Altered periaqueductal gray resting state functional connectivity in migraine and the modulation effect of treatment

• Published in: Scientific reports Vol. 6; no. 1; p. 20298
• Main Authors: Li, Zhengjie, Liu, Mailan, Lan, Lei, Zeng, Fang, Makris, Nikos, Liang, Yilin, Guo, Taipin, Wu, Feng, Gao, Yujie, Dong, Mingkai, Yang, Jie, Li, Ying, Gong, Qiyong, Liang, Fanrong, Kong, Jian
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 03.02.2016; Nature Publishing Group
• Subjects: 692/1807/410/2610; 692/617/375/226/1654; Acupuncture; Acupuncture Therapy; Adolescent; Adult; Brain mapping; Brain Mapping - methods; Cortex (cingulate); Female; Functional magnetic resonance imaging; Gyrus Cinguli - physiopathology; Headache; Humanities and Social Sciences; Humans; Magnetic Resonance Imaging - methods; Male; Migraine; Migraine without Aura - physiopathology; Migraine without Aura - therapy; multidisciplinary; Neostriatum; Neural networks; Pain; Pain - physiopathology; Pain Threshold; Periaqueductal Gray - physiopathology; Periaqueductal gray area; Prefrontal cortex; Prefrontal Cortex - physiopathology; Random Allocation; Science; Young Adult
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep20298

The aims of this study were to 1) compare resting state functional connectivity (rs-fc) of the periaqueductal gray (PAG), a key region in the descending pain modulatory system (DPMS) between migraine without aura (MwoA) patients and healthy controls (HC) and 2) investigate how an effective treatment can influence the PAG rs-fc in MwoA patients. One hundred MwoA patients and forty-six matched HC were recruited. Patients were randomized to verum acupuncture, sham acupuncture and waiting list groups. Resting state fMRI data were collected and seed based functional connectivity analysis was applied. Compared with HC, MwoA patients showed reduced rs-fc between the PAG and rostral anterior cingulate cortex/medial prefrontal cortex (rACC/mPFC), key regions in the DPMS and other pain related brain regions. The reduced rs-fc between the PAG and rACC/mPFC was associated with increased migraine headache intensity at the baseline. After treatments, rs-fc between the PAG and the rACC in MwoA patients significantly increased. The changes of rs-fc among the PAG, rACC and ventral striatum were significantly associated with headache intensity improvement. Impairment of the DPMS is involved in the neural pathophysiology of migraines. Impaired DPMS in migraine patients can be normalized after effective treatment.