Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Mol Psychiatry. 2021 Nov;26(11):6599-6608. doi: 10.1038/s41380-021-01085-2. Epub 2021 Apr 9.
Migraine patients frequently report cognitive symptoms during the different phases of migraine. The most affected cognitive domains are visuospatial abilities, processing speed, attention and executive functions. We explored migraine patients' performance during a visuospatial task and investigated the activity of brain areas involved in visuospatial processing. A functional magnetic resonance imaging (MRI) visuospatial task, including an angle and a colour discrimination paradigm, was administrated to 17 headache-free migraine patients and 16 controls. Correlations between functional MRI abnormalities and subjects' performance, clinical and neuropsychological variables were also investigated. Deficits at visuospatial cognitive tests were present in around 20% of patients. Migraine patients maintained a preserved behavioural performance (reaction time and number of correct responses) during the angle discrimination task, while they performed less correctly in the colour task compared to controls (p = 0.05).The comparison of angle vs. colour task revealed an increased activity of the right insula, bilateral orbitofrontal cortex and medial frontal gyrus, and decreased activity of the bilateral posterior cingulate cortex in migraine patients compared to controls. In migraine patients, a better performance in the angle task was associated with higher activation of the right insula and orbitofrontal cortex, as well as with decreased activation of the right posterior cingulate cortex. Our results suggest an adaptive functional plasticity that might help migraine patients to overcome impaired visuospatial skills and preserve an adequate performance during a visuospatial task. These compensatory mechanisms seem to take advantage of recruiting brain areas that are commonly involved also in nociception.
偏头痛患者在偏头痛的不同阶段经常报告认知症状。受影响最严重的认知领域是视空间能力、加工速度、注意力和执行功能。我们探索了偏头痛患者在视空间任务中的表现，并研究了参与视空间加工的脑区的活动。一项功能磁共振成像 (MRI) 视空间任务，包括角度和颜色辨别范式，被施用于 17 名无头痛偏头痛患者和 16 名对照者。还研究了功能 MRI 异常与受试者表现、临床和神经心理学变量之间的相关性。大约 20%的患者在视空间认知测试中存在缺陷。偏头痛患者在角度辨别任务中保持了良好的行为表现（反应时间和正确反应次数），而在颜色任务中的表现明显低于对照组（p=0.05）。角度任务与颜色任务的比较显示，偏头痛患者的右侧脑岛、双侧眶额皮质和内侧额回活动增加，而双侧后扣带回皮质活动减少。在偏头痛患者中，角度任务表现越好，右侧脑岛和眶额皮质的激活越高，右侧后扣带回皮质的激活越低。我们的结果表明，适应性功能可塑性可能有助于偏头痛患者克服受损的视空间技能，并在视空间任务中保持适当的表现。这些补偿机制似乎利用了通常也参与痛觉的大脑区域。
