Atypical Resting-State Functional Connectivity of Affective Pain Regions in Chronic Migraine

Authors

  • Todd J. Schwedt MD,

    Corresponding author
    1. Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
    • Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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  • Bradley L. Schlaggar MD, PhD,

    1. Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
    2. Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
    3. Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
    4. Department of Anatomy & Neurobiology, Washington University School of Medicine, St. Louis, MO, USA
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  • Soe Mar MD,

    1. Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
    2. Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
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  • Tracy Nolan BS,

    1. Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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  • Rebecca S. Coalson BS,

    1. Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
    2. Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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  • Binyam Nardos BA,

    1. Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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  • Tammie Benzinger MD, PhD,

    1. Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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  • Linda J. Larson-Prior PhD

    1. Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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  • Conflict of Interest: The authors report no conflict of interest.
  • Funding: This work was supported by the National Headache Foundation (to T.J.S.); the National Institutes of Health (K23NS070891 to T.J.S., KL2RR024994 to T.J.S., UL1RR024992 to Washington University); and American Roentgen Ray Scholar Award (to T.B.).

Address all correspondence to T. Schwedt, Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA, email: schwedt.todd@mayo.edu

Abstract

Objective.—

Chronic migraineurs (CM) have painful intolerances to somatosensory, visual, olfactory, and auditory stimuli during and between migraine attacks. These intolerances are suggestive of atypical affective responses to potentially noxious stimuli. We hypothesized that atypical resting-state functional connectivity (rs-fc) of affective pain-processing brain regions may associate with these intolerances. This study compared rs-fc of affective pain-processing regions in CM with controls.

Methods.—

Twelve minutes of resting-state blood oxygenation level-dependent data were collected from 20 interictal adult CM and 20 controls. Rs-fc between 5 affective regions (anterior cingulate cortex, right/left anterior insula, and right/left amygdala) with the rest of the brain was determined. Functional connections consistently differing between CM and controls were identified using summary analyses. Correlations between number of migraine years and the strengths of functional connections that consistently differed between CM and controls were calculated.

Results.—

Functional connections with affective pain regions that differed in CM and controls included regions in anterior insula, amygdala, pulvinar, mediodorsal thalamus, middle temporal cortex, and periaqueductal gray. There were significant correlations between the number of years with CM and functional connectivity strength between the anterior insula with mediodorsal thalamus and anterior insula with periaqueductal gray.

Conclusion.—

CM is associated with interictal atypical rs-fc of affective pain regions with pain-facilitating and pain-inhibiting regions that participate in sensory-discriminative, cognitive, and integrative domains of the pain experience. Atypical rs-fc with affective pain regions may relate to aberrant affective pain processing and atypical affective responses to painful stimuli characteristic of CM.

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