Abstract
BackgroundMost migraineurs develop cutaneous allodynia (CA) during migraine, and the underlying mechanism of CA in migraine is thought to be sensitization of the third-order trigeminovascular neurons in the posterior thalamic nuclei. This study aimed to investigate whether the ascending/descending pathway associated with the thalamus is disturbed in migraineurs with CA (MWCA) using effective connectivity analysis of resting-state functional magnetic resonance imaging.MethodsThirty four migraineurs without aura (14 MWCA and 20 migraineurs without CA (MWoCA)) and 25 matched healthy controls (HC) were recruited in the study. The effective connectivity pathways associated with the posterior thalamus (PTH) were investigated using the Granger causality analysis. We chose bilateral PTH as two individual seeds, and compared MWCA with MWoCA and HC, respectively. Spearman correlation analysis was performed to test the correlation between the abnormal effective connectivity and the allodynia severity of MWCA.ResultsCompared with MWoCA, MWCA showed decreased inflows from the left limbic regions and dorsal medial prefrontal cortex (dmPFC) to the ipsilateral PTH, as well as increased inflow from the right ventral medial prefrontal cortex (vmPFC) to the ipsilateral PTH; no significantly different outflows from the bilateral PTH to other regions were found. Compared with HC, MWCA showed increased outflows from the left PTH to the bilateral vmPFC, decreased outflows from the right PTH to the bilateral temporoparietal areas, decreased inflow from the left parietooccipital area to the ipsilateral PTH, and increased inflows from the right dorsolateral prefrontal cortex and the bilateral temporoparietal areas to the right PTH. Correlation analyses revealed that the disturbed connectivities between PTH and cuneus, as well as PTH and middle frontal gyrus were associated with the allodynia severity of MWCA.ConclusionsMWCA demonstrated disrupted effective connection pathways between the PTH and other cortical or subcortical regions that participated in multi-dimentional pain processing. Our findings highlight the dysfunctional ascending and descending pain network at the thalamic-level and may help to illuminate the possible pathophysiologic mechanisms of CA.
Highlights
Most migraineurs develop cutaneous allodynia (CA) during migraine, and the underlying mechanism of CA in migraine is thought to be sensitization of the third-order trigeminovascular neurons in the posterior thalamic nuclei
migraineurs with CA (MWCA) demonstrated disrupted effective connection pathways between the posterior thalamus (PTH) and other cortical or subcortical regions that participated in multi-dimentional pain processing
Of the 34 migraineurs without aura, 14 were classified as MWCA and 20 as MWoCA according to their Allodynia symptom checklist (ASC) scores
Summary
Most migraineurs develop cutaneous allodynia (CA) during migraine, and the underlying mechanism of CA in migraine is thought to be sensitization of the third-order trigeminovascular neurons in the posterior thalamic nuclei. Migraine is a disabling and common neurological disorder, typically characterized by unilateral, throbbing, pulsating headache [1]. It affects about 12 % of general population and causes substantial personal and social burden [2]. CA is associated with high frequency of attacks, and has been proposed as a risk factor for progression to chronic migraine [6, 7]. It has been proposed as a predictor of poor response to triptan therapy [8]. Probing the mechanism of CA in migraine may have significant implications for our understanding of the pathophysiology of migraine and its prognosis
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
