Journal of Neurology

, Volume 259, Issue 9, pp 1903–1912

Pain processing in patients with migraine: an event-related fMRI study during trigeminal nociceptive stimulation

  • Antonio Russo
  • Alessandro Tessitore
  • Fabrizio Esposito
  • Laura Marcuccio
  • Alfonso Giordano
  • Renata Conforti
  • Andrea Truini
  • Antonella Paccone
  • Florindo d’Onofrio
  • Gioacchino Tedeschi
Original Communication

DOI: 10.1007/s00415-012-6438-1

Cite this article as:
Russo, A., Tessitore, A., Esposito, F. et al. J Neurol (2012) 259: 1903. doi:10.1007/s00415-012-6438-1

Abstract

We explored the functional pattern of the pain-processing network in patients with migraine, in the interictal periods, during trigeminal noxious stimulation. Contact heat evoked potential stimulation induced thermal pain and functional magnetic resonance imaging were used to measure whole-brain activation in 16 patients with episodic migraine without aura and 16 age- and gender-matched healthy controls in response to a severe (53°C) noxious, a moderate (51°C) noxious, and a control (41°C) stimulus applied to the maxillary skin. When comparing the fMRI activation over the entire brain, patients with migraine, with respect to healthy controls, showed a significantly greater activation in the perigenual part of anterior cingulate cortex at 51°C and less activation in the bilateral secondary somatosensory cortex at 53°C. A group-by-stimulus interaction analysis revealed a region in the pons showing a divergent response in patients and healthy controls. Correlation analyses demonstrated that the pons activation correlated with higher headache-related disability in patients. Our findings demonstrate increased antinociceptive activity in patients with migraine, which may represent a compensatory reorganization to modulate pain perception at the same intensity of healthy controls.

Keywords

fMRIMigrainePain processingAnterior cingulate cortexSecondary somatosensory cortexPons

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Antonio Russo
    • 1
    • 2
  • Alessandro Tessitore
    • 1
  • Fabrizio Esposito
    • 2
    • 3
  • Laura Marcuccio
    • 1
  • Alfonso Giordano
    • 1
    • 2
  • Renata Conforti
    • 2
  • Andrea Truini
    • 4
    • 5
  • Antonella Paccone
    • 2
  • Florindo d’Onofrio
    • 6
  • Gioacchino Tedeschi
    • 1
    • 2
  1. 1.Department of Neurological SciencesSecond University of NaplesNaplesItaly
  2. 2.Neurological Institute for Diagnosis and Care “Hermitage Capodimonte”NaplesItaly
  3. 3.Department of NeuroscienceUniversity of Naples “Federico II”NaplesItaly
  4. 4.Department of Neurology and PsychiatryUniversity SapienzaRomeItaly
  5. 5.Don Gnocchi FoundationMilanItaly
  6. 6.Unit of NeurologyAzienda Ospedaliera “S.G. Moscati” AvellinoAvellinoItaly