Journal
CEPHALALGIA
Volume 36, Issue 1, Pages 53-66Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0333102415583144
Keywords
Anterior insula; dorsal attention network; middle frontal gyrus; migraine; visual aura
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Funding
- National Science Council, Taiwan [NSC 100-2314-B-010-019-MY2, NSC 100-2314-B-010-018-MY3]
- Taipei Veterans General Hospital [VGHUST102-G7-6-1, V102C-118, V102E9-001]
- Ministry of Health and Welfare [MOHW 103-TDU-B-211-113003]
- NSC
- National Central University, Taiwan [NSC101-2911-I-008-001]
- Brain Research Center, National Yang-Ming University
- Ministry of Education, Aim for Top University Plan
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Background Migraine with visual aura (MA) is associated with distinct visual disturbances preceding migraine attacks, but shares other visual deficits in between attacks with migraine without aura (MO). Here, we seek to determine if abnormalities specific to interictal MA patients exist in functional brain connectivity of intrinsic cognitive networks. In particular, these networks are involved in top-down modulation of visual processing. Methods Using resting-state functional magnetic resonance imaging, whole-brain functional connectivity maps were derived from seeds placed in the anterior insula and the middle frontal gyrus, key nodes of the salience and dorsal attention networks, respectively. Twenty-six interictal MA patients were compared with 26 matched MO patients and 26 healthy matched controls. Results The major findings were: connectivity between the anterior insula and occipital areas, including area V3A, was reduced in MA but not in MO. Connectivity changes between the anterior insula and occipital areas further correlated with the headache severity in MA only. Conclusions The unique pattern of connectivity changes found in interictal MA patients involved area V3A, an area previously implicated in aura generation. Hypoconnectivity to this and other occipital regions may either represent a compensatory response to occipital dysfunctions or predispose MA patients to the development of aura.
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