Michels, L;
Christidi, F;
Steiger, VR;
Sándor, PS;
Gantenbein, AR;
Landmann, G;
Schreglmann, SR;
... Riederer, F; + view all
(2017)
Pain modulation is affected differently in medication-overuse headache and chronic myofascial pain - A multimodal MRI study.
Cephalalgia
, 37
(8)
pp. 764-779.
10.1177/0333102416652625.
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Abstract
BACKGROUND: Neuroimaging studies revealed structural and functional changes in medication-overuse headache (MOH), but it remains unclear whether similar changes could be observed in other chronic pain disorders. METHODS: In this cross-sectional study, we investigated functional connectivity (FC) with resting-state functional magnetic resonance imaging (fMRI) and white matter integrity using diffusion tensor imaging (DTI) to measure fractional anisotropy (FA) and mean diffusivity (MD) in patients with MOH (N = 12) relative to two control groups: patients with chronic myofascial pain (MYO; N = 11) and healthy controls (CN; N = 16). RESULTS: In a data-driven approach we found hypoconnectivity in the fronto-parietal attention network in both pain groups relative to CN (i.e. MOH < CN and MYO < CN). In contrast, hyperconnectivity in the saliency network (SN) was detected only in MOH, which correlated with FA in the insula. In a seed-based analysis we investigated FC between the periaqueductal grey (PAG) and all other brain regions. In addition to overlapping hyperconnectivity seen in patient groups (relative to CN), MOH had a distinct connectivity pattern with lower FC to parieto-occipital regions and higher FC to orbitofrontal regions compared to controls. FA and MD abnormalities were mostly observed in MOH, involving the insula. CONCLUSIONS: Hyperconnectivity within the SN along with associated white matter changes therein suggest a particular role of this network in MOH. In addition, abnormal connectivity between the PAG and other pain modulatory (frontal) regions in MOH are consistent with dysfunctional central pain control.
| Type: | Article |
|---|---|
| Title: | Pain modulation is affected differently in medication-overuse headache and chronic myofascial pain - A multimodal MRI study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/0333102416652625 |
| Publisher version: | http://doi.org/10.1177/0333102416652625 |
| Language: | English |
| Additional information: | © International Headache Society 2016. This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Functional magnetic resonance imaging, functional connectivity, medication overuse, headache, diffusion tensor imaging, myofascial pain |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10045551 |
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