Abstract Details

Title Neural Correlates of Visuospatial Processing in Migraine Patients: Does the Pain Network Interfere?

Topic Headache

Presentation(s) P13 - Poster Session 13 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-007

Objective

To explore functional and structural magnetic resonance imaging (MRI) correlates of visuospatial processing in migraine patients.

Background

Previous clinical studies demonstrated worse cognitive performance in migraine patients during the inter-ictal phase. The most affected cognitive domains are visuospatial abilities, processing speed, attention, memory and executive functions.

Design/Methods

A functional MRI visuospatial task, including an angle and a colour discrimination paradigm, was administrated to 17 headache-free migraine patients and 16 controls. 3D T1-weighted scans and voxel-based morphometry were used to explore whether cortical areas activated during the visuospatial task had significant grey matter volume (GMV) alterations. The correlations between functional and structural MRI abnormalities and subjects’ performance, clinical and neuropsychological variables were also investigated.

Results The response accuracy and reaction times did not differ between migraineurs and controls. All study subjects activated frontal, parietal, occipital and cerebellar regions during both the angle and colour task. The comparison angle vs colour task revealed an increased activity of the right insula, middle frontal gyrus, bilateral orbitofrontal cortex and middle cingulate cortex and decreased activity of the bilateral posterior cingulate cortex (PCC) in migraine patients compared to controls (p<0.05, FWE corrected). No significant regional GMV differences were found between patients and controls. In migraineurs, a better performance in the angle task was associated with higher activation of the right insula (r=0.84, p<0.001, uncorrected) and orbitofrontal cortex (r=0.83, p<0.001, uncorrected). Decreased activity of the PCC correlated with shorter disease duration (r=0.92, p<0.05, FWE corrected).

Conclusions

Migraine patients experienced abnormal activation of visuospatial processing brain areas that are commonly involved also in nociception. The increased activity of the insula and frontal lobes and the decreased recruitment of the PCC might represent an adaptive response, strengthen by the recurrent activation of these regions during migraine attacks.

Authors/Disclosures
Roberta Messina, MD, PhD (San Raffaele Hospital) PRESENTER	Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pfizer. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lundbeck. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Organon. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eli Lilly.
Gianna Carla Riccitelli (San Raffaele)	No disclosure on file
Bruno Colombo	Bruno Colombo has nothing to disclose.
Alessandro Meani	Alessandro Meani has nothing to disclose.
Massimo Filippi, MD, F�鶹��ýӳ�� (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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