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Enhanced Pain-Induced Activity of Pain Processing Regions in a Case-Control Study of Episodic Migraine

T. Schwedt, C. Chong, Chia-Chun Chiang, L. Baxter, B. Schlaggar, D. Dodick

Cephalalgia, 2014

139 citations

Abstract

Objective The objective of this study was to identify brain regions having aberrant pain-induced activation in migraineurs, thereby gaining insight into particular aspects of pain processing that are atypical in migraineurs. Methods Functional magnetic resonance imaging assessed whole brain responses to painful heat in 24 adult episodic migraineurs who were at least 48 hours pain free and 27 healthy controls. Regions differentially activated in migraineurs compared to controls were identified. Activation intensities in these regions were correlated with headache frequency, number of migraine years, and time to next migraine attack. Results Migraineurs had greater pain-induced activation of lentiform nucleus, fusiform gyrus, subthalamic nucleus, hippocampus, middle cingulate cortex, premotor cortex, somatosensory cortex, and dorsolateral prefrontal cortex, and less activation in precentral gyrus and superior temporal gyrus. There were significant correlations between activation strength and headache frequency for middle cingulate (r = 0.627, p = 0.001), right dorsolateral prefrontal cortex (r = 0.568, p = 0.004), left fusiform gyrus (r = 0.487, p = 0.016), left precentral gyrus (r = 0.415, p = 0.044), and left hippocampus (r = 0.404, p = 0.050) and with number of migraine years for left fusiform gyrus (r = 0.425, p = 0.038). There were no significant correlations between activation strength and time to next migraine attack. Conclusions The majority of regions with enhanced…

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Evidence Hub reads this as a case-control. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.

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