What Have We Learned From Brain Functional Connectivity Studies in Migraine Headache?

Maleki, Nasim; Gollub, Randy L.

doi:10.1111/head.12756

Cited by 37 publications

(32 citation statements)

References 75 publications

(139 reference statements)

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“…The insula cortex is another key region associated with pain processing and modulation. 66 , 67 The activity in the insula was increased even if someone just imagines levels of pain when looking at images of painful events (without any actual physical injuries). 68 In our present work, abnormal local coherence of the MTG, precuneus, and insula were detected in the brain scans.…”

Section: Discussionmentioning

confidence: 99%

Altered Spontaneous Brain Activity in Patients With Idiopathic Trigeminal Neuralgia

Yuan

Cao²,

Huang

et al. 2018

The Clinical Journal of Pain

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Objectives:To identify the changes of local coherence and intrinsic brain activity in resting-state idiopathic trigeminal neuralgia (ITN) patients by using regional homogeneity (ReHo) and fractional aptitude of low-frequency fluctuation (fALFF) analysis.Methods:ReHo and fALFF were analyzed in 23 ITN patients and 23 age-matched and sex-matched pain-free controls to detect the functional abnormality in the brains of ITN patients. Correlations between ReHo and fALFF were analyses. ITN pain intensity were also assessed in the ITN group.Results:Compared with pain-free controls, ITN patients exhibited significantly abnormal ReHo and fALFF in several brain regions, including the cerebellum, cingulate cortex, temporal lobe, putamen, occipital lobe, limbic lobe, precuneus, insula, medial, and superior frontal gyrus compared with healthy controls. Correlation analysis showed that ReHo values of several altered brain areas positively correlated with visual analog scale values. But no correlation was found between fALFF and visual analog scale.Discussion:Our results showed that ITN patients exhibited significantly abnormal spontaneous brain activity in several brain regions that are involved in pain modulation and perception. The present study reflects the maladaptive process of daily pain attacks and may enhance the understanding of how chronic pain affects local intrinsic brain activity.

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Section: Discussionmentioning

confidence: 99%

Altered Spontaneous Brain Activity in Patients With Idiopathic Trigeminal Neuralgia

Yuan

Cao²,

Huang

et al. 2018

The Clinical Journal of Pain

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“…However, the general impression emerging from migraine connectivity studies is that very different and hardly comparable recording and analysis methods are used. In any case, the presence of connectivity modifications in the asymptomatic phase of migraine is a very robust data [ 25 – 29 ], although the differences between the two forms of migraine are less clear. Coppola et al [ 30 ] observed a reduced function of oscillating networks across the brainstem, the thalamus and the cortex in the default mode network and the visual spatial system in migraine without aura compared with controls, a finding that may be comparable with our observation of reduced causal connections in almost all bands in the MO group.…”

Section: Discussionmentioning

confidence: 99%

Brain networking analysis in migraine with and without aura

et al. 2017

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BackgroundTo apply effective connectivity by means of nonlinear Granger Causality (GC) and brain networking analysis to basal EEG and under visual stimulation by checkerboard gratings with 0.5 and 2.0 cpd as spatial frequency in migraine with aura (MA) and without aura (MO), and to compare these findings with Blood Oxygen Level Dependent (BOLD) signal changes.MethodsNineteen asymptomatic MA and MO patients and 11 age and sex matched controls (C) were recorded by 65 EEG channels. The same visual stimulation was employed to evaluate BOLD signal changes in a subgroup of MA and MO. The GC and brain networking were applied to EEG signals.ResultsA different pattern of reduced vs increased GC respectively in MO and MA patients, emerged in resting state. During visual stimulation, both MA and MO showed increased information transfer toward the fronto-central regions, while MA patients showed a segregated cluster of connections in the posterior regions, and an increased bold signal in the visual cortex, more evident at 2 cpd spatial frequency.ConclusionsThe wealth of information exchange in the parietal-occipital regions indicates a peculiar excitability of the visual cortex, a pivotal condition for the manifestation of typical aura symptoms.Electronic supplementary materialThe online version of this article (10.1186/s10194-017-0803-5) contains supplementary material, which is available to authorized users.

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“…Such science is needed to advance our understanding of why youth with headache and migraine benefit from different treatments, including psychological therapies, medications, or a combination of therapies. Research technologies, such as genetics and genomics, application of bioinformatics, functional brain imaging, and pain processing assessments such as quantitative sensory testing and the conditioned pain modulation paradigm offer much for the pursuit of this scientific knowledge that has great promise for translation into practice . A recently funded NIH project (1R01NS101321‐01A1) will provide a better understanding of how and why youth with migraine get better when they receive CBT, placebo pill, or amitriptyline therapy .…”

Section: A Research Strategy For Pediatric Headache and Migraine Goinmentioning

confidence: 99%

Cognitive Behavioral Therapy for Pediatric Headache and Migraine: Why to Prescribe and What New Research Is Critical for Advancing Integrated Biobehavioral Care

Diest

Powers

2018

Headache

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Purpose of Review To highlight current evidence supporting the prescription of cognitive behavioral therapy (CBT) as part of first‐line preventive treatment for children and adolescents with headache and discuss a research strategy aimed at: (1) understanding how and why CBT works, and (2) developing effective and efficient approaches for integrating CBT into headache specialty, neurology, and primary care settings. Recent Findings Although preventive medications for pediatric headache and migraine are commonly prescribed, recent meta‐analyses and an NIH‐funded, multi‐center clinical trial suggests that the effect of pill‐taking therapies may be mostly due to a placebo effect. These findings have led to greater consideration of prescription of non‐pharmacological therapies as first‐line interventions (either alone or in combination with pill‐based therapy). A literature that extends back to the 1980s and includes recent clinical trials and meta‐analyses demonstrates that CBT decreases headache frequency and related disability in youth with headache and migraine and has a favorable benefit to risk profile with almost no negative side effects. Summary CBT has been repeatedly demonstrated as effective in treating pediatric headache and migraine. As such, it should be considered as part of first‐line preventive treatment for pediatric headache (either alone or in combination with a pill‐based therapy). We need to better understand how this therapy works and what makes it distinct (if anything) from the placebo effect. What we need to achieve is empirical support for efficient access to this evidence‐based treatment and clarity on how to match the intensity of non‐pharmacological intervention to the needs of our patients at the time they present for care.

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What Have We Learned From Brain Functional Connectivity Studies in Migraine Headache?

Cited by 37 publications

References 75 publications

Altered Spontaneous Brain Activity in Patients With Idiopathic Trigeminal Neuralgia

Altered Spontaneous Brain Activity in Patients With Idiopathic Trigeminal Neuralgia

Brain networking analysis in migraine with and without aura

Cognitive Behavioral Therapy for Pediatric Headache and Migraine: Why to Prescribe and What New Research Is Critical for Advancing Integrated Biobehavioral Care

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