ABSTRACT
Background
Migraine is commonly seen as a cyclic disorder with variable cortical excitability at different phases. Herein, we investigated the cortical excitability in migraine without aura patients during an attack (MWoA-DA) and interictal period (MWoA-DI) and further explored the functional connectivity (FC) in brain regions with cortical excitability abnormalities in patients.
Methods
Seven MWoA-DA patients, twenty-seven MWoA-DI patients, and twenty-nine healthy controls (HC) underwent resting-state functional magnetic resonance imaging (rs-fMRI) scan. The amplitude of low-frequency fluctuations (ALFF) was assessed to identify spontaneous brain activity. Then, brain regions showing significant differences across groups were identified as regions of interest (ROI) in FC analysis.
Results
Compared with MWoA-DI patients and HC, the ALFF in the trigeminocervical complex (TCC) was higher in the MWoA-DA patients. Decreased FC in MWoA-DA patients was found between TCC and left postcentral gyrus compared with MWoA-DI patients. Compared with HC, ALFF was lower in the right cuneus but higher in the right rolandic operculum of MWoA-DI patients. Additionally, the ALFF in the right cuneus was negatively correlated with the Migraine Disability Assessment Scale (MIDAS) in MWoA-DI patients.
Conclusions
The trigeminovascular system and impairments in descending pain modulatory pathways participate in the pathophysiology of migraine during the ictal period. The defense effect exists in the interictal phase, and the dysfunction in the cuneus may be related to the disease severity. This dynamic change in different brain regions could deepen our understanding of the physiopathology underlying migraine.
Abbreviations
MWoA-DA | = | migraine without aura during the attack |
MWoA-DI | = | migraine without aura during the interictal period |
HC | = | healthy controls |
ALFF | = | amplitude of low-frequency fluctuation |
FC | = | functional connectivity |
rs-fMRI | = | resting-state functional magnetic resonance imaging |
ROI | = | regions of interest |
TCC | = | trigeminocervical complex |
VAS | = | visual analogue scale |
MIDAS | = | Migraine Disability Assessment Scale |
HIT-6 | = | Headache Impact Test |
SF-MPQ-2 | = | Short-form McGill Pain Questionnaire-2 scores |
S2 | = | secondary somatosensory cortex. |
Acknowledgments
We would like to thank the volunteers for their involvement in the study.
Disclosure statement
No potential conflict of interest was reported by the author(s).
CRediT authorship contribution statement
Luping Zhang: Conceptualization, Methodology, Investigation, Data curation, Validation, Formal analysis, Writing – original draft, Visualization. Wenjing Yu: Software, Methodology, Data curation, Formal analysis. Zhengxiang Zhang: Investigation, Writing – review & editing. Maosheng Xu: Resources, Writing – review & editing. Feng Cui: Resources, Writing – review & editing. Wenwen Song: Software, Methodology. Zhijian Cao: Conceptualization, Project administration, Writing – review & editing, Supervision, Resources, Funding acquisition.
Statement of ethics
The study was carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) and was approved by the Ethics Committee of the first Affiliated Hospital of Zhejiang Chinese Medical University (2018-KL-081-02).