Abstract
To investigate the neuroanatomical and functional brain changes in migraine patients relative to healthy controls, we used a combined analytical approach including voxel- and surface-based morphometry along with resting-state functional connectivity to determine whether areas showing structural alterations in patients also showed abnormal functional connectivity. Additionally, we wanted to assess whether these structural and functional changes were associated with group differences in pain catastrophizing and migraine-related disease variables in patients. We acquired T1-weighted anatomical and functional magnetic resonance imaging scans during rest in human subjects with a diagnosis of migraine and healthy controls. Structural analyses revealed greater left hippocampal gray matter volume and reduced cortical thickness in the left anterior midcingulate in patients compared with controls. We also observed negative associations between pain catastrophizing and migraine disease variables and gray matter in areas implicated in processing the sensory, affective, and cognitive aspects of pain in patients. Functional connectivity analyses showed that migraine patients displayed disrupted connectivity between default mode, salience, cognitive, visuospatial, and sensorimotor networks, which was associated with group differences in pain catastrophizing and migraine-related disease variables in patients. Together, our findings show widespread morphological and functional brain abnormalities in migraineurs in affective, cognitive, visual, and pain-related brain areas, which are associated with increased pain catastrophizing, disease chronicity, and severity of symptoms, suggesting that these structural and functional changes may be a consequence of repeated, long-term nociceptive signaling leading to increased pain sensitivity, mood disturbances, and maladaptive coping strategies to deal with unrelenting pain.
Highlights
Migraine is a debilitating pain condition associated with substantial personal and societal disability (Lipton et al, 2007)
Recent neuroimaging studies have demonstrated that migraine patients show widespread functional and structural brain abnormalities relative to healthy controls, and these abnormalities have been associated with migraine-related disease variables, including disease duration and attack frequency, indicating a possible link between the observed anatomical and functional brain changes, symptom severity, and migraine disease progression (Bashir et al, 2013; Maniyar and Goadsby, 2013)
We provide evidence that migraine patients have concurrent structural and functional abnormalities in default mode, salience, visuospatial, cognitive control, and pain-related brain networks, which were associated with disease-related symptomology and the degree of pain catastrophizing
Summary
Migraine is a debilitating pain condition associated with substantial personal and societal disability (Lipton et al, 2007). Recent neuroimaging studies have demonstrated that migraine patients show widespread functional and structural brain abnormalities relative to healthy controls, and these abnormalities have been associated with migraine-related disease variables, including disease duration and attack frequency, indicating a possible link between the observed anatomical and functional brain changes, symptom severity, and migraine disease progression (Bashir et al, 2013; Maniyar and Goadsby, 2013). VBM studies have reported that migraine patients have altered cortical and subcortical GMV, including areas involved in processing the sensory-discriminative, affective, and cognitive-evaluative aspects of pain, as well as increased GMV in brainstem structures such as the periaqueductal gray (PAG) and dorsolateral pons, known to play a critical role in descending pain modulation
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