Hippocampus and amygdala volume in relation to migraine frequency and prognosis

Liu, Hung Yu; Chou, Kun Hsien; Lee, Pei-Lin; Fuh, Jong Ling; Niddam, David M.; Lai, Kuo-Lung; Hsiao, Fu Jung; Lin, Yung Yang; Chen, Wei Ta; Wang, Shuu Jiun; Lin, Ching Po

doi:10.1177/0333102416678624

Cited by 68 publications

(66 citation statements)

References 35 publications

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“…Few neuroimaging studies have explored brain signatures of migraine prognosis. Our previous studies have shown that the volumes of the right hippocampus and the orbitofrontal cortex are associated with headache outcomes in patients with migraine and patients with CM with medication overuse, respectively [16,38]. The current study showed the posterior lobe of cerebellum was associated with long-term migraine prognosis, specifically in patients with HFM without medication overuse.…”

Section: Discussionsupporting

confidence: 52%

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

Liu

Lee

Chou

et al. 2020

Preprint

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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.

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Section: Discussionsupporting

confidence: 52%

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

Liu

Lee

Chou

et al. 2020

Preprint

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“…Specifically, Borsook et al found less hippocampal volume in high‐frequency episodic migraine patients who had on average 8‐14 headache days per month relative to low‐frequency migraine patients who had on average 1‐2 headache days per month . Liu et al reported that fluctuations of hippocampal volume were associated with the frequency of migraine attacks and reported that in migraine patients, there was a positive association between right hippocampal volume and good 2‐year headache outcome (>50% reduction of headache frequency). Less hippocampal volume has also been reported in patients with myofascial pain and fibromyalgia relative to healthy control cohorts .…”

Section: Discussionmentioning

confidence: 99%

“…Mounting evidence from structural and functional neuroimaging studies of migraine indicate alterations in a broad network of brain regions associated with pain processing, including several studies that have shown alterations in the hippocampus. [1][2][3][4] However, the relationship between the hippocampus with other brain regions involved in pain processing and the precise role of the hippocampus in the pathophysiology of migraine remain insufficiently understood. One way of interrogating intrinsic brain connectivity is to investigate how brain regions co-vary with one another in size, or in function.…”

mentioning

confidence: 99%

Structural Co‐Variance Patterns in Migraine: A Cross‐Sectional Study Exploring the Role of the Hippocampus

2017

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Objective To interrogate hippocampal morphology and structural co-variance patterns in migraine patients and to investigate whether structural co-variance patterns relate to migraine disease characteristics. Background Migraine is associated with structural alterations in widespread cortical and subcortical regions associated with the sensory, cognitive, and affective components of pain processing. Recent studies have shown that migraine patients have differences in hippocampal structure and function relative to healthy control subjects, but whether hippocampal structure relates to disease characteristics including frequency of attacks, years lived with migraine and symptoms of allodynia remains unknown. Furthermore, this study investigated hippocampal volume co-variance patterns in migraineurs, an indirect measure of brain network connectivity. Here, we explore differences in hippocampal volume and structural co-variance patterns in migraine patients relative to healthy controls and examine whether these hippocampal measures relate to migraine disease burden. Methods This study included 61 migraine patients and 57 healthy control subjects (healthy controls: median age=34.0, IQR=19.0; migraine patients: median age=35.0, IQR=17.5; p=0.65). Regional brain volumes were automatically calculated using FreeSurfer version 5.3. Symptoms of allodynia were determined using the Allodynia Symptom Checklist 12 (ASC-12). Structural covariance patterns were interrogated using pairwise correlations and group differences in correlation strength were estimated using Euclidian distance. A stepwise regression was used to investigate the relationship between structural co-variance patterns with migraine burden. Results Migraine patients had less left hippocampal volume (healthy controls: left hippocampal volume = 4276.8mm3, SD= 425.3mm3, migraine patients: left hippocampal volume= 4089.5mm3, SD= 453.9mm3, p= 0.02) and less total (right plus left) hippocampal volume (healthy controls: total hippocampal volume= 8690.8mm3, SD= 855.1mm3; migraine patients: total hippocampal volume= 8341.8mm3, SD=917.9mm3; p= 0.03) compared to healthy controls. Migraineurs had stronger structural covariance between the hippocampi and cortico-limbic regions in the frontal lobe (inferior opercular gyrus), temporal lobe (planum temporale, amygdala), parietal lobe (angular gyrus, precuneus,) and the cerebellar white matter. Results of a stepwise regression showed that hippocampal volumes and the interactions between hippocampal volumes with the volumes of other cortico-limbic regions associate with migraine-related allodynia but not with headache frequency or years lived with migraine. Conclusion Migraineurs have less hippocampal volume and stronger hippocampal-cortico-limbic connectivity compared to healthy controls. Hippocampal volumes and measures of hippocampal volume connectivity with other cortico-limbic network regions associate with symptoms of allodynia.

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“…Of note, 32 of 56 patients with HFM and 29 of 37 HC in this study were also included in a dataset that was recently used to analyze hippocampal volume changes in patients with migraine [16]; these patients underwent the first acquisition pulse sequence, whereas the rest and the HC underwent the second acquisition pulse sequence.…”

Section: Mri Data Acquisitionmentioning

confidence: 99%

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

Liu

Lee²,

Chou³

et al. 2020

J Headache Pain

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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

Hippocampus and amygdala volume in relation to migraine frequency and prognosis

Cited by 68 publications

References 35 publications

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

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

Structural Co‐Variance Patterns in Migraine: A Cross‐Sectional Study Exploring the Role of the Hippocampus

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

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