Altered functional connectivity architecture of the brain in medication overuse headache using resting state fMRI

Abstract

Background: Functional connectivity density (FCD) could identify the abnormal intrinsic and spontaneous activity over the whole brain, and a seed-based resting-state functional connectivity (RSFC) could further reveal the altered functional network with the identified brain regions. This may be an effective assessment strategy for headache research. This study is to investigate the RSFC architecture changes of the brain in the patients with medication overuse headache (MOH) using FCD and RSFC methods.

Methods: 3D structure images and resting-state functional MRI data were obtained from 37 MOH patients, 18 episodic migraine (EM) patients and 32 normal controls (NCs). FCD was calculated to detect the brain regions with abnormal functional activity over the whole brain, and the seed-based RSFC was performed to explore the functional network changes in MOH and EM.

Results: The decreased FCD located in right parahippocampal gyrus, and the increased FCD located in left inferior parietal gyrus and right supramarginal gyrus in MOH compared with NC, and in right caudate and left insula in MOH compared with EM. RSFC revealed that decreased functional connectivity of the brain regions with decreased FCD anchored in the right dorsal-lateral prefrontal cortex, right frontopolar cortex in MOH, and in left temporopolar cortex and bilateral visual cortices in EM compared with NC, and in frontal-temporal-parietal pattern in MOH compared with EM.

Conclusions: These results provided evidence that MOH and EM suffered from altered intrinsic functional connectivity architecture, and the current study presented a new perspective for understanding the neuromechanism of MOH and EM pathogenesis.

Keywords: Brain; Functional connectivity; Functional connectivity density; Magnetic resonance imaging; Medication overuse headache.

Fig. 1

a, Fucntioal connectivity density (FCD) distribution in normal controls; b, FCD distribution in MOH patients; c, FCD distribution in EM patients; d, The brain regions with significant decreased FCD in MOH compared with NC; e, The brain regions with significant increased FCD in MOH compared with NC; f, The brain regions with significant decreased FCD in EM compared with NC; g, The brain regions with significant increased FCD in EM compared with NC; h, The brain regions with significant decreased FCD in MOH compared with EM. L, left hemisphere; R, right hemisphere

Fig. 2

a, The decreased RSFC of the right parahippocampal gyrus in MOH compared with NC; b, The decreased RSFC of the left ACC in EM compared with NC; c, The decreased RSFC of the right IFG-orb in EM compared with NC; d, The decreased RSFC of the right caudate in MOH compared with EM; e, The decreased RSFC of the left insula in MOH compared with EM; L, left hemisphere; R, right hemisphere