, P = 0.008). Conclusions: Structural volume and connectivity changes of the cerebellum may underlie headache persistence in patients with HFM.

show abstract

“…Previous studies have shown that cerebellar inhibition is reduced in migraineurs, but the mechanism remains obscure (Brighina et al, 2009;Mehnert and May, 2019). In the animal studies reported here, an acute migraine model was established by electrically stimulating the trigeminal ganglia in the rat.…”

Section: Discussionmentioning

confidence: 99%