Abstract
BackgroundSpatial normalization of brain images, a prerequisite for voxel based morphometry analysis, may account for the large variability of the volumetric data in medication overuse headache (MOH); possibly because this disease concerns patients differing on both sex and age, and hence with different brain size and shape.MethodsThe present study aimed at providing a subject-based analysis of macrostructure using a native space volumes segmentation (Freesurfer), and microstructure using a region of interest (ROI: i.e. hippocampus) tractography approach in MOH patients.ResultsThe results show that MOH patients had decreased volumes of left hemisphere temporal gyri (temporal superior, fusiform) and occipital middle gyrus, together with an increased volume of the left inferior (temporal) lateral ventricle. The left temporal volume was negatively correlated with depression score and medication dependence parameters. Seed-based tractography of the hippocampus revealed a decreased number of reconstructed fibers passing through the left hippocampus.ConclusionTo our knowledge, these alterations have not been described with methods involving brain normalization, and they indicate that left hemisphere temporal areas, including the hippocampus, may play a role in MOH pathophysiology.Trial registration number NCT00833209. Registered 29 January 2009
Highlights
Spatial normalization of brain images, a prerequisite for voxel based morphometry analysis, may account for the large variability of the volumetric data in medication overuse headache (MOH); possibly because this disease concerns patients differing on both sex and age, and with different brain size and shape
A secondary aim to the present study was related to previous findings obtained in the same sample of MOH patients who were compared to subjects with episodic migraine without medication overuse [4]; findings addressed the modifications of functional connectivity within one prominent resting-state network: the default-mode network (DMN)
We explored the hippocampal surrounding microstructure using a region of interest (ROI) tractography approach, and a fiber tract tool which enables modelling of fiber tract anatomy within each person’s own diffusion space
Summary
Spatial normalization of brain images, a prerequisite for voxel based morphometry analysis, may account for the large variability of the volumetric data in medication overuse headache (MOH); possibly because this disease concerns patients differing on both sex and age, and with different brain size and shape. We first aimed to specify whole-brain patterns of morphometric alterations in MOH patients To this end, we investigated macrostructure of all brain tissues using a native space volumes segmentation approach. When compared to healthy controls, MOH patients had a decreased connectivity between the left precuneus seed and other regions of the DMN such as the frontal and parietal cortices, as well as an increased connectivity with the hippocampus and temporal areas Both decreased and increased functional connectivity were related to duration of the disease, while increased functional connectivity in the hippocampus area was related to medication dependence processes, as represented by the number of pills taken monthly [4]. We speculated that volumes and/or microstructure of specific brain regions, which would present morphometric alterations, would appear to be related to variables describing pathology processes
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