Functional connectivity of the visual cortex in chronic migraine before and after medication withdrawal therapy
Acute withdrawal of headache medication in chronic migraine patients with medication overuse may lead to a dramatic reduction in headache frequency and severity. However, the brain networks underlying chronic migraine and a favorable response to acute withdrawal are still poorly understood. The goal...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | NeuroImage: Clinical |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158223002346 |
| _version_ | 1797526215547944960 |
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| author | Veronica Mäki-Marttunen Dennis A. Kies Judith A. Pijpers Mark A. Louter Nic J. van der Wee Serge A.R.B. Rombouts Sander Nieuwenhuis Mark Kruit Gisela M. Terwindt |
| author_facet | Veronica Mäki-Marttunen Dennis A. Kies Judith A. Pijpers Mark A. Louter Nic J. van der Wee Serge A.R.B. Rombouts Sander Nieuwenhuis Mark Kruit Gisela M. Terwindt |
| author_sort | Veronica Mäki-Marttunen |
| collection | DOAJ |
| description | Acute withdrawal of headache medication in chronic migraine patients with medication overuse may lead to a dramatic reduction in headache frequency and severity. However, the brain networks underlying chronic migraine and a favorable response to acute withdrawal are still poorly understood. The goal of the present study was to characterize the pattern of intrinsic magnetic resonance imaging (MRI) functional connectivity (FC) specific to chronic migraine and to identify changes in FC that characterize subjects with CM reverting to less frequent headaches. Subjects with chronic migraine (N = 99) underwent a resting-state functional MRI scan before and after three months of medication withdrawal therapy. In addition, we included four control groups who were scanned once: healthy participants (N = 27), patients with episodic migraine (N = 25), patients with chronic back pain (N = 22), and patients with clinical depression (N = 17). Using dual regression analysis, we compared whole-brain voxel-level functional connectivity with ten well-known resting-state networks between chronic migraine and control groups, and between responders to treatment (≥50 % reduction in monthly headache days) and non-responders (<50 % reduction), before and after treatment. Subjects with chronic migraine showed differences in FC with a number of RS-networks, most of which involved the visual cortex, compared with healthy controls. A comparison with patients with episodic migraine, chronic pain and depression showed differences in the same direction, suggesting that altered patterns of functional connectivity in chronic migraine patients could to some extent be explained by shared symptomatology with other pain, depression, or migraine conditions. A comparison between responders and non-responders indicated that effective withdrawal reduced FC with the visual cortex for responders. Interestingly, responders already differed in functional connectivity of the visual cortex at baseline compared with non-responders. Altogether, we show that chronic migraine and successful medication withdrawal therapy are linked to changes in the functional connectivity of the visual cortex. These neuroimaging findings provide new insights into the pathways underlying migraine chronification and its reversibility. |
| first_indexed | 2024-03-10T09:27:01Z |
| format | Article |
| id | doaj.art-d4e1ed34bb24420da717ff636c788131 |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-03-10T09:27:01Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-d4e1ed34bb24420da717ff636c7881312023-11-22T04:47:20ZengElsevierNeuroImage: Clinical2213-15822023-01-0140103543Functional connectivity of the visual cortex in chronic migraine before and after medication withdrawal therapyVeronica Mäki-Marttunen0Dennis A. Kies1Judith A. Pijpers2Mark A. Louter3Nic J. van der Wee4Serge A.R.B. Rombouts5Sander Nieuwenhuis6Mark Kruit7Gisela M. Terwindt8Cognitive Psychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The NetherlandsDepartment of Neurology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Neurology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, the NetherlandsLeiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, the NetherlandsLeiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The NetherlandsCognitive Psychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The NetherlandsDepartment of Radiology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Corresponding author at: neurologist-biologist, Dept. of Neurology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands.Acute withdrawal of headache medication in chronic migraine patients with medication overuse may lead to a dramatic reduction in headache frequency and severity. However, the brain networks underlying chronic migraine and a favorable response to acute withdrawal are still poorly understood. The goal of the present study was to characterize the pattern of intrinsic magnetic resonance imaging (MRI) functional connectivity (FC) specific to chronic migraine and to identify changes in FC that characterize subjects with CM reverting to less frequent headaches. Subjects with chronic migraine (N = 99) underwent a resting-state functional MRI scan before and after three months of medication withdrawal therapy. In addition, we included four control groups who were scanned once: healthy participants (N = 27), patients with episodic migraine (N = 25), patients with chronic back pain (N = 22), and patients with clinical depression (N = 17). Using dual regression analysis, we compared whole-brain voxel-level functional connectivity with ten well-known resting-state networks between chronic migraine and control groups, and between responders to treatment (≥50 % reduction in monthly headache days) and non-responders (<50 % reduction), before and after treatment. Subjects with chronic migraine showed differences in FC with a number of RS-networks, most of which involved the visual cortex, compared with healthy controls. A comparison with patients with episodic migraine, chronic pain and depression showed differences in the same direction, suggesting that altered patterns of functional connectivity in chronic migraine patients could to some extent be explained by shared symptomatology with other pain, depression, or migraine conditions. A comparison between responders and non-responders indicated that effective withdrawal reduced FC with the visual cortex for responders. Interestingly, responders already differed in functional connectivity of the visual cortex at baseline compared with non-responders. Altogether, we show that chronic migraine and successful medication withdrawal therapy are linked to changes in the functional connectivity of the visual cortex. These neuroimaging findings provide new insights into the pathways underlying migraine chronification and its reversibility.http://www.sciencedirect.com/science/article/pii/S2213158223002346MigraineFunctional connectivityWithdrawal therapyVisual cortexfMRI |
| spellingShingle | Veronica Mäki-Marttunen Dennis A. Kies Judith A. Pijpers Mark A. Louter Nic J. van der Wee Serge A.R.B. Rombouts Sander Nieuwenhuis Mark Kruit Gisela M. Terwindt Functional connectivity of the visual cortex in chronic migraine before and after medication withdrawal therapy NeuroImage: Clinical Migraine Functional connectivity Withdrawal therapy Visual cortex fMRI |
| title | Functional connectivity of the visual cortex in chronic migraine before and after medication withdrawal therapy |
| title_full | Functional connectivity of the visual cortex in chronic migraine before and after medication withdrawal therapy |
| title_fullStr | Functional connectivity of the visual cortex in chronic migraine before and after medication withdrawal therapy |
| title_full_unstemmed | Functional connectivity of the visual cortex in chronic migraine before and after medication withdrawal therapy |
| title_short | Functional connectivity of the visual cortex in chronic migraine before and after medication withdrawal therapy |
| title_sort | functional connectivity of the visual cortex in chronic migraine before and after medication withdrawal therapy |
| topic | Migraine Functional connectivity Withdrawal therapy Visual cortex fMRI |
| url | http://www.sciencedirect.com/science/article/pii/S2213158223002346 |
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