Abstract
Background: Hypothesis-driven functional connectivity (FC) analyses have revealed abnormal functional interaction of regions or networks involved in pain processing in episodic migraine patients. We aimed to investigate the resting-state FC patterns in episodic migraine by combining data-driven voxel-wise degree centrality (DC) calculation and seed-based FC analysis.Methods: Thirty-nine patients suffering from episodic migraine without aura and 35 healthy controls underwent clinical assessment and functional MRI. DC was analyzed voxel-wise and compared between groups, and FC of regions with DC differences were further examined using a seed-based approach.Results: Compared with the control group, the migraine group showed increased and decreased DC in the right posterior insula and left crus I, respectively. Seed-based FC analyses revealed that migraine patients demonstrated increased right posterior insula connections with the postcentral gyrus, supplementary motor area/paracentral lobule, fusiform gyrus and temporal pole. The left crus I showed decreased FC with regions of the default mode network (DMN), including the medial prefrontal cortex (mPFC), angular gyrus, medial and lateral temporal cortex in patients with migraine. Furthermore, pain intensity positively correlated with DC in the right amygdala/parahippocampal gyrus, and migraine frequency negatively correlated with FC between the left crus I and mPFC.Conclusion: Patients with episodic migraine without aura have increased FC with the right posterior insula and decreased FC within the DMN, which may underlie disturbed sensory integration and cognitive processing of pain. The left crus I-mPFC connectivity may be a useful biomarker for assessing migraine frequency.
Highlights
Migraine is a common and debilitating episodic neurological disorder with a 1-year prevalence of about 12% in the general population (Lipton et al, 2007)
The findings fitted previous studies based on the regions of interest frequently showing altered function in the insula (Borsook et al, 2016) and expand the foci in migraine pathophysiology to the cerebellum, a region often neglected, by showing that it may serve as a source of interference for information flow with the connectome
Our further seed-based analyses revealed that the abnormalities detected in network information processing resulted from enhanced right-posterior insula functional connectivity (FC) with multiple regions related to pain processing and reduced cerebellum FC with components of the default mode network (DMN)
Summary
Migraine is a common and debilitating episodic neurological disorder with a 1-year prevalence of about 12% in the general population (Lipton et al, 2007) It is characterized by recurrent, unilateral, moderate or severe, throbbing, and pulsating headaches, often accompanied by nausea, vomiting, and hypersensitivities to visual, auditory, olfactory, and somatosensory stimuli (Schwedt, 2013). A large number of migraine studies have utilized the resting-state imaging technique and the results have indicated atypical connectivity between regions involved in pain processing (Schwedt et al, 2015; Messina et al, 2018). Hypothesis-driven functional connectivity (FC) analyses have revealed abnormal functional interaction of regions or networks involved in pain processing in episodic migraine patients. We aimed to investigate the resting-state FC patterns in episodic migraine by combining data-driven voxel-wise degree centrality (DC) calculation and seed-based FC analysis
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