Abstract
Background:The neural mechanisms of chronic migraine remain largely unknown but linked to the decreased connectivity to intrinsic brain networks.Objective:To characterize the intranetwork functional connectivity within the Central Executive Network (CEN) and Default Mode Network (DMN) in chronic migraine (CM), with and without medication overuse headache (MOH).Methods:Using functional magnetic resonance imaging, we performed post-hoc analysis of a total of 136 pairs of nodes to node functional connectivity (NTNC) within the CEN and 6 pairs of NTNC within the DMN in CM (n=13) and CMMOH (n=16) as compared to controls, and between these two subgroups.Results:Connectivity between right ventrolateral prefrontal cortex (PFC) to contralateral anterior thalamus and connectivity between left dorsal PFC/frontal eye field (FEF) to dorsomedial PFC were decreased within the CEN in both CM and CMMOH subgroups. In the CEN, there was more widespread disruption in the CMMOH (n=16) versus CM (n=13), when compared to healthy controls. Within the subgroups, connectivity between right inferior frontal gyrus to left dorsolateral PFC was decreased in CMMOH compared to CM. In the DMN, only one NTNC (left lateral parietal to precuneus/PCC) was disrupted in the CMMOH group when compared to controls.Conclusion:There are similar patterns of NTNC dysfunction within CEN in CM regardless of MOH status. We observed more extensive intranetwork disruption in CMMOH than CM. The decreased coherence between the right inferior frontal gyrus and the left dorsolateral PFC in CMMOH is likely associated with a significant disruption in the inhibitory control and a maladaptive response in risk aversion and reward; whereas the decreased coherence between right dorsolateral and ventrolateral PFC to contralateral dorsal PFC/FEF may be related to lack of cognitive control and top-down regulation of pain in both CM and CMMOH.
Highlights
Neuroimaging studies have significantly advanced our knowledge on the functional and structural changes of the cortical and subcortical regions in chronic migraine (CM) [1], Recently, studies have utilized intrinsic resting state functional connectivity networks as a tool for analyzing functional brain alterations in various neurological disorders
The decreased coherence between the right inferior frontal gyrus and the left dorsolateral prefrontal cortex (PFC) in CMMOH is likely associated with a significant disruption in the inhibitory control and a
Participants A total of 16 CM and 13 CMMOH patients were recruited between January 2015 and August 2016 from the headache clinic at University of South Carolina (Columbia, SC)
Summary
Neuroimaging studies have significantly advanced our knowledge on the functional and structural changes of the cortical and subcortical regions in chronic migraine (CM) [1], Recently, studies have utilized intrinsic resting state functional connectivity networks as a tool for analyzing functional brain alterations in various neurological disorders. Alteration in intrinsic Functional Brain Networks (IFBNs), such as the default mode network (DMN), central executive network (CEN) and salience network (SN) may serve as neuroimaging biomarkers for evaluating the pathophysiological consequence of repeated migraine attacks. These IFBNs are comprised of brain regions that are functionally linked at rest when the subject is not involved in performing any externally-oriented task. The neural mechanisms of chronic migraine remain largely unknown but linked to the decreased connectivity to intrinsic brain networks
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