Functional connectivity of hypothalamus in chronic migraine with medication overuse

Lerebours, Fleur; Boulanouar, Kader; Barége, Michèle; Denuelle, Marie; Bonneville, Fabrice; Payoux, Pierre; Larrue, Vincent; Fabre, Nelly

doi:10.1177/0333102419833087

Cited by 33 publications

(30 citation statements)

References 23 publications

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“…The posterior part of the hypothalamus seems to be involved in the acute pain stage, while the anterior part seems to be involved in the attack generation and preictal phase and also migraine frequency, suggesting that it plays an important role in chronification [153]. This is supported by the fact that there is an increased connectivity between the anterior hypothalamus and spinal trigeminal nucleus in the CM compared to the episodic group [154]. A study that have compared EM and CM patients using resting state technique, points to stronger connectivity in the pain matrix of CM patients that might play a role in migraine chronification [155].…”

Section: Neuroimagingmentioning

confidence: 92%

From transformation to chronification of migraine: pathophysiological and clinical aspects

Torres‐Ferrús¹,

Ursitti

Alpuente³

et al. 2020

J Headache Pain

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Chronic migraine is a neurological disorder characterized by 15 or more headache days per month of which at least 8 days show typical migraine features. The process that describes the development from episodic migraine into chronic migraine is commonly referred to as migraine transformation or chronification. Ample studies have attempted to identify factors associated with migraine transformation from different perspectives. Understanding CM as a pathological brain state with trigeminovascular participation where biological changes occur, we have completed a comprehensive review on the clinical, epidemiological, genetic, molecular, structural, functional, physiological and preclinical evidence available.

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Section: Neuroimagingmentioning

confidence: 92%

From transformation to chronification of migraine: pathophysiological and clinical aspects

Torres‐Ferrús¹,

Ursitti

Alpuente³

et al. 2020

J Headache Pain

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“…Different regions of the hypothalamus seem be involved in the onset of the migraine attack and in migraine chronification. Chronic migraine patients with and without medication overuse showed a selective increased activity of the anterior hypothalamus during trigeminal painful stimulation (22) and in a rest condition (16,19), compared to controls and patients with episodic migraine. Thus, suggesting that the anterior hypothalamus plays a crucial role in the pathophysiology of chronic migraine.…”

Section: Imaging the Migraine "Generators" In Chronic Migrainementioning

confidence: 96%

The Chronic Migraine Brain: What Have We Learned From Neuroimaging?

Filippi

Messina

2020

Front. Neurol.

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Chronic migraine is a highly disabling disease with a great impact on socioeconomic functioning and quality of life of migraine patients. Chronic migraine usually evolves from episodic migraine that gradually increases in attack frequency, supporting the view of migraine as a spectrum disorder. Pathophysiological mechanisms responsible for migraine chronification are not fully understood. Likewise episodic migraine, chronic migraine patients show widespread functional and structural alterations of cortical and subcortical pain-related brain areas. However, chronic migraine patients experience a more pronounced dysfunction of the pain inhibitory network and an increased sensitization of the central pain pathways, which might explain the higher susceptibility to migraine attacks. Imaging studies have highlighted that brain regions with a key role in migraine attack generation, like the pons and hypothalamus, might also be involved in migraine chronification. Whether brain alterations are biomarkers that predispose migraine patients to chronification or reflect adaptive or maladaptive responses to the increasing headache frequency is still a matter of debate. The central mechanisms of action of chronic migraine preventive treatments and imaging biomarkers that could predict patients' treatment response have also been explored. In this new era of migraine treatments, a better understanding of chronic migraine pathophysiology will pave the way for the development of new improved treatments specifically designed for chronic migraine patients.

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“…With the help of modern neuroimaging, some recent studies have supported the historical view 24 of the hypothalamus as a cerebral structure playing a pivotal role in the recurrence of migraine attacks, its anterior part showing increased neural activity up to 48 h before an attack, in a time period when premonitory symptoms may occur [1][2][3] . Hypothalamic activation has also been described during the chronic daily or almost daily presentation of migraine attacks, especially in its anterior part when migraine is chronic, and its posterior region during headaches 6,7,25 . Volume of the posterior hypothalamic regions in voxel-based morphometry processing was found lower in episodic migraine patients when compared with controls 26 .…”

Section: Discussionmentioning

confidence: 99%

Hypothalamic structural integrity and temporal complexity of cortical information processing at rest in migraine without aura patients between attacks

Porcaro

Renzo

Tinelli

et al. 2021

Sci Rep

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The hypothalamus has been attributed an important role during the premonitory phase of a migraine attack. Less is known about the role played by the hypothalamus in the interictal period and its relationship with the putative neurocognitive networks previously identified in the pathophysiology of migraine. Our aim was to test whether the hypothalamic microstructure would be altered during the interictal period and whether this co-existed with aberrant connectivity at cortical level. We collected multimodal MRI data from 20 untreated patients with migraine without aura between attacks (MO) and 20 healthy controls (HC) and studied fractional anisotropy, mean (MD), radial (RD), and axial diffusivity of the hypothalamus ROI as a whole from diffusion tensor imaging (DTI). Moreover, we performed an exploratory analysis of the same DTI metrics separately for the anterior and posterior hypothalamic ROIs bilaterally. From resting-state functional MRI, we estimated the Higuchi’s fractal dimension (FD), an index of temporal complexity sensible to describe non-periodic patterns characterizing BOLD signature. Finally, we correlated neuroimaging findings with migraine clinical features. In comparison to HC, MO had significantly higher MD, AD, and RD values within the hypothalamus. These findings were confirmed also in the exploratory analysis on the sub-regions of the hypothalamus bilaterally, with the addition of lower FA values on the posterior ROIs. Patients showed higher FD values within the salience network (SN) and the cerebellum, and lower FD values within the primary visual (PV) network compared to HC. We found a positive correlation between cerebellar and SN FD values and severity of migraine. Our findings of hypothalamic abnormalities between migraine attacks may form part of the neuroanatomical substrate that predisposes the onset of the prodromal phase and, therefore, the initiation of an attack. The peculiar fractal dimensionality we found in PV, SN, and cerebellum may be interpreted as an expression of abnormal efficiency demand of brain networks devoted to the integration of sensory, emotional, and cognitive information related to the severity of migraine.

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Functional connectivity of hypothalamus in chronic migraine with medication overuse

Cited by 33 publications

References 23 publications

From transformation to chronification of migraine: pathophysiological and clinical aspects

From transformation to chronification of migraine: pathophysiological and clinical aspects

The Chronic Migraine Brain: What Have We Learned From Neuroimaging?

Hypothalamic structural integrity and temporal complexity of cortical information processing at rest in migraine without aura patients between attacks

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