Hyperconnection and hyperperfusion of overlapping brain regions in patients with menstrual-related migraine: a multimodal neuroimaging study

• Published in: Neuroradiology 2021-05, Vol.63 (5), p.741-749
• Main Authors: Li, Xinyu, Khan, Ahsan, Li, Yingying, Chen, Diansen, Yang, Jing, Zhan, Haohui, Du, Ganqin, Xu, Jin, Lou, Wutao, Tong, Raymond Kai-yu
• Format: Article
• Language: English
• Subjects: Blood flow; Brain; Brain mapping; Cerebral blood flow; Connectivity analysis; Correlation; Eigenvectors; Frontal gyrus; Functional magnetic resonance imaging; Functional Neuroradiology; Headache; Imaging; Magnetic resonance imaging; Medical imaging; Medicine; Medicine & Public Health; Menstruation; Migraine; Neural networks; Neuroimaging; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Pain; Perfusion; Radiology; Spin labeling; Supplementary motor area
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-020-02623-5

Purpose Menstrual-related migraine (MRM) results in moderate to severe intensity headaches accompanied by physical and emotional disability over time in women. Neuroimaging methodologies have advanced our understanding of migraine; however, the neural mechanisms of MRM are not clearly understood. Methods In this study, fourteen MRM patients in the interictal phase and fifteen age- and education-matched healthy control females were recruited. Resting-state functional magnetic resonance imaging (fMRI) and pulsed arterial spin labeling (PASL) MRI were collected for both the subject groups outside of their menstrual periods. Eigenvector centrality mapping (ECM) was performed on resting-state fMRI, and the relative cerebral blood flow (relCBF) was assessed using PASL-MRI. Results MRM patients showed a significantly increased eigenvector centrality in the right medial frontal gyrus compared to healthy controls. Seed-based ECM analysis revealed that increased centrality was associated with the right medial frontal gyrus’s hyperconnectivity with the left insula and the right supplementary motor area. The perfusion MRI revealed significantly increased relCBF in the hyperconnected regions. Furthermore, the hyperconnection positively correlated with the attack frequency, while the hyperperfusion showed a positive correlation with the disease duration. Conclusion The results suggest that menstrual-related migraine is associated with cerebral hyperconnection and hyperperfusion in critical pain-processing brain regions. Furthermore, this elevated cerebral activity is correlated with different aspects of functional impairment in MRM patients suggesting that perfusion analysis, along with whole-brain connectivity analysis, can provide a comprehensive understanding of neural mechanisms of MRM.