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. 2024 Jul-Aug;64(7):825-837.
doi: 10.1111/head.14750. Epub 2024 Jun 4.

Early effect of onabotulinumtoxinA on EEG-based functional connectivity in patients with chronic migraine: A pilot study

Matteo Conti  1 , Roberta Bovenzi  1 , Maria Giuseppina Palmieri  1 , Fabio Placidi  1 , Alessandro Stefani  1 , Nicola Biagio Mercuri  1 , Maria Albanese  1   2
Affiliations

Early effect of onabotulinumtoxinA on EEG-based functional connectivity in patients with chronic migraine: A pilot study

Matteo Conti et al. Headache. 2024 Jul-Aug.

Abstract

Objective: In this pilot prospective cohort study, we aimed to evaluate, using high-density electroencephalography (HD-EEG), the longitudinal changes in functional connectivity (FC) in patients with chronic migraine (CM) treated with onabotulinumtoxinA (OBTA).

Background: OBTA is a treatment for CM. Several studies have shown the modulatory action of OBTA on the central nervous system; however, research on migraine is limited.

Methods: This study was conducted at the Neurology Unit of "Policlinico Tor Vergata," Rome, Italy, and included 12 adult patients with CM treated with OBTA and 15 healthy controls (HC). Patients underwent clinical scales at enrollment (T0) and 3 months (T1) from the start of treatment. HD-EEG was recorded using a 64-channel system in patients with CM at T0 and T1. A source reconstruction method was used to identify brain activity. FC in δ-θ-α-β-low-γ bands was analyzed using the weighted phase-lag index. FC changes between HCs and CM at T0 and T1 were assessed using cross-validation methods to estimate the results' reliability.

Results: Compared to HCs at T0, patients with CM showed hyperconnected networks in δ (p = 0.046, area under the receiver operating characteristic curve [AUC: 0.76-0.98], Cohen's κ [0.65-0.93]) and β (p = 0.031, AUC [0.68-0.95], Cohen's κ [0.51-0.84]), mainly involving orbitofrontal, occipital, temporal pole and orbitofrontal, superior temporal, occipital, cingulate areas, and hypoconnected networks in α band (p = 0.029, AUC [0.80-0.99], Cohen's κ [0.42-0.77]), predominantly involving cingulate, temporal pole, and precuneus. Patients with CM at T1, compared to T0, showed hypoconnected networks in δ band (p = 0.032, AUC [0.73-0.99], Cohen's κ [0.53-0.90]) and hyperconnected networks in α band (p = 0.048, AUC [0.58-0.93], Cohen's κ [0.37-0.78]), involving the sensorimotor, orbitofrontal, cingulate, and temporal cortex.

Conclusion: These preliminary results showed that patients with CM presented disrupted EEG-FC compared to controls restored by a single session of OBTA treatment, suggesting a primary central modulatory action of OBTA.

Keywords: central effects; chronic migraine; high‐density electroencephalography; onabotulinumtoxinA.

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References

REFERENCES

    1. Olesen J, Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1‐211.
    1. Becker WJ. Botulinum toxin in the treatment of headache. Toxins. 2020;12:803.
    1. Tonini MC, Fiorencis A, Iannacchero R, et al. Narrative medicine to integrate patients', caregivers' and clinicians' migraine experiences: the DRONE multicentre project. Neurol Sci. 2021;42(12):5277‐5288.
    1. Iyengar S, Ossipov MH, Johnson KW. The role of calcitonin gene‐related peptide in peripheral and central pain mechanisms including migraine. Pain. 2017;158:543‐559.
    1. Altamura C, Brunelli N, Viticchi G, et al. Quantitative and qualitative pain evaluation in response to onabotulinumtoxinA for chronic migraine: an observational real‐life study. Toxins (Basel). 2023;15(4):284.

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