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Ictal and interictal brain activation in episodic migraine: Neural basis for extent of allodynia

In some patients, migraine attacks are associated with symptoms of allodynia which can be localized (cephalic) or generalized (extracephalic). Using functional neuroimaging and cutaneous thermal stimulation, we aimed to investigate the differences in brain activation of patients with episodic migrai...

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Autores principales: Maleki, Nasim, Szabo, Edina, Becerra, Lino, Moulton, Eric, Scrivani, Steven J., Burstein, Rami, Borsook, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781392/
https://www.ncbi.nlm.nih.gov/pubmed/33395413
http://dx.doi.org/10.1371/journal.pone.0244320
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author Maleki, Nasim
Szabo, Edina
Becerra, Lino
Moulton, Eric
Scrivani, Steven J.
Burstein, Rami
Borsook, David
author_facet Maleki, Nasim
Szabo, Edina
Becerra, Lino
Moulton, Eric
Scrivani, Steven J.
Burstein, Rami
Borsook, David
author_sort Maleki, Nasim
collection PubMed
description In some patients, migraine attacks are associated with symptoms of allodynia which can be localized (cephalic) or generalized (extracephalic). Using functional neuroimaging and cutaneous thermal stimulation, we aimed to investigate the differences in brain activation of patients with episodic migraine (n = 19) based on their allodynic status defined by changes between ictal and interictal pain tolerance threshold for each subject at the time of imaging. In this prospective imaging study, differences were found in brain activity between the ictal and interictal visits in the brainstem/pons, thalamus, insula, cerebellum and cingulate cortex. Significant differences were also observed in the pattern of activation along the trigeminal pathway to noxious heat stimuli in no allodynia vs. generalized allodynia in the thalamus and the trigeminal nucleus but there were no activation differences in the trigeminal ganglion. The functional magnetic resonance imaging (fMRI) findings provide direct evidence for the view that in migraine patients who are allodynic during the ictal phase of their attacks, the spinal trigeminal nucleus and posterior thalamus become hyper-responsive (sensitized)–to the extent that they mediate cephalic and extracephalic allodynia, respectively. In addition, descending analgesic systems seem as “switched off” in generalized allodynia.
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spelling pubmed-77813922021-01-07 Ictal and interictal brain activation in episodic migraine: Neural basis for extent of allodynia Maleki, Nasim Szabo, Edina Becerra, Lino Moulton, Eric Scrivani, Steven J. Burstein, Rami Borsook, David PLoS One Research Article In some patients, migraine attacks are associated with symptoms of allodynia which can be localized (cephalic) or generalized (extracephalic). Using functional neuroimaging and cutaneous thermal stimulation, we aimed to investigate the differences in brain activation of patients with episodic migraine (n = 19) based on their allodynic status defined by changes between ictal and interictal pain tolerance threshold for each subject at the time of imaging. In this prospective imaging study, differences were found in brain activity between the ictal and interictal visits in the brainstem/pons, thalamus, insula, cerebellum and cingulate cortex. Significant differences were also observed in the pattern of activation along the trigeminal pathway to noxious heat stimuli in no allodynia vs. generalized allodynia in the thalamus and the trigeminal nucleus but there were no activation differences in the trigeminal ganglion. The functional magnetic resonance imaging (fMRI) findings provide direct evidence for the view that in migraine patients who are allodynic during the ictal phase of their attacks, the spinal trigeminal nucleus and posterior thalamus become hyper-responsive (sensitized)–to the extent that they mediate cephalic and extracephalic allodynia, respectively. In addition, descending analgesic systems seem as “switched off” in generalized allodynia. Public Library of Science 2021-01-04 /pmc/articles/PMC7781392/ /pubmed/33395413 http://dx.doi.org/10.1371/journal.pone.0244320 Text en © 2021 Maleki et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Maleki, Nasim
Szabo, Edina
Becerra, Lino
Moulton, Eric
Scrivani, Steven J.
Burstein, Rami
Borsook, David
Ictal and interictal brain activation in episodic migraine: Neural basis for extent of allodynia
title Ictal and interictal brain activation in episodic migraine: Neural basis for extent of allodynia
title_full Ictal and interictal brain activation in episodic migraine: Neural basis for extent of allodynia
title_fullStr Ictal and interictal brain activation in episodic migraine: Neural basis for extent of allodynia
title_full_unstemmed Ictal and interictal brain activation in episodic migraine: Neural basis for extent of allodynia
title_short Ictal and interictal brain activation in episodic migraine: Neural basis for extent of allodynia
title_sort ictal and interictal brain activation in episodic migraine: neural basis for extent of allodynia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781392/
https://www.ncbi.nlm.nih.gov/pubmed/33395413
http://dx.doi.org/10.1371/journal.pone.0244320
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