Objective

The aim of the current study was to identify typical alterations in resting state connectivity within different stages of the migraine cycle and to thus explore task-free mechanisms of headache attack generation in migraineurs.

Background

Recent evidence in migraine pathophysiology suggests that hours and even days before headache certain changes in brain activity take place, ultimately leading to an attack. Here, we investigate changes before headache onset using resting state functional magnetic resonance imaging (fMRI).

Methods

Nine episodic migraineurs underwent daily resting state functional magnetic resonance imaging for a minimum period of 30 consecutive days, leading to a cumulative number of 282 total days scanned. Thus, data from 15 spontaneous headache attacks were acquired. This allows analysing not only the ictal and the interictal phase of migraine but also the preictal phase. ROI-to-ROI (region of interest) and ROI-to-voxel connectivity was calculated over the migraine cycle.

Results

Within the ROI-to-ROI analysis, the right nucleus accumbens showed enhanced functional connectivity to the left amygdala, hippocampus and gyrus parahippocampalis in the preictal phase compared to the interictal phase. ROI-to-voxel connectivity of the right accumbens with the dorsal rostral pons was enhanced during the preictal phase compared to interictally. Regarding custom defined ROIs, the dorsal pons was ictally functionally more strongly coupled to the hypothalamic area than interictally.

Conclusions

This unique data set suggests that particularly connectivity changes in dopaminergic centres and between the dorsal pons and the hypothalamus are important within migraine attack generation and sustainment.

中文翻译：

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偏头痛患者的大脑网络：超过 30 天的连续静息状态 fMRI。

客观的

当前研究的目的是确定偏头痛周期不同阶段静息状态连接的典型改变，从而探索偏头痛发作的无任务机制。

背景

偏头痛病理生理学的最新证据表明，在头痛发生前数小时甚至数天，大脑活动会发生某些变化，最终导致发作。在这里，我们使用静息状态功能磁共振成像 (fMRI) 调查头痛发作前的变化。

方法

9 位发作性偏头痛患者每天接受至少连续 30 天的静息状态功能性磁共振成像，累计扫描总天数为 282 天。因此，获得了 15 次自发性头痛发作的数据。这不仅可以分析偏头痛的发作期和发作间期，还可以分析发作前期。在偏头痛周期内计算了 ROI 到 ROI（感兴趣区域）和 ROI 到体素的连接性。

结果

在 ROI 到 ROI 分析中，与发作间期相比，右侧伏隔核在发作前期与左侧杏仁核、海马和海马旁回的功能连接增强。与发作间期相比，在发作前期，右侧伏隔与背侧脑桥的 ROI 到体素连接得到增强。关于自定义定义的 ROI，与间歇期相比，脑桥背侧在功能上与下丘脑区域的耦合更强。

结论

这个独特的数据集表明，特别是多巴胺能中枢以及脑桥背侧和下丘脑之间的连接变化在偏头痛发作和维持中很重要。