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Increased neural connectivity between the hypothalamus and cortical resting-state functional networks in chronic migraine

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Abstract

Objective

The findings of resting-state functional MRI studies have suggested that abnormal functional integration between interconnected cortical networks characterises the brain of patients with migraine. The aim of this study was to investigate the functional connectivity between the hypothalamus, brainstem, considered as the migraine generator, and the following areas/networks that are reportedly involved in the pathophysiology of migraine: default mode network (DMN), executive control network, dorsal attention system, and primary and dorsoventral visual networks.

Methods

Twenty patients with chronic migraine (CM) without medication overuse and 20 healthy controls (HCs) were prospectively recruited. All study participants underwent 3-T MRI scans using a 7.5-min resting-state protocol. Using a seed-based approach, we performed a ROI-to-ROI analysis selecting the hypothalamus as the seed.

Results

Compared to HCs, patients with CM showed significantly increased neural connectivity between the hypothalamus and brain areas belonging to the DMN and dorsal visual network. We did not detect any connectivity abnormalities between the hypothalamus and the brainstem. The correlation analysis showed that the severity of the migraine headache was positively correlated with the connectivity strength of the hypothalamus and negatively with the connectivity strength of the medial prefrontal cortex, which belongs to the DMN.

Conclusion

These data provide evidence for hypothalamic involvement in large-scale reorganisation at the functional-network level in CM and in proportion with the perceived severity of the migraine pain.

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Acknowledgements

The contribution of the G.B. Bietti Foundation in this paper was supported by the Italian Ministry of Health and the Fondazione Roma.

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Authors and Affiliations

  1. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy

    Gianluca Coppola, Mariano Serrao & Francesco Pierelli

  2. Research Unit of Neurophysiology of Vision and Neurophthalmology, IRCCS-Fondazione Bietti, Via Livenza 3, 00198, Rome, Italy

    Antonio Di Renzo & Vincenzo Parisi

  3. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

    Barbara Petolicchio, Emanuele Tinelli, Valentina Calistri, Stefano Tardioli, Gaia Cartocci, Francesca Caramia & Vittorio Di Piero

  4. Don Carlo Gnocchi Onlus Foundation, Milan, Italy

    Cherubino Di Lorenzo

  5. IRCCS-Neuromed, Pozzilli, IS, Italy

    Francesco Pierelli

Authors
  1. Gianluca Coppola
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Corresponding author

Correspondence to Vincenzo Parisi.

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The authors declare no financial or other conflicts of interest.

Ethical standard

The study was approved by ethical review board of the Faculty of Medicine, University of Rome, Italy. Written informed consent was obtained from all participants in this study.

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Coppola, G., Di Renzo, A., Petolicchio, B. et al. Increased neural connectivity between the hypothalamus and cortical resting-state functional networks in chronic migraine. J Neurol 267, 185–191 (2020). https://doi.org/10.1007/s00415-019-09571-y

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  • DOI: https://doi.org/10.1007/s00415-019-09571-y

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