The role of BOLD-fMRI in elucidating migraine pathophysiology

Tedeschi, Gioacchino; Russo, Antonio; Conte, Francesca; Salemi, Fabrizio; Tessitore, Alessandro

doi:10.1007/s10072-013-1383-z

Cited by 15 publications

(9 citation statements)

References 39 publications

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“…The second network we observed, covered parts of the so called “pain matrix” [ 32 ], a network which is involved in processing a large variety of painful sensations [ 43 – 45 ]. The core regions of this network are the primary and secondary somatosensory areas, the insula, and the anterior cingulate cortex [ 46 – 48 ].…”

Section: Discussionmentioning

confidence: 99%

Same Same but Different. Different Trigeminal Chemoreceptors Share the Same Central Pathway

et al. 2015

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Intranasal trigeminal sensations are important in everyday life of human beings, as they play a governing role in protecting the airways from harm. Trigeminal sensations arise from the binding of a ligand to various sub-types of transient receptor potential (TRP) channels located on mucosal branches of the trigeminal nerve. Which underlying neural networks are involved in the processing of various trigeminal inputs is still unknown. To target this unresolved question fourteen healthy human subjects were investigated by completing three functional magnetic resonance imaging (fMRI) scanning sessions during which three trigeminal substances, activating varying sub-types of chemoreceptors and evoking different sensations in the nose were presented: CO2, menthol and cinnamaldehyde. We identified similar functional networks responding to all stimuli: an olfactory network, a somatosensory network and an integrative network. The processing pathway of all three stimulants was represented by the same functional networks, although CO2 evokes painful but virtually odorless sensations, and the two other stimulants, menthol and cinnamaldehyde are perceived as mostly non painful with a clear olfactory percept. Therefore, our results suggest a common central processing pathway for trigeminal information regardless of the trigeminal chemoreceptor and sensation type.

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Section: Discussionmentioning

confidence: 99%

Same Same but Different. Different Trigeminal Chemoreceptors Share the Same Central Pathway

et al. 2015

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“…Therefore, only including MWoA helps us to analyze the abnormal brain structure and function of these patients, and the regulation of abnormal brain function by acupuncture. Furthermore, advances in neuroimaging techniques have provided significant new insights into the neural mechanism underlying the effect of acupuncture on MWoA (Tedeschi et al, 2013 ). Lots of studies have helped to explore the regulation effect of acupuncture on abnormal brain function and functional network in MWoA (Lakhan et al, 2013 ; Liu et al, 2018 ; Colombo et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Revealing the Neural Mechanism Underlying the Effects of Acupuncture on Migraine: A Systematic Review

Liu

Tian

et al. 2021

Front. Neurosci.

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Background: Migraine is a chronic neurological disorder characterized by attacks of moderate or severe headache and various neurological symptoms. Migraine is typically treated by pharmacological or non-pharmacological therapies to relieve pain or prevent migraine attacks. Pharmacological therapies show limited efficacy in relieving headache and are often accompanied by adverse effects, while the benefits of acupuncture, a non-pharmacological therapy, have been well-documented in both the treatment and prevention of acute migraine attacks. However, the underlying mechanism of the effect of acupuncture on relieving migraine remains unclear. Recent advances in neuroimaging technology have offered new opportunities to explore the underlying neural mechanism of acupuncture in treating migraine. To pave the way for future research, this review provides an overview neuroimaging studies on the use of acupuncture for migraine in the last 10 years.Methods: Using search terms about acupuncture, neuroimaging and migraine, we searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and China National Knowledge Infrastructure from January 2009 to June 2020 for neuroimaging studies that examined the effect of acupuncture in migraine. All published randomized and non-randomized controlled neuroimaging studies were included. We summarized the proposed neural mechanism underlying acupuncture analgesia in acute migraine, and the proposed neural mechanism underlying the sustained effect of acupuncture in migraine prophylaxis.Results: A total of 619 articles were retrieved. After removing reviews, meta-analyses, animal studies and etc., 15 articles were eligible and included in this review. The methods used were positron emission computed tomography (PET-CT; n = 2 studies), magnetic resonance spectroscopy (n = 1), and functional magnetic resonance imaging (fMRI; n = 12). The analyses used included the regional homogeneity (ReHo) method (n = 3), amplitude of low frequency (ALFF) method (n = 2), independent component analysis (ICA; n = 3), seed-based analysis (SBA; n = 1), both ICA and SBA (n = 1), Pearson's correlation to calculate functional connectivity (FC) between brain regions (n = 1), and a machine learning method (n = 1). Five studies focused on the instant effect of acupuncture, and the research objects were those with acute migraine (n = 2) and migraine in the interictal phase (n = 3). Ten studies focused on the lasting effect of acupuncture, and all the studies selected migraine patients in the interictal phase. This review included five task-based studies and 10 resting-state studies. None of the studies conducted a correlation analysis between functional brain changes and instant clinical efficacy. For studies that performed a correlation analysis between functional brain changes and sustained clinical efficacy, the prophylactic effect of acupuncture on migraine might be through regulation of the visual network, default mode network (DMN), sensory motor network, frontoparietal network (FPN), limbic system, and/or descending pain modulatory system (DPMS).Conclusion: The neural mechanism underlying the immediate effect of acupuncture analgesia remains unclear, and the neural mechanism of sustained acupuncture treatment for migraine might be related to the regulation of pain-related brain networks. The experimental design of neuroimaging studies that examined the effect of acupuncture in migraine also have some shortcomings, and it is necessary to standardize and optimize the experimental design. Multi-center neuroimaging studies are needed to provide a better insight into the neural mechanism underlying the effect of acupuncture on migraine. Multi-modality neuroimaging studies that integrate multiple data analysis methods are required for cross-validation of the neuroimaging results. In addition, applying machine learning methods in neuroimaging studies can help to predict acupuncture efficacy and screen for migraineurs for whom acupuncture treatment would be suitable.

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“…sensory-discriminative, affective-motivational, cognitive) yields insights into the hypersensitive and hypervigilant migraine brain. Although there have been a few other migraine fMRI studies investigating brain responses to noxious cutaneous stimulation, most have taken a region-of-interest approach, an approach noted to have substantial limitations for studying migraine pathophysiology (9). This study adds to existing literature because it: 1) investigated whole brain responses to pain; 2) used stimulation temperatures that were individualized for each subject; 3) included more subjects compared to most migraine fMRI studies and thus had greater statistical power; and 4) allowed for fMRI findings to be correlated with markers of migraine burden, including headache frequency and number of years with migraine, and with time to next migraine attack.…”

Section: Introductionmentioning

confidence: 99%

Enhanced pain-induced activity of pain-processing regions in a case-control study of episodic migraine

et al. 2014

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Objective To identify brain regions having aberrant pain-induced activation in migraineurs, thereby gaining insight into particular aspects of pain processing that are atypical in migraineurs. Methods Functional magnetic resonance imaging assessed whole brain responses to painful heat in 24 adult episodic migraineurs who were at least 48 hours pain free and 27 healthy controls. Regions differentially activated in migraineurs compared to controls were identified. Activation intensities in these regions were correlated with headache frequency, number of migraine years, and time to next migraine attack. Results Migraineurs had greater pain-induced activation of lentiform nucleus, fusiform gyrus, subthalamic nucleus, hippocampus, middle cingulate cortex, premotor cortex, somatosensory cortex and dorsolateral prefrontal cortex, and less activation in precentral gyrus and superior temporal gyrus. There were significant correlations between activation strength and headache frequency for middle cingulate (r=0.627, p=.001), right dorsolateral prefrontal cortex (r=.568, p=.004), left fusiform gyrus (r=0.487, p=.016), left precentral gyrus (r=.415, p=.044), and left hippocampus (r=0.404, p=.050) and with number of migraine years for left fusiform gyrus (r=0.425, p=.038). There were no significant correlations between activation strength and time to next migraine attack. Conclusions The majority of regions with enhanced pain-induced activation in headache-free migraineurs participate in cognitive aspects of pain perception such as attending to pain and pain memory. Enhanced cognitive pain processing by migraineurs might reflect cerebral hypersensitivity related to high expectations and hypervigilance for pain.

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The role of BOLD-fMRI in elucidating migraine pathophysiology

Cited by 15 publications

References 39 publications

Same Same but Different. Different Trigeminal Chemoreceptors Share the Same Central Pathway

Same Same but Different. Different Trigeminal Chemoreceptors Share the Same Central Pathway

Revealing the Neural Mechanism Underlying the Effects of Acupuncture on Migraine: A Systematic Review

Enhanced pain-induced activity of pain-processing regions in a case-control study of episodic migraine

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