Reduced functional connectivity between salience and visual networks in migraine with aura

Niddam, David M.; Lai, Kuo-Lung; Fuh, Jong Ling; Chuang, Chih Ying; Chen, Wei Ta; Wang, Shuu Jiun

doi:10.1177/0333102415583144

Cited by 80 publications

(74 citation statements)

References 48 publications

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“…The NTS is known to send monosynaptic projections to higher brain regions such as the parabrachial nucleus, ventromedial medulla, periaqueductal gray, anterior cingulate and lateral prefrontal cortex [8; 64] - regions hypothesized to support VNS therapeutic effects [81]. Altered connectivity in these pain-processing regions has been noted in interictal migraine patients [25; 29; 55; 67; 79]. Abnormalities in insula connectivity are of particular relevance, given that this region integrates multimodal afference from somatosensory, nociceptive and visceral streams with activity in prefrontal cortex, limbic structures, and olfactory, visual and auditory processing regions [11].…”

Section: Discussionmentioning

confidence: 99%

Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation in migraine patients

García

Lin

Lee

et al. 2017

Pain

117

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Migraine pathophysiology includes altered brainstem excitability, and recent neuromodulatory approaches aimed at controlling migraine episodes have targeted key brainstem relay and modulatory nuclei. In this study, we evaluated the impact of respiratory-gated auricular vagal afferent nerve stimulation (RAVANS), a novel neuromodulatory intervention based on an existing transcutaneous Vagus Nerve Stimulation approach, in the modulation of brainstem activity and connectivity in migraine patients. We applied 3T-functional magnetic resonance imaging with improved in-plane spatial resolution (2.62×2.62 mm) in episodic migraine (interictal) and age- and sex-matched healthy controls to evaluate brain response to RAVANS (gated to either inhalation or exhalation) and sham stimulation. We further investigated RAVANS modulation of tactile trigeminal sensory afference response in the brainstem using air-puff stimulation directed to the forehead during functional magnetic resonance imaging. Compared to sham and inhalatory-gated RAVANS (iRAVANS), exhalatory-gated RAVANS (eRAVANS) activated an ipsilateral pontomedullary region consistent with nucleus tractus solitarii (NTS). During eRAVANS, NTS connectivity was increased to anterior insula and anterior mid-cingulate cortex, compared to both sham and iRAVANS, in migraine patients. Increased connectivity was inversely correlated with relative time to the next migraine attack, suggesting clinical relevance to this change in connectivity. Post-stimulation effects were also noted immediately following eRAVANS, as we found increased activation in putative pontine serotonergic (i.e. nucleus raphe centralis) and noradrenergic (i.e. locus coeruleus) nuclei in response to trigeminal sensory afference. Regulation of activity and connectivity of brainstem and cortical regions involved in serotonergic and noradrenergic regulation and pain modulation may constitute an underlying mechanism supporting beneficial clinical outcomes for eRAVANS applied for episodic migraine.

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Section: Discussionmentioning

confidence: 99%

Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation in migraine patients

García

Lin

Lee

et al. 2017

Pain

117

View full text Add to dashboard Cite

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“…Similarly, a number of recent rs-fc MRI studies have indicated abnormal fc within the salience network, a core resting-state network that includes paralimbic-limbic regions believed to play a role in the detection of stimuli and the allocation of attentional resources. Rs-fc results indicate heightened connectivity within the salience network in migraineurs without aura [68] and reduced functional connectivity between the salience and the visual networks in migraine patients with aura [69].…”

Section: Attention/cognition Deficits In Migraine: An Ongoing Debatementioning

confidence: 92%

Migraine: What Imaging Reveals

Chong

Schwedt

Dodick

2016

Curr Neurol Neurosci Rep

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Although migraine symptomatology is well-defined, our understanding of migraine pathophysiology is incomplete. Structural and functional brain imaging can contribute to a greater understanding of migraine pathophysiology. Recent neuroimaging studies demonstrate that migraine is associated with structural and functional alterations of brain regions commonly implicated in pain processing. This review summarizes recent brain structural and functional imaging findings in migraine and highlights those that are associated with characteristics such as the presence or absence of aura, associated cognitive dysfunction, sex-differences (male vs. female migraineurs), age, and disease burden.

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“…We can expect that the reporting of premonitory symptomatology is going to be different in the paediatric population, depending on age and cognition, and because of dependence on a third party history and assessment for the symptoms through a parent, teacher or carer. Additionally, features such as face changes may be caused by pallor or facial swelling, flushing or sweating, which we would interpret as cranial autonomic features [30••]. There is of course the possibility that face changes could be related to irritability and low mood.…”

Section: Introductionmentioning

confidence: 99%

“…These have included cranial allodynia, cranial autonomic symptoms such as nasal stuffiness and flushing, as well as facial pallor to name a few [30••]. Additionally, data analysis from retrospective studies does not allow true estimation of the population prevalence of premonitory symptoms as the study data collection populations from all the studies are so varied, and apart from the Giffin and Quintela studies, the studies do not look at the reproducibility of these symptoms across serial attacks [14, 15].…”

Section: Introductionmentioning

confidence: 99%

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Premonitory Symptoms of Migraine in Childhood and Adolescence

Karsan

Prabhakar

Goadsby

2017

Curr Pain Headache Rep

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Purpose of ReviewPremonitory symptoms in migraine; symptoms occurring before the onset of migraine pain or aura, are an increasingly recognised area of interest within headache research. It has been recently documented in the literature that these symptoms also occur in children and adolescents, with a comparable phenotype to adults. This review discusses the wide presentation of premonitory symptoms in migraine in children and adolescents, and the importance of understanding how these early symptoms are mediated in order to ensure that targeted abortive therapies are developed in the future. Recognition of these symptoms by parents, guardians, teachers and carers is of importance in ensuring early and effective attack treatment.Recent FindingsA previous clinic-based questionnaire study in 103 children found a prevalence of premonitory symptoms in paediatric migraine of 67%, with a mean number of reported symptoms of two. A recent study found that in a clinic population of 100 children or adolescents with a migraine diagnosis who were preselected as having at least one premonitory symptom associated with their attacks, two or more premonitory symptoms were reported by 85% of patients. The most common symptoms were fatigue, mood change and neck stiffness.SummaryAlthough the population prevalence of premonitory symptoms in migraine within the paediatric population, or their ability to predict accurately the onset of an impending headache cannot be deduced from the retrospective studies performed to date, premonitory symptoms occur in children as young as 18 months old. Understanding the biological basis of these, and their heterogeneous phenotype may help future targeted therapeutic research, helping the development of drugs that act before the onset of pain, limiting the morbidity associated with the migraine attack.

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Reduced functional connectivity between salience and visual networks in migraine with aura

Cited by 80 publications

References 48 publications

Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation in migraine patients

Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation in migraine patients

Migraine: What Imaging Reveals

Premonitory Symptoms of Migraine in Childhood and Adolescence

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