Report Details Disrupted Functional Connectivity in Brains of Those With Migraines

May 26, 2020
Gianna Melillo

Gianna is an assistant editor of The American Journal of Managed Care® (AJMC®). She has been working on AJMC® since 2019 and has a BA in philosophy and journalism & professional writing from The College of New Jersey.

Migraineurs’ brains experience disrupted functional connectivity (FC) between subregions in the sensorimotor areas and cortex, according to a study published in The Journal of Headache and Pain.

Migraineurs’ brains experience disrupted functional connectivity (FC) between subregions in the sensorimotor areas and cortex, according to a study published in The Journal of Headache and Pain.

Although the underlying mechanisms of migraine are unknown, migraineurs do experience altered pain perception while headache attacks can disrupt sensory information processing and sensorimotor integration.

Resting-state functional magnetic resonance imaging scans (MRIs) were carried out on 48 patients with migraine without aura and 48 age- and sex-matched controls. Seed-based FC analyses were used to investigate abnormal FC in the brain regions.

The sensorimotor cortex (S1), along with the motor and premotor cortex (PMC) are all involved in spatial discrimination and pain intensity pathways. A previous study found episodic migraineurs exhibited significant hypometabolism in the PMC and S1 when compared with healthy controls, authors said.

“The interactions between sensorimotor regions and multiple cortical areas are necessary for the integration of information within and across the sensory modalities and, thus, could play an important role in the initiation of migraine attack and/or the development of its associated symptoms,” researchers hypothesize.

Average age of study participants was 38 (SD 10.4) and migraineurs were scanned during an interictal period, with no headache 48 hours before or 24 hours after MRI scans. Demographic data, in addition to scores from the Migraine Disability Assessment Scale (MIDAS) and Headache Impact Test (HIT-6) were collected.

Healthy controls had no chronic pain or headache disorders in the last year, and none of their immediate family members suffered from migraine.

Analyses revealed migraineurs without aura “exhibited disrupted functional connectivity between the sensorimotor areas and the visual cortex, temporal cortex, posterior parietal lobule, prefrontal areas, precuneus, cingulate gyrus, sensorimotor areas proper and cerebellum areas compared with healthy controls.” In addition, investigators found disease duration, pain intensity, and HIT-6 score were negatively correlated with the impaired FC.

The negative association of reduced disease duration suggests that “recurrent headache attacks may drive functional changes and contribute to this disrupted network among the left (L) primary motor cortex (M1), L S1, and temporal regions.”

One limitation of the study is its examination of patients in only the interictal phase of migraine and not the ictal phase. Further studies should be carried out investigating FC in migraineurs with aura and chronic migraineurs.

“Recurrent headache attacks might lead to the disrupted network between the L M1 and temporal regions and between the L S1 and temporal regions” researchers conclude.

“Disrupted FC might contribute to abnormalities in visual processing, multisensory integration, nociception processing, spatial attention and intention and dysfunction in cognitive evaluation and modulation of pain.”

Reference:

Qin Z, Su J, He X, et al. Disrupted functional connectivity between subregions in the sensorimotor areas and cortex in migraine without aura. J Headache Pain. 2020; 21(47). doi:10.1186/s10194-020-01118-1