Altered regional cerebral blood flow and hypothalamic connectivity immediately prior to a migraine headache
MetadataShow full item record
Funding and Sponsorship
© International Headache Society 2020. Background: There is evidence of altered resting hypothalamic activity patterns and connectivity prior to a migraine, however it remains unknown if these changes are driven by changes in overall hypothalamic activity levels. If they are, it would corroborate the idea that changes in hypothalamic function result in alteration in brainstem pain processing sensitivity, which either triggers a migraine headache itself or allows an external trigger to initiate a migraine headache. We hypothesise that hypothalamic activity increases immediately prior to a migraine headache and this is accompanied by altered functional connectivity to pain processing sites in the brainstem. Methods: In 34 migraineurs and 26 healthy controls, we collected a series comprising 108 pseudo-continuous arterial spin labelling images and 180 gradient-echo echo planar resting-state functional magnetic resonance volumes to measure resting regional cerebral blood flow and functional connectivity respectively. Images were pre-processed and analysed using custom SPM12 and Matlab software. Results: Our results reflect that immediately prior to a migraine headache, resting regional cerebral blood flow decreases in the lateral hypothalamus. In addition, resting functional connectivity strength decreased between the lateral hypothalamus and important regions of the pain processing pathway, such as the midbrain periaqueductal gray, dorsal pons, rostral ventromedial medulla and cingulate cortex, only during this critical period before a migraine headache. Conclusion: These data suggest altered hypothalamic function and connectivity in the period immediately prior to a migraine headache and supports the hypothesis that the hypothalamus is involved in migraine initiation.
Showing items related by title, author, creator and subject.
Meylakh, N.; Marciszewski, K.K.; Harrington, Flavia ; Macefield, V.G.; Macey, P.M.; Henderson, L.A. (2018)© 2018 Wiley Periodicals, Inc. The neural mechanism responsible for migraine remains unclear. While the role of an external trigger in migraine initiation remains vigorously debated, it is generally assumed that migraineurs ...
Marciszewski, K.K.; Meylakh, N.; Harrington, Flavia ; Mills, E.P.; Macefield, V.G.; Macey, P.M.; Henderson, L.A. (2018)© 2018 the authors. The neural mechanism responsible for migraine remains unclear. While an external trigger has been proposed to initiate a migraine, it has also been proposed that changes in brainstem function are ...
Fluctuating regional brainstem diffusion imaging measures of microstructure across the migraine cycleMarciszewski, K.K.; Meylakh, N.; Di Pietro, Flavia ; Macefield, V.G.; Macey, P.M.; Henderson, L.A. (2019)© 2019 Marciszewski et al. The neural mechanisms responsible for the initiation and expression of migraines remain unknown. Although there is growing evidence of changes in brainstem anatomy and function between attacks, ...