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January 12, 2016; 86 (2) Article

Change in brain network connectivity during PACAP38-induced migraine attacks

A resting-state functional MRI study

Faisal Mohammad Amin, Anders Hougaard, Stefano Magon, Mohammad Sohail Asghar, Nur Nabil Ahmad, Egill Rostrup, Till Sprenger, Messoud Ashina
First published December 16, 2015, DOI: https://doi.org/10.1212/WNL.0000000000002261
Faisal Mohammad Amin
From the Danish Headache Center and Department of Neurology (F.M.A., A.H., M.S.A., N.N.A., M.A.) and the Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine (E.R.), Rigshospitalet Glostrup, University of Copenhagen, Denmark; the Department of Neurology (S.M.), University Hospital Basel, Switzerland; and the Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Germany.
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Anders Hougaard
From the Danish Headache Center and Department of Neurology (F.M.A., A.H., M.S.A., N.N.A., M.A.) and the Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine (E.R.), Rigshospitalet Glostrup, University of Copenhagen, Denmark; the Department of Neurology (S.M.), University Hospital Basel, Switzerland; and the Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Germany.
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Stefano Magon
From the Danish Headache Center and Department of Neurology (F.M.A., A.H., M.S.A., N.N.A., M.A.) and the Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine (E.R.), Rigshospitalet Glostrup, University of Copenhagen, Denmark; the Department of Neurology (S.M.), University Hospital Basel, Switzerland; and the Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Germany.
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Mohammad Sohail Asghar
From the Danish Headache Center and Department of Neurology (F.M.A., A.H., M.S.A., N.N.A., M.A.) and the Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine (E.R.), Rigshospitalet Glostrup, University of Copenhagen, Denmark; the Department of Neurology (S.M.), University Hospital Basel, Switzerland; and the Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Germany.
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Nur Nabil Ahmad
From the Danish Headache Center and Department of Neurology (F.M.A., A.H., M.S.A., N.N.A., M.A.) and the Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine (E.R.), Rigshospitalet Glostrup, University of Copenhagen, Denmark; the Department of Neurology (S.M.), University Hospital Basel, Switzerland; and the Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Germany.
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Egill Rostrup
From the Danish Headache Center and Department of Neurology (F.M.A., A.H., M.S.A., N.N.A., M.A.) and the Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine (E.R.), Rigshospitalet Glostrup, University of Copenhagen, Denmark; the Department of Neurology (S.M.), University Hospital Basel, Switzerland; and the Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Germany.
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Till Sprenger
From the Danish Headache Center and Department of Neurology (F.M.A., A.H., M.S.A., N.N.A., M.A.) and the Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine (E.R.), Rigshospitalet Glostrup, University of Copenhagen, Denmark; the Department of Neurology (S.M.), University Hospital Basel, Switzerland; and the Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Germany.
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Messoud Ashina
From the Danish Headache Center and Department of Neurology (F.M.A., A.H., M.S.A., N.N.A., M.A.) and the Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine (E.R.), Rigshospitalet Glostrup, University of Copenhagen, Denmark; the Department of Neurology (S.M.), University Hospital Basel, Switzerland; and the Department of Neurology (T.S.), DKD Helios Klinik Wiesbaden, Germany.
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Citation
Change in brain network connectivity during PACAP38-induced migraine attacks
A resting-state functional MRI study
Faisal Mohammad Amin, Anders Hougaard, Stefano Magon, Mohammad Sohail Asghar, Nur Nabil Ahmad, Egill Rostrup, Till Sprenger, Messoud Ashina
Neurology Jan 2016, 86 (2) 180-187; DOI: 10.1212/WNL.0000000000002261

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Abstract

Objective: To investigate resting-state functional connectivity in the salience network (SN), the sensorimotor network (SMN), and the default mode network (DMN) during migraine attacks induced by pituitary adenylate cyclase-activating polypeptide-38 (PACAP38).

Methods: In a double-blind, randomized study, 24 female migraine patients without aura received IV PACAP38 or vasoactive intestinal polypeptide (VIP) over 20 minutes. Both peptides are closely related and cause vasodilation, but only PACAP38 induces migraine attacks. VIP was therefore used as active placebo. Resting-state functional MRI was recorded before and during PACAP38-induced migraine attacks and before and after VIP infusion. We analyzed data by Statistical Parametric Mapping 8 and the Resting-State fMRI Data Analysis Toolkit for Matlab in a seed-based fashion.

Results: PACAP38 (n = 16) induced migraine attacks and increased connectivity with the bilateral opercular part of the inferior frontal gyrus in the SN. In SMN, there was increased connectivity with the right premotor cortex and decreased connectivity with the left visual cortex. Several areas showed increased (left primary auditory, secondary somatosensory, premotor, and visual cortices) and decreased (right cerebellum and left frontal lobe) connectivity with DMN. We found no resting-state network changes after VIP (n = 15).

Conclusions: PACAP38-induced migraine attack is associated with altered connectivity of several large-scale functional networks of the brain.

GLOSSARY

BOLD=
blood oxygen level–dependent;
DMN=
default mode network;
MNI=
Montreal Neurological Institute;
PACAP38=
pituitary adenylate cyclase-activating polypeptide-38;
ROI=
region of interest;
RSFC=
resting-state functional connectivity;
SMN=
sensorimotor network;
SN=
salience network;
VIP=
vasoactive intestinal polypeptide

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received May 5, 2015.
  • Accepted in final form September 2, 2015.
  • © 2015 American Academy of Neurology
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