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. 2022 Jun 21:13:915346.
doi: 10.3389/fneur.2022.915346. eCollection 2022.

fMRI Findings in Cortical Brain Networks Interactions in Migraine Following Repetitive Transcranial Magnetic Stimulation

Kirill Markin  1 , Artem Trufanov  2   3 , Daria Frunza  2 , Igor Litvinenko  2 , Dmitriy Tarumov  1 , Alexander Krasichkov  4 , Victoria Polyakova  5 , Alexander Efimtsev  3   6 , Dmitriy Medvedev  7   8
Affiliations

fMRI Findings in Cortical Brain Networks Interactions in Migraine Following Repetitive Transcranial Magnetic Stimulation

Kirill Markin et al. Front Neurol. .

Abstract

Background: Repetitive transcranial magnetic stimulation (rTMS) is one of the high-potential non-pharmacological methods for migraine treatment. The purpose of this study is to define the neuroimaging markers associated with rTMS therapy in patients with migraine based on data from functional MRI (fMRI).

Materials and methods: A total of 19 patients with episodic migraine without aura underwent a 5-day course of rTMS of the fronto-temporo-parietal junction bilaterally, at 10 Hz frequency and 60% of motor threshold response of 900 pulses. Resting-state functional MRI (1.5 T) and a battery of tests were carried out for each patient to clarify their diagnosis, qualitative and quantitative characteristics of pain, and associated affective symptoms. Changes in functional connectivity (FC) in the brain's neural networks before and after the treatment were identified through independent components analysis.

Results: Over the course of therapy, we observed an increase in FC of the default mode network within it, with pain system components and with structures of the visual network. We also noted a decrease in FC of the salience network with sensorimotor and visual networks, as well as an increase in FC of the visual network. Besides, we identified 5 patients who did not have a positive response to one rTMS course after the first week of treatment according to the clinical scales results, presumably because of an increasing trend of depressive symptoms and neuroimaging criteria for depressive disorder.

Conclusions: Our results show that a 5-day course of rTMS significantly alters the connectivity of brain networks associated with pain and antinociceptive brain systems in about 70% of cases, which may shed light on the neural mechanisms underlying migraine treatment with rTMS.

Keywords: functional connectivity; headache; migraine; neuroimaging; neurostimulation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Changes in the functional connectivity in the default mode network, salience, and visual networks after a 5-day TMS course. Column 3 shows ROI with changed FC (blue–before TMS; orange–after TMS). The pictures represent neural network models from Chabran et al. (29).
Figure 2
Figure 2
Changed functional connectivity of the medial prefrontal cortex in the default mode network (ICA_5) in the responders in comparison with the non-responders.
Figure 3
Figure 3
The overall scheme of 5-day rTMS course affects changes in FC between main resting-state neural networks. FC, functional connectivity; VN, visual network; DMN, default mode network; SN, salience network; SMN, sensorimotor network.
See this image and copyright information in PMC

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