Hypoechogenicity of brainstem raphe nuclei is associated with increased attack frequency in episodic migraine

Ayzenberg, Ilya; Nastos, Ilias; Straßburger-Krogias, Katrin; Obermann, Mark; Gold, Ralf; Krogias, Christos

doi:10.1177/0333102415617415

Cited by 17 publications

(30 citation statements)

References 35 publications

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“…Besides, MRN is also an important brain region in the human ascending arousal system, which is related with consciousness maintenance and its disorders such as fatigue and sleep disturbance [28]. In migraine patients, recent transcranial sonography studies reported that a hypoechogenic MRN correlated to a higher migraine attack frequency [46] and depression [47]. MRN is the main source of 5-hydroxytryptamine (5-HT, also known as serotonin) in the brain [48].…”

Section: Discussionmentioning

confidence: 99%

Concurrent brain structural and functional alterations in patients with migraine without aura: an fMRI study

Zhou

Lan

et al. 2020

J Headache Pain

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Objectives To explore the possible concurrent brain functional and structural alterations in patients with migraine without aura (MwoA) patients compared to healthy subjects (HS). Methods Seventy-two MwoA patients and forty-six HS were recruited. 3D-T1 and resting state fMRI data were collected during the interictal period for MwoA and HS. Voxel-based morphometry (VBM) for structure analysis and regional homogeneity (Reho) for fMRI analysis were applied. The VBM and Reho maps were overlapped to determine a possible brain region with concurrent functional and structural alteration in MwoA patients. Further analysis of resting state functional connectivity (FC) alteration was applied with this brain region as the seed. Results Compared with HS, MwoA patients showed decreased volume in the bilateral superior and inferior colliculus, periaqueductal gray matter (PAG), locus ceruleus, median raphe nuclei (MRN) and dorsal pons medulla junction. MwoA patients showed decreased Reho values in the middle occipital gyrus and inferior occipital gyrus, and increased Reho values in the MRN. Only a region in the MRN showed both structural and functional alteration in MwoA patients. Pearson correlation analysis showed that there was no association between volume or Reho values of the MRN and headache frequency, headache intensity, disease duration, self-rating anxiety scale or self-rating depression scale in MwoA patients. Resting state functional connectivity (FC) with the MRN as the seed showed that MwoA patients had increased FC between the MRN and PAG. Conclusions MRN are involved in the pathophysiology of migraine during the interictal period. This study may help to better understand the migraine symptoms. Trial registration NCT01152632. Registered 27 June 2010.

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Section: Discussionmentioning

confidence: 99%

Concurrent brain structural and functional alterations in patients with migraine without aura: an fMRI study

Zhou

Lan

et al. 2020

J Headache Pain

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“…Hamerla et al found that reduced BR echogenicity was more often in migraine patients than in healthy controls, and proposed that this finding may be a reflection of an alteration of the serotonergic raphe nuclei [15]. In another brain sonography study, the occurrence rate of BR hypoechogenicity did not differ between migraineurs and healthy subjects, but associated with higher headache attack frequency [14]. Whereas, neither the increased occurrence rate of BR hypoechogenicity in migraineurs compared with healthy control nor the association of BR hypoechogenicity with migraine headache attack frequency was found in current study.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, growing evidences indicate that comorbid depression is a risk factor for chronification of migraine and development of medication overuse headache [13]. But, up to date, it has never been reported about the association of BR alterations in TCS with depression in migraineurs, though BR hypoechogenicity has been shown to be correlated to higher headache attack frequency in migraineurs without depression in one study [14] but not in another one study [15].…”

Section: Introductionmentioning

confidence: 99%

Hypoechogenicity of brainstem raphe correlates with depression in migraine patients

et al. 2019

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BackgroundBrainstem raphe (BR) hypoechogenicity in transcranial sonography (TCS) has been depicted in patients with major depression (MD) and in depressed patients with different neurodegenerative diseases. But, up to date, the association of BR alterations in TCS with depression in migraineurs has never been reported. This study was to investigate the possible role of BR examination via TCS in migraineurs with depression.MethodsForty two migraine without aura (MwoA) patients and 40 healthy controls were recruited. Echogenicity of lentiform nuclei (LN), caudate nuclei (CN), substantia nigra (SN) and brainstem raphe (BR) and width of the frontal horns of the lateral ventricles and the third ventricle were assessed with TCS. The diagnosis of depression was based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV (DSM –IV), and the severity of depression was measured by Hamilton Rating Scale for Depression (HAM-D) and Hospital Anxiety and Depression Scale depression subscale (HADS-D).ResultsThere were no significant differences between migraineurs and controls in the width of frontal horn of the lateral ventricle (p = 0.955), width of third ventricle (p = 0.129) as well as in the echogenicity of SN (p = 0.942), CN (p = 0.053), LN (p = 0.052) and BR (p = 0.677). Here, it seems that more migraineurs were detected with increased echogenecity of CN and LN compared with controls (33.3% versus 15.0% for CN, 19.0% versus 5.0% for LN) though they had no statistical significance. Patients with hypoechogenic BR had significantly higher HAM-D and HADS-D scores than those with normal BR signal (p = 0.000 for both HAM-D and HADS-D), and most (83.33%) migraineurs with depression exhibited hypoechogenic raphe but none (0.00%) of the migraineurs without depression exhibited hypoechogenic raphe (p = 0.000).ConlusionsTCS signal alteration of BR can be a biomarker for depression in migraine but it is not associated with migraine headache itself. LN and CN alterations in TCS may reflect a potential role of them in the pathogenesis of migraine, which needs to be further elucidated.

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“…Besides, MRN is also an important brain region in the human ascending arousal system, which is related with consciousness maintenance and its disorders such as fatigue and sleep disturbance [24]. In migraine patients, recent transcranial sonography studies reported that a hypoechogenic MRN correlated to a higher migraine attack frequency [42] and depression [43]. MRN is the main source of 5-hydroxytryptamine (5-HT, also known as serotonin) in the brain [44].…”

Section: Discussionmentioning

confidence: 99%

“…Serotonin receptors have been found on the trigeminal nerve and cranial vessels and their agonists especially triptans are effective in migraine treatment [47]. Although there is a growing body of evidence for a direct role for dysfunctions of central 5-HT and MRN availability in migraine, the exact and speci c action of endogenous 5-HT system and MRN in migraine continues to be the focus of active investigation [42,43,48].…”

Section: Discussionmentioning

confidence: 99%

Concurrent Brain Structural and Functional Alterations in Patients with Migraine without Aura: An fMRI Study

Zhou

Lan

et al. 2020

Preprint

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Objectives: To explore the possible concurrent brain functional and structural alterations in patients with migraine without aura (MwoA) patients compared to healthy subjects (HS). Methods: Seventy-two MwoA patients and forty-six HS were recruited. 3D-T1 and resting state fMRI data were collected during the interictal period for MwoA and HS. Voxel-based morphometry (VBM) for structure analysis and regional homogeneity (Reho) for fMRI analysis were applied. The VBM and Reho maps were overlapped to determine a possible brain region with concurrent functional and structural alteration in MwoA patients. Further analysis of resting state functional connectivity (FC) alteration was applied with this brain region as the seed.Results: Compared with HS, MwoA patients showed decreased volume in the bilateral superior and inferior colliculus, periaqueductal gray matter (PAG), locus ceruleus, median raphe nuclei (MRN) and dorsal pons medulla junction. MwoA patients showed decreased Reho values in the middle occipital gyrus and inferior occipital gyrus, and increased Reho values in the MRN. Only a region in the MRN showed both structural and functional alteration in MwoA patients. Pearson correlation analysis showed that there was no association between volume or Reho values of the MRN and headache frequency, headache intensity, disease duration, self-rating anxiety scale or self-rating depression scale in MwoA patients. Resting state functional connectivity (FC) with the MRN as the seed showed that MwoA patients had increased FC between the MRN and PAG.Conclusions: MRN are involved in the pathophysiology of migraine during the interictal period. This study may help to better understand the migraine symptoms.Trial registration: NCT01152632. Registered 27 June 2010.

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Hypoechogenicity of brainstem raphe nuclei is associated with increased attack frequency in episodic migraine

Abstract: Sonographic findings did not differ between migraine patients and controls. Hypoechogenic BRN correlated to a higher migraine attack frequency, probably indicating more severe disease activity.

Cited by 17 publications

References 35 publications

Concurrent brain structural and functional alterations in patients with migraine without aura: an fMRI study

Concurrent brain structural and functional alterations in patients with migraine without aura: an fMRI study

Hypoechogenicity of brainstem raphe correlates with depression in migraine patients

Concurrent Brain Structural and Functional Alterations in Patients with Migraine without Aura: An fMRI Study

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