Abstract
Background/ObjectiveMigraineurs have atypical pain processing, increased expectations for pain, and hypervigilance for pain. Recent studies identified correlations between brain structure and pain sensation in healthy adults. The objective of this study was to compare cortical thickness-to-pain threshold correlations in migraineurs to healthy controls. We hypothesized that migraineurs would have aberrant relationships between the anatomical neurocorrelates of pain processing and pain thresholds.MethodsPain thresholds to cutaneously applied heat were determined for 31 adult migraineurs and 32 healthy controls. Cortical thickness was determined from magnetic resonance imaging T1-weighted sequences. Regional cortical thickness-to-pain threshold correlations were determined for migraineurs and controls separately using a general linear model whole brain vertex-wise analysis. A pain threshold-by-group interaction analysis was then conducted to estimate regions where migraineurs show alterations in the pain threshold-to-cortical thickness correlations relative to healthy controls.ResultsControls had negative correlations (p<0.01 uncorrected) between pain thresholds and cortical thickness in left posterior cingulate/precuneus, right superior temporal, right inferior parietal, and left inferior temporal regions, and a negative correlation (p<0.01 Monte Carlo corrected) with a left superior temporal/inferior parietal region. Migraineurs had positive correlations (p<0.01 uncorrected) between pain thresholds and cortical thickness in left superior temporal/inferior parietal, right precuneus, right superior temporal/inferior parietal, and left inferior parietal regions. Cortical thickness-to-pain threshold correlations differed between migraine and control groups (p<0.01 uncorrected) for right superior temporal/inferior parietal, right precentral, left posterior cingulate/precuneus, and right inferior parietal regions and (p<0.01 Monte Carlo corrected) for a left superior temporal/inferior parietal region.ConclusionsUnlike healthy control subjects who have a significant negative correlation between cortical thickness in a superior temporal/inferior parietal region with pain thresholds, migraineurs have a non-significant positive correlation between cortical thickness in a superior temporal/inferior parietal region with pain thresholds. Since this region participates in orienting and attention to painful stimuli, absence of the normal correlation might represent a migraineurs inability to inhibit pain sensation via shifting attention away from the painful stimulus.
Highlights
Migraineurs have atypical processing of sensory stimuli, including painful stimuli, during and between migraine attacks
Cortical thickness-to-pain threshold correlations differed between migraine and control groups (p,0.01 uncorrected) for right superior temporal/ inferior parietal, right precentral, left posterior cingulate/precuneus, and right inferior parietal regions and (p,0.01 Monte Carlo corrected) for a left superior temporal/inferior parietal region
Unlike healthy control subjects who have a significant negative correlation between cortical thickness in a superior temporal/inferior parietal region with pain thresholds, migraineurs have a non-significant positive correlation between cortical thickness in a superior temporal/inferior parietal region with pain thresholds. Since this region participates in orienting and attention to painful stimuli, absence of the normal correlation might represent a migraineurs inability to inhibit pain sensation via shifting attention away from the painful stimulus
Summary
Migraineurs have atypical processing of sensory stimuli, including painful stimuli, during and between migraine attacks. Imaging experiments investigating brain function are beginning to elucidate the mechanisms for migraine hypersensitivities. Several migraine functional magnetic resonance imaging (fMRI) studies have demonstrated hyperexcitability of regions that facilitate sensory processing in response to pain, visual stimuli and olfactory stimuli. [21] The objective of this study was to further investigate pain-processing regions in the migraine brain by comparing correlations between cortical thickness and pain thresholds in migraineurs to those in healthy controls. This study aimed to interrogate neuro-anatomical correlates of pain processing in migraineurs relative to healthy controls. We hypothesized that migraineurs would demonstrate atypical cortical thickness-to-pain threshold correlations. Identification of brain regions with atypical cortical thickness-to-pain threshold correlations could elucidate anatomical regions involved in aberrant pain processing, a potentially fruitful step for further defining mechanisms of atypical pain processing by the migraine brain, identifying migraine biomarkers, and identifying brain targets for migraine treatments
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