Association between migraine frequency and neural response to emotional faces: An fMRI study

Abstract

Previous studies have demonstrated that migraine is associated with enhanced perception and altered cerebral processing of sensory stimuli. More recently, it has been suggested that this sensory hypersensitivity might reflect a more general enhanced response to aversive emotional stimuli. Using functional magnetic resonance imaging and emotional face stimuli (fearful, happy and sad faces), we compared whole-brain activation between 41 migraine patients without aura in interictal period and 49 healthy controls. Migraine patients showed increased neural activation to fearful faces compared to neutral faces in the right middle frontal gyrus and frontal pole relative to healthy controls. We also found that higher attack frequency in migraine patients was related to increased activation mainly in the right primary somatosensory cortex (corresponding to the face area) to fearful expressions and in the right dorsal striatal regions to happy faces. In both analyses, activation differences remained significant after controlling for anxiety and depressive symptoms. These findings indicate that enhanced response to emotional stimuli might explain the migraine trigger effect of psychosocial stressors that gradually leads to increased somatosensory response to emotional clues and thus contributes to the progression or chronification of migraine.

Keywords: Emotion processing; Headache chronification; Migraine; Psychosocial stress; Somatosensory cortex; fMRI.

Fig. 1

Experimental paradigm (block design). N, Neutral blocks; H, Happy blocks; S, Sad blocks; F, Fear blocks; R, Rest blocks.

Fig. 2

Migraine patients displayed increased activation in response to fearful faces compared to healthy controls. The significant cluster is shown at p_FWE = 0.05, corrected for multiple comparison. The key areas are primarily located in the right middle frontal gyrus. Coordinates are in Montreal Neurological Institute (MNI) space.

Fig. 3

During exposure to fearful faces migraine frequency was associated with increased activation in the right postcentral gyrus and right inferior parietal lobule, and estimated lifetime number of migraine attacks were related to increased right postcentral gyrus and right angular gyrus activation. Increased neural response related to happy faces showed significant association with migraine frequency in the right caudate nucleus and right putamen. Significantly activated clusters are shown at p_FWE = 0.05, corrected for multiple comparison. Coordinates are in Montreal Neurological Institute (MNI) space.