The altered right frontoparietal network functional connectivity in migraine and the modulation effect of treatment

Abstract

Aims This study aims to investigate the resting-state functional connectivity (rs-fc) of the right frontoparietal network (rFPN) between migraineurs and healthy controls (HCs) in order to determine how the rFPN rs-fc can be modulated by effective treatment. Methods One hundred patients and 46 matched HCs were recruited. Migraineurs were randomized to verum acupuncture, sham acupuncture, and waiting list groups. Resting-state functional magnetic resonance imaging data were collected before and after longitudinal treatments. Independent component analysis was applied in the data analysis. Results We found that migraineurs showed decreased rs-fc between the rFPN and bilateral precuneus compared with HCs. After treatments (real and sham), rFPN rs-fc with the precuneus was significantly reduced. This reduction was associated with headache intensity relief. In order to explore the role of the precuneus in acupuncture modulation, we performed a seed-based rs-fc analysis using the precuneus as a seed and found that the precuneus rs-fc with the bilateral rostral anterior cingulate cortex/medial prefrontal cortex, ventral striatum, and dorsolateral prefrontal cortex was significantly enhanced after treatment. Conclusion Our results suggest that migraineurs are associated with abnormal rFPN rs-fc. An effective treatment, such as acupuncture, may relieve symptoms by strengthening the cognitive adaptation/coping process. Elucidation of the adaptation/coping mechanisms may open up a new window for migraine management.

Keywords: Acupuncture; fMRI; frontoparietal network; independent component analysis; migraine without aura; resting-state functional connectivity.

Figure 1

Study flow chart. HC, healthy controls; MRI, magnetic resonance image; n, number; VA, verum acupuncture; SA, sham acupuncture; WT, waiting list.

Figure 2

Acupoint locations. GB, Gallbladder meridian; LI, Large intestine meridian; NAP, non acupoints; SA, sham acupuncture; SJ, Sanjiao meridian; ST; Stomach meridian; VA, verum acupuncture; WT, waiting list.

Figure 3

rFPN revealed by independent component analysis in this study.

Figure 4

rFPN resting state functional connectivity (rs-fc) results. 4A. MwoA showed reduced rFPN rs-fc with the precuneus at baseline compared with HC; 4B. fFPN rs-fc between the precuneus and MPFC/rACC was associated with headache VAS at baseline; 4C. The reduced rFPN rs-fc with the precuneus due to acupuncture treatment (verum + sham); 4D. The greater reduction of rFPN rs-fc with the right precuneus was associated with greater headache intensity relief. A threshold of Z > 2.3, P < 0.05 was applied. AG, acupuncture groups; HC, healthy controls; MwoA, migraine without aura; R, right side; rFPN, right frontoparietal network; VAS, visual analogue scale.

Figure 5

Precuneus resting state functional connectivity (rs-fc) results. 5A. MwoA showed reduced precuneus rs-fc with the supramarginal gyrus and inferior temporal gyrus, compared with HC. 5B. MwoA patients showed increased right precuneus rs-fc with the bilateral rACC/MPFC, ventral striatum, DLPFC and VLPFC, due to acupuncture treatment (verum + sham). A threshold of Voxelwise P < 0.005 and p < 0.05 FWE corrected was applied. AG, acupuncture groups; DLPFC, dorsolateral prefrontal cortex; HC, healthy controls; Inf, inferior; L, left side; MPFC, medial prefrontal cortex; MwoA, migraine without aura; Mid, middle; R, right side; rACC, rostral anterior cingulate cortex; VLPFC, ventrolateral prefrontal cortex.