1 G.B. Bietti Foundation IRCCS, Research Unit of Neurophysiology of Vision and Neurophthalmology, Rome, Italy.
2 "Sapienza" University of Rome, Department of Neurology and Psychiatry, Neuroradiology section, Rome, Italy.
Cephalalgia. 2018 Apr;38(5):846-854. doi: 10.1177/0333102417715230. Epub 2017 Jun 12.
Background Previous functional MRI studies have revealed that ongoing clinical pain in different chronic pain syndromes is directly correlated to the connectivity strength of the resting default mode network (DMN) with the insula. Here, we investigated seed-based resting state DMN-insula connectivity during acute migraine headaches. Methods Thirteen migraine without aura patients (MI) underwent 3 T MRI scans during the initial six hours of a spontaneous migraine attack, and were compared to a group of 19 healthy volunteers (HV). We evaluated headache intensity with a visual analogue scale and collected seed-based MRI resting state data in the four core regions of the DMN: Medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC), and left and right inferior parietal lobules (IPLs), as well as in bilateral insula. Results Compared to HV, MI patients showed stronger functional connectivity between MPFC and PCC, and between MPFC and bilateral insula. During migraine attacks, the strength of MPFC-to-insula connectivity was negatively correlated with pain intensity. Conclusion We show that greater subjective intensity of pain during a migraine attack is associated with proportionally weaker DMN-insula connectivity. This is at variance with other chronic extra-cephalic pain disorders where the opposite was found, and may thus be a hallmark of acute migraine head pain.
先前的功能磁共振成像研究表明,不同慢性疼痛综合征中的持续性临床疼痛与静息默认模式网络(DMN)与岛叶之间的连通强度直接相关。在这里,我们研究了急性偏头痛发作期间基于种子的静息状态 DMN-岛叶连接。
13 名无先兆偏头痛患者(MI)在自发性偏头痛发作的最初 6 小时内接受了 3T MRI 扫描,并与 19 名健康志愿者(HV)进行了比较。我们使用视觉模拟量表评估头痛强度,并在 DMN 的四个核心区域(内侧前额叶皮质(MPFC)、后扣带皮层(PCC)以及左、右顶下小叶(IPL))和双侧岛叶采集基于种子的 MRI 静息状态数据。
与 HV 相比,MI 患者的 MPFC 与 PCC 之间以及 MPFC 与双侧岛叶之间的功能连接更强。在偏头痛发作期间,MPFC 与岛叶之间连接的强度与疼痛强度呈负相关。
我们发现,偏头痛发作期间疼痛的主观强度越大,DMN-岛叶连接的强度就越弱。这与其他慢性颅外疼痛障碍相反,因此可能是急性偏头痛头痛的特征。