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. 2013 Nov;33(15):1264-8.
doi: 10.1177/0333102413490344. Epub 2013 May 29.

The missing link: enhanced functional connectivity between amygdala and visceroceptive cortex in migraine

Nouchine Hadjikhani  1 , Noreen Ward, Jasmine Boshyan, Vitaly Napadow, Yumi Maeda, Andrea Truini, Francesca Caramia, Emanuele Tinelli, Caterina Mainero
Affiliations

The missing link: enhanced functional connectivity between amygdala and visceroceptive cortex in migraine

Nouchine Hadjikhani et al. Cephalalgia. 2013 Nov.

Abstract

Background: Migraine is a neurovascular disorder in which altered functional connectivity between pain-modulating circuits and the limbic system may play a role. Cortical spreading depression (CSD), which underlies migraine aura (MWA), induces C-fos expression in the amygdala. The role of CSD and amygdala connectivity in migraine without aura (MwoA) is less clear and may differentiate migraine from other chronic pain disorders.

Methods: Using resting-state functional MRI, we compared functional connectivity between the amygdala and the cortex in MWA and MWoA patients as well as in healthy subjects and in two other chronic pain conditions not associated with CSD: trigeminal neuralgia (TGN) and carpal tunnel syndrome (CTS).

Results: Amygdala connectivity in both MWA and MWoA was increased to the visceroceptive insula relative to all other groups examined.

Conclusion: The observed increased connectivity within the limbic/viscerosensory network, present only in migraineurs, adds to the evidence of a neurolimbic pain network dysfunction and may reflect repetitive episodes of CSD leading to the development of migraine pain.

Keywords: Migraine; amygdala; cortical spreading depression; insula; neurolimbic pain network.

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Figures

Figure 1
Figure 1
Top and bottom panels: Statistical maps of connectivity between the amygdala and the rest of the brain (p<0.005, uncorrected), in MWA, MWoA, TGN and CTS. Although MWA exhibit the stronger connectivity between the amygdala and the insula, MWoA also present connectivity between these structures, whereas they are absent in TGN and CTS patients. The maps are displayed on the inflated cortical surface of the template FreeSurfer brain (fsaverage) on the lateral surface of the brain
Figure 2
Figure 2
Coronal section at the level of the insula at y=2 on the MNI average brain, showing the statistical maps of difference in connectivity with the amygdala between MWoA vs. matched controls, MWA vs. matched controls, TG vs. matched controls and CTS vs. matched controls. As in the direct maps of connectivity shown in Figure 1, one can see that both groups of migraineurs show connectivity between the amygdala and the insula, when compared with controls, whereas this is not the case in the two other groups.
See this image and copyright information in PMC

References

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