TY - JOUR
T1 - Alterations in pain processing circuitries in episodic migraine
AU - Mungoven, Tiffani J.
AU - Marciszewski, Kasia K.
AU - Macefield, Vaughan G.
AU - Macey, Paul M.
AU - Henderson, Luke A.
AU - Meylakh, Noemi
N1 - Funding Information:
This work was supported by grants 1032072 and 1059182 awarded by the National Health and Medical Research Council of Australia.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/1/15
Y1 - 2022/1/15
N2 - Background: The precise underlying mechanisms of migraine remain unknown. Although we have previously shown acute orofacial pain evoked changes within the brainstem of individuals with migraine, we do not know if these brainstem alterations are driven by changes in higher cortical regions. The aim of this investigation is to extend our previous investigation to determine if higher brain centers display altered activation patterns and connectivity in migraineurs during acute orofacial noxious stimuli. Methods: Functional magnetic resonance imaging was performed in 29 healthy controls and 25 migraineurs during the interictal and immediately (within 24-h) prior to migraine phases. We assessed activation of higher cortical areas during noxious orofacial heat stimulation using a thermode device and assessed whole scan and pain-related changes in connectivity. Results: Despite similar overall pain intensity ratings between all three groups, migraineurs in the group immediately prior to migraine displayed greater activation of the ipsilateral nucleus accumbens, the contralateral ventrolateral prefrontal cortex and two clusters in the dorsolateral prefrontal cortex (dlPFC). Reduced whole scan dlPFC [Z + 44] connectivity with cortical/subcortical and brainstem regions involved in pain modulation such as the putamen and primary motor cortex was demonstrated in migraineurs. Pain-related changes in connectivity of the dlPFC and the hypothalamus immediately prior to migraine was also found to be reduced with brainstem pain modulatory areas such as the rostral ventromedial medulla and dorsolateral pons. Conclusions: These data reveal that the modulation of brainstem pain modulatory areas by higher cortical regions may be aberrant during pain and these alterations in this descending pain modulatory pathway manifests exclusively prior to the development of a migraine attack.
AB - Background: The precise underlying mechanisms of migraine remain unknown. Although we have previously shown acute orofacial pain evoked changes within the brainstem of individuals with migraine, we do not know if these brainstem alterations are driven by changes in higher cortical regions. The aim of this investigation is to extend our previous investigation to determine if higher brain centers display altered activation patterns and connectivity in migraineurs during acute orofacial noxious stimuli. Methods: Functional magnetic resonance imaging was performed in 29 healthy controls and 25 migraineurs during the interictal and immediately (within 24-h) prior to migraine phases. We assessed activation of higher cortical areas during noxious orofacial heat stimulation using a thermode device and assessed whole scan and pain-related changes in connectivity. Results: Despite similar overall pain intensity ratings between all three groups, migraineurs in the group immediately prior to migraine displayed greater activation of the ipsilateral nucleus accumbens, the contralateral ventrolateral prefrontal cortex and two clusters in the dorsolateral prefrontal cortex (dlPFC). Reduced whole scan dlPFC [Z + 44] connectivity with cortical/subcortical and brainstem regions involved in pain modulation such as the putamen and primary motor cortex was demonstrated in migraineurs. Pain-related changes in connectivity of the dlPFC and the hypothalamus immediately prior to migraine was also found to be reduced with brainstem pain modulatory areas such as the rostral ventromedial medulla and dorsolateral pons. Conclusions: These data reveal that the modulation of brainstem pain modulatory areas by higher cortical regions may be aberrant during pain and these alterations in this descending pain modulatory pathway manifests exclusively prior to the development of a migraine attack.
KW - Brainstem pain modulation
KW - Cortical pain modulation
KW - Dorsolateral prefrontal cortex
KW - Functional connectivity
KW - Hypothalamus
KW - Migraine
KW - Orofacial pain
KW - PPI
KW - Spinal trigeminal nucleus
UR - http://www.scopus.com/inward/record.url?scp=85122918075&partnerID=8YFLogxK
U2 - 10.1186/s10194-021-01381-w
DO - 10.1186/s10194-021-01381-w
M3 - Article
C2 - 35033014
AN - SCOPUS:85122918075
VL - 23
JO - The Journal of Headache and Pain
JF - The Journal of Headache and Pain
SN - 1129-2369
IS - 1
M1 - 9
ER -