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Functional neuroimaging in migraine: usefulness for the clinical neurologist

  • CRANIO-FACIAL PAIN AND FUNCTIONAL NEUROIMAGING
  • Published:
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Abstract

Migraine is a common, multifactorial disorder, typically characterized by recurrent attacks of throbbing unilateral headache, autonomic nervous system dysfunction and, in approximately one-third of cases, neurological transient symptoms (migraineous aura). The diagnosis of primary headaches is exclusively a clinical task but, for this reason, it is sometimes subjective and arbitrary. However, until today no single diagnostic tool is able to define, ensure or differentiate idiopathic headache syndromes, although, in the clinical setting, conventional neuroimaging techniques are often widely and improperly used in headache patients. Recent years have seen rapid growth of neuroimaging methodology which has provided new insights into functional brain organization of migraine patients. Although functional magnetic resonance imaging has today little or no value in clinical practice, clinicians role is crucial since without a proper clinical selection neuroimaging studies could generate inconclusive results. Likewise, functional neuroimaging is crucial for clinicians in order to further elucidate pathophysiological mechanisms underlying this complex and often disabling disease and to provide new therapeutical approaches for migraine patients.

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References

  1. Ferrari MD (1998) Migraine. Lancet 351:1043–1051

    Article  PubMed  CAS  Google Scholar 

  2. Headache Classification Subcommittee of International Headache Society (2004) The International classification of headache disorder (2nd edn) Cephalalgia 24 [Suppl 1]:9–160

  3. Launer LJ, Terwindr GM, Ferrari MD (1999) The prevalence and characteristics of migraine in a population-based cohort: the GEM study. Neurology 53:537–542

    Article  PubMed  CAS  Google Scholar 

  4. World Health Organization (2001). Mental Health: New understanding, new hope

  5. Frishberg BM, Rosenberg JH, Matchar DB Evidence based guidelines in the primary care setting: neuroimaging in patients with non acute headache. http://www.aan.com/professionals/practice/guideline/index.cfm

  6. Moschiano F, D’Amico D, Di Stefano M, Rocca N, Bussone G (2007) The role of the clinician in interpreting conventional neuroimaging findings in migraine patients. Neurol Sci 28:S114–S117

    Article  PubMed  Google Scholar 

  7. Bergerot A, Holland PR, Akerman S, Bartsch T, Ahn AH, MaassenVanDenBrink A, Reuter U, Tassorelli C, Schoenen J, Mitsikostas DD, van den Maagdenberg AM, Goadsby PJ (2006) Animal models of migraine: looking at the component parts of a complex disorder. Eur J Neurosci 24:1517–1534

    Article  PubMed  CAS  Google Scholar 

  8. What has imaging taught us about migraine? P. Davies Maturitas 70 (2011) 34–36

  9. Tfelt-Hansen PC, Koehler PJ (2011) One hundred years of migraine research: major clinical and scientific observations from 1910 to 2010. Headache 51(5):752–778

    Article  PubMed  Google Scholar 

  10. Olesen J, Larsen B, Lauritzen M (1981) Focal hyperemia followed by spreading oligemia and impaired activation of rCBF in classic migraine. Ann Neurol 9:344–352

    Article  PubMed  CAS  Google Scholar 

  11. Olesen J, Friberg L (1991) Xenon-133 SPECT studies in migraine without aura. Migraine and other headaches: the vascular mechanisms (ed) Raven Press, London, pp 237–243

  12. Lauritzen M, Olesen J (1984) Regional cerebral blood flow during migraine attacks by Xenon-133 inhalation and emission tomography. Brain 107(Pt 2):447–461

    Article  PubMed  Google Scholar 

  13. Sanchez del Rio M, Bakker D, Wu O, Agosti R, Mitsikostas DD, Ostergaard L, Wells WA, Rosen BR, Sorensen G, Moskowitz MA, Cutrer FM (1999) Perfusion weighted imaging during migraine: spontaneous visual aura and headache. Cephalalgia 19:701–707

    Article  PubMed  CAS  Google Scholar 

  14. Leão AAP (1944) Spreading depression of activity in the cerebral cortex. J Neurophysiol 7:359–390

    Google Scholar 

  15. Ayata C (2010) Cortical spreading depression triggers migraine attack: pro. Headache 50(4):725–30

    Google Scholar 

  16. Hadjikhani N, Sanchez Del Rio M, Wu O, Schwartz D, Bakker D, Fischl B, Kwong KK, Cutrer FM, Rosen BR, Tootell RB, Sorensen AG, Moskowitz MA (2001) Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci USA 98:4687–92

  17. Hall GC, Brown MM, Mo J, MacRae KD (2004) Triptans in migraine: the risks of stroke, cardiovascular disease, and death in practice. Neurology 62(4):563–568

    Article  PubMed  CAS  Google Scholar 

  18. Weiller C, May A, Limmroth V, Jüptner M, Kaube H, Schayck RV, Coenen HH, Diener HC (1995) Brain stem activation in spontaneous human migraine attacks. Nat Med 1:658–660

    Article  PubMed  CAS  Google Scholar 

  19. Bahra A, Matharu MS, Buchel C, Frackowiak RS, Goadsby PJ (2001) Brainstem activation specific to migraine headache. Lancet 357(9261):1016–1017

    Article  PubMed  CAS  Google Scholar 

  20. Afridi SK, Giffin NJ, Kaube H, Friston KJ, Ward NS, Frackowiak RS, Goadsby PJ (2005) A positron emission tomographic study in spontaneous migraine. Arch Neurol 62:1270–1275

    Article  PubMed  Google Scholar 

  21. Afridi SK, Matharu MS, Lee L, Kaube H, Friston KJ, Frackowiak RS, Goadsby PJ (2005) A PET study exploring the laterality of brainstem activation in migraine using glyceryl trinitrate. Brain 128:932–939

    Article  PubMed  CAS  Google Scholar 

  22. Sprenger T, Goadsby PJ (2010) What has functional neuroimaging done for primary headache…and for the clinical neurologist? J Clin Neurosci 17:547–553

    Article  PubMed  Google Scholar 

  23. Rocca MA, Ceccarelli A, Falini A, Colombo B, Tortorella P, Bernasconi L, Comi G, Scotti G, Filippi M (2006) Brain gray matter changes in migraine patients with T2-visible lesions: a 3-T MRI study. Stroke 37:1765–1770

    Article  PubMed  Google Scholar 

  24. Welch KM, Nagesh V, Aurora SK, Gelman N (2001) Periaqueductal gray matter dysfunction in migraine: cause or the burden of illness? Headache 41:629–637

    Article  PubMed  CAS  Google Scholar 

  25. Messlinger K, Fischer MJ, Lennerz JK (2011) Neuropeptide effects in the trigeminal system: pathophysiology and clinical relevance in migraine. Keio J Med 60(3):82–89

    Article  PubMed  CAS  Google Scholar 

  26. Stankewitz A, Voit HL, Bingel U, Peschke C, May A (2009) A new trigemino-nociceptive stimulation model for event-related fMRI. Cephalalgia 30(4):475–485

    Google Scholar 

  27. Ogawa S, Lee TM, Kay AR, Tank DW (1990) Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proc Natl Acad Sci USA 87(24):9868–72

    Google Scholar 

  28. Weissman-Fogel I, Sprecher E, Granovsky Y, Yarnitsky D (2003) Repeated noxious stimulation of the skin enhances cutaneous pain perception of migraine patients in-between attacks: clinical evidence for continuous sub-threshold increase in membrane excitability of central trigeminovascular neurons. Pain 104(3):693–700

    Article  PubMed  Google Scholar 

  29. Moulton EA, Burstein R, Tully S, Hargreaves R, Becerra L, Borsook D (2008) Interictal dysfunction of a brainstem descending modulatory center in migraine patients. PLoS One 3(11):e3799

    Google Scholar 

  30. Russo A, Tessitore A, Esposito F, Marcuccio L, Giordano A, Conforti R, Truini A, Paccone A, d’Onofrio F, Tedeschi G (2012) Pain processing in patients with migraine: an event-related fMRI study during trigeminal nociceptive stimulation. J Neurol [Epub ahead of print]

  31. Garcia-Larrea L, Frot M, Valeriani M (2003) Brain generators of laser-evoked potentials: from dipoles to functional significance. Neurophysiol Clin 33:279–292

    Article  PubMed  CAS  Google Scholar 

  32. Bushnell MC, Apkarian AV (2005) Representation of pain in the brain. In: McMahon S, Koltzenburg M (eds) Textbook of pain, 5th edn edn. Churchill Livingstone, Philadelphia, pp 267–289

    Google Scholar 

  33. May A, Kaube H, Büchel C, Eichten C, Rijntjes M, Jüptner M, Weiller C, Diener HC (1998) Experimental cranial pain elicited by capsaicin: a PET study. Pain 74:61–66

    Article  PubMed  CAS  Google Scholar 

  34. Bishop KL, Holm JE, Borowiak DM, Wilson BA (2001) Perceptions of pain in women with headache: a laboratory investigation of the influence of pain-related anxiety and fear. Headache 41:494–499

    Article  PubMed  CAS  Google Scholar 

  35. Grazzi L, Chiapparini L, Ferraro S, Usai S, Andrasik F, Mandelli ML, Bruzzone MG, Bussone G (2010) Chronic migraine with medication overuse pre-post withdrawal of symptomatic medication: clinical results and FMRI correlations. Headache 50(6):998–1004

    Article  PubMed  Google Scholar 

  36. Gierse-Plogmeier B, Colak-Ekici R, Wolowski A, Gralow I, Marziniak M, Evers S (2009) Differences in trigeminal and peripheral electrical pain perception in women with and without migraine. J Headache Pain 10(4):249–254

    Article  PubMed  Google Scholar 

  37. Brooks J, Tracey I (2005) From nociception to pain perception: imaging the spinal and supraspinal pathways. J Anat 207:19–33

    Article  PubMed  Google Scholar 

  38. Peyron R, Laurent B, Garcia-Larrea L (2000) Functional imaging of brain responses to pain. A review and meta-analysis. Neurophysiol Clin 30:263–288

    Article  PubMed  CAS  Google Scholar 

  39. Valet M, Sprenger T, Boecker H, Willoch F, Rummeny E, Conrad B, Erhard P, Tolle TR (2004) Distraction modulates connectivity of the cingulo-frontal cortex and the midbrain during pain—an fMRI analysis. Pain 109:399–408

    Article  PubMed  Google Scholar 

  40. Ingvar M (1999) Pain and functional imaging. Philos Trans R Soc Lond B Biol Sci 354:1347–1358

    Article  PubMed  CAS  Google Scholar 

  41. Albe-Fessard D, Berkley KJ, Kruger L, Ralston HJ 3rd, Willis WD Jr (1985) Diencephalic mechanisms of pain sensation. Brain Res 356:217–296

    PubMed  CAS  Google Scholar 

  42. Avenanti A, Bueti D, Galati G, Aglioti SM (2005) Transcranial magnetic stimulation highlights the sensorimotor side of empathy for pain. Nat Neurosci 8:955–960

    PubMed  CAS  Google Scholar 

  43. Bandettini PA (2009) What’s new in neuroimaging methods? Ann N Y Acad Sci 1156:260–293

    Article  PubMed  Google Scholar 

  44. Tessitore A, Russo A, Esposito F, Giordano A, Taglialatela G, De Micco R, Cirillo M, Conte F, d’Onofrio F, Cirillo S, Tedeschi G (2011) Interictal cortical reorganization in episodic migraine without aura: an event-related fMRI study during parametric trigeminal nociceptive stimulation. Neurol Sci 32(Suppl 1):S165–S167

    Article  PubMed  Google Scholar 

  45. May A (2007) Neuroimaging: visualising the brain in pain. Neurol Sci 28:S101–S107

    Article  PubMed  Google Scholar 

  46. Cutrer FM (2008) Functional imaging in primary headache disorders. Headache 48:704–706

    Article  PubMed  Google Scholar 

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The authors certifies that there is no actual or potential conflict of interest in relation to this article.

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Authors and Affiliations

  1. Clinica Neurologica II, Seconda Università degli Studi di Napoli, Naples, Italy

    Gioacchino Tedeschi, Antonio Russo & Alessandro Tessitore

  2. Istituto di Diagnosi e Cura Hermitage-Capodimonte, Naples, Italy

    Antonio Russo

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  1. Gioacchino Tedeschi
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  2. Antonio Russo
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  3. Alessandro Tessitore
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Correspondence to Gioacchino Tedeschi.

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Tedeschi, G., Russo, A. & Tessitore, A. Functional neuroimaging in migraine: usefulness for the clinical neurologist. Neurol Sci 33 (Suppl 1), 91–94 (2012). https://doi.org/10.1007/s10072-012-1049-2

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  • DOI: https://doi.org/10.1007/s10072-012-1049-2

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