The Chronic Migraine Brain: What Have We Learned From Neuroimaging?

Chronic migraine is a highly disabling disease with a great impact on socioeconomic functioning and quality of life of migraine patients. Chronic migraine usually evolves from episodic migraine that gradually increases in attack frequency, supporting the view of migraine as a spectrum disorder. Path...

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Main Authors: Massimo Filippi, Roberta Messina
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-01-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fneur.2019.01356/full
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author Massimo Filippi
Massimo Filippi
Massimo Filippi
Roberta Messina
Roberta Messina
author_facet Massimo Filippi
Massimo Filippi
Massimo Filippi
Roberta Messina
Roberta Messina
author_sort Massimo Filippi
collection DOAJ
description Chronic migraine is a highly disabling disease with a great impact on socioeconomic functioning and quality of life of migraine patients. Chronic migraine usually evolves from episodic migraine that gradually increases in attack frequency, supporting the view of migraine as a spectrum disorder. Pathophysiological mechanisms responsible for migraine chronification are not fully understood. Likewise episodic migraine, chronic migraine patients show widespread functional and structural alterations of cortical and subcortical pain-related brain areas. However, chronic migraine patients experience a more pronounced dysfunction of the pain inhibitory network and an increased sensitization of the central pain pathways, which might explain the higher susceptibility to migraine attacks. Imaging studies have highlighted that brain regions with a key role in migraine attack generation, like the pons and hypothalamus, might also be involved in migraine chronification. Whether brain alterations are biomarkers that predispose migraine patients to chronification or reflect adaptive or maladaptive responses to the increasing headache frequency is still a matter of debate. The central mechanisms of action of chronic migraine preventive treatments and imaging biomarkers that could predict patients' treatment response have also been explored. In this new era of migraine treatments, a better understanding of chronic migraine pathophysiology will pave the way for the development of new improved treatments specifically designed for chronic migraine patients.
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spelling doaj.art-11bd5d9acca647a2b25564252418e1232022-12-22T00:09:11ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-01-011010.3389/fneur.2019.01356500543The Chronic Migraine Brain: What Have We Learned From Neuroimaging?Massimo Filippi0Massimo Filippi1Massimo Filippi2Roberta Messina3Roberta Messina4Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, ItalyNeurology Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyVita-Salute San Raffaele University, Milan, ItalyNeuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, ItalyNeurology Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyChronic migraine is a highly disabling disease with a great impact on socioeconomic functioning and quality of life of migraine patients. Chronic migraine usually evolves from episodic migraine that gradually increases in attack frequency, supporting the view of migraine as a spectrum disorder. Pathophysiological mechanisms responsible for migraine chronification are not fully understood. Likewise episodic migraine, chronic migraine patients show widespread functional and structural alterations of cortical and subcortical pain-related brain areas. However, chronic migraine patients experience a more pronounced dysfunction of the pain inhibitory network and an increased sensitization of the central pain pathways, which might explain the higher susceptibility to migraine attacks. Imaging studies have highlighted that brain regions with a key role in migraine attack generation, like the pons and hypothalamus, might also be involved in migraine chronification. Whether brain alterations are biomarkers that predispose migraine patients to chronification or reflect adaptive or maladaptive responses to the increasing headache frequency is still a matter of debate. The central mechanisms of action of chronic migraine preventive treatments and imaging biomarkers that could predict patients' treatment response have also been explored. In this new era of migraine treatments, a better understanding of chronic migraine pathophysiology will pave the way for the development of new improved treatments specifically designed for chronic migraine patients.https://www.frontiersin.org/article/10.3389/fneur.2019.01356/fullchronic migraineneuroimagingchronificationpain networkbiomarkers
spellingShingle Massimo Filippi
Massimo Filippi
Massimo Filippi
Roberta Messina
Roberta Messina
The Chronic Migraine Brain: What Have We Learned From Neuroimaging?
Frontiers in Neurology
chronic migraine
neuroimaging
chronification
pain network
biomarkers
title The Chronic Migraine Brain: What Have We Learned From Neuroimaging?
title_full The Chronic Migraine Brain: What Have We Learned From Neuroimaging?
title_fullStr The Chronic Migraine Brain: What Have We Learned From Neuroimaging?
title_full_unstemmed The Chronic Migraine Brain: What Have We Learned From Neuroimaging?
title_short The Chronic Migraine Brain: What Have We Learned From Neuroimaging?
title_sort chronic migraine brain what have we learned from neuroimaging
topic chronic migraine
neuroimaging
chronification
pain network
biomarkers
url https://www.frontiersin.org/article/10.3389/fneur.2019.01356/full
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