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WASHINGTON, DC—Correlations between the cortical thickness of the left superior temporal/inferior parietal region and pain thresholds are abnormal among adults with migraine, compared with healthy controls, according to research presented at the 67th Annual Meeting of the American Academy of Neurology. The absence of the normal correlation in this region, which participates in orienting and attention to painful stimuli, might represent an inability for people with migraine to inhibit pain sensation by shifting their attention away from the pain, said the researchers.
Recent studies have identified correlations between brain structure and pain sensation in healthy adults. Data suggest that people with migraine are hypersensitive and hypervigilant to painful stimuli and have atypical brain processing of pain. Todd Schwedt, MD, Associate Professor of Neurology at Mayo Clinic in Phoenix, Arizona, and colleagues conducted a study to test the hypothesis that people with migraine have aberrant relationships between the cortical thickness of regions that participate in pain processing and pain thresholds.
To compare correlations between cortical thickness and pain thresholds, the investigators studied 31 adults with migraine and 32 healthy controls. Dr. Schwedt and colleagues determined the participants’ pain thresholds using cutaneously applied heat. Participants underwent MRI T1-weighted sequences, and the investigators used the imaging to estimate cortical thickness.
Using a general linear model whole brain vertex-wise analysis, the researchers determined regional correlations between cortical thickness and pain threshold for subjects with migraine and controls separately. They conducted a pain-threshold-by-group interaction analysis to estimate regions where the participants with migraine have alterations in pain-threshold-to-cortical-thickness correlations, compared with healthy controls.
Dr. Schwedt’s group found that healthy controls had negative correlations between pain thresholds and cortical thickness in the left superior temporal/inferior parietal, left inferior temporal, left posterior cingulate/precuneus, right superior temporal, and right inferior parietal regions. Patients with migraine, however, had positive correlations between pain thresholds and cortical thickness in left superior temporal/inferior parietal, left inferior parietal, right precuneus, and right superior temporal/inferior parietal regions. Correlations between cortical thickness and pain threshold differed between migraine and control groups for the left superior temporal/inferior parietal region.
These findings indicate that not only the standard approach, but also techniques such as cognitive behavioral therapy may be useful in migraine treatment, said Natalia S. Rost, MD, Director of Acute Stroke Service at Massachusetts General Hospital in Boston, who did not participate in the study. During cognitive behavioral therapy, patients may learn biofeedback, as well as mechanisms of distracting or reorienting their attention in the moment of pain.
“This [research] is opening a very interesting segue to studying the dynamic interactions of neurons during migraine,” she added. “We may be moving away from a dogma of neuron, vessel, and particular pain relief medication. I think there’s a way to retrain the brain, and plasticity plays a role in that. Therapies, as well as biofeedback, would play a significant role.”
—Erik Greb
WASHINGTON, DC—Correlations between the cortical thickness of the left superior temporal/inferior parietal region and pain thresholds are abnormal among adults with migraine, compared with healthy controls, according to research presented at the 67th Annual Meeting of the American Academy of Neurology. The absence of the normal correlation in this region, which participates in orienting and attention to painful stimuli, might represent an inability for people with migraine to inhibit pain sensation by shifting their attention away from the pain, said the researchers.
Recent studies have identified correlations between brain structure and pain sensation in healthy adults. Data suggest that people with migraine are hypersensitive and hypervigilant to painful stimuli and have atypical brain processing of pain. Todd Schwedt, MD, Associate Professor of Neurology at Mayo Clinic in Phoenix, Arizona, and colleagues conducted a study to test the hypothesis that people with migraine have aberrant relationships between the cortical thickness of regions that participate in pain processing and pain thresholds.
To compare correlations between cortical thickness and pain thresholds, the investigators studied 31 adults with migraine and 32 healthy controls. Dr. Schwedt and colleagues determined the participants’ pain thresholds using cutaneously applied heat. Participants underwent MRI T1-weighted sequences, and the investigators used the imaging to estimate cortical thickness.
Using a general linear model whole brain vertex-wise analysis, the researchers determined regional correlations between cortical thickness and pain threshold for subjects with migraine and controls separately. They conducted a pain-threshold-by-group interaction analysis to estimate regions where the participants with migraine have alterations in pain-threshold-to-cortical-thickness correlations, compared with healthy controls.
Dr. Schwedt’s group found that healthy controls had negative correlations between pain thresholds and cortical thickness in the left superior temporal/inferior parietal, left inferior temporal, left posterior cingulate/precuneus, right superior temporal, and right inferior parietal regions. Patients with migraine, however, had positive correlations between pain thresholds and cortical thickness in left superior temporal/inferior parietal, left inferior parietal, right precuneus, and right superior temporal/inferior parietal regions. Correlations between cortical thickness and pain threshold differed between migraine and control groups for the left superior temporal/inferior parietal region.
These findings indicate that not only the standard approach, but also techniques such as cognitive behavioral therapy may be useful in migraine treatment, said Natalia S. Rost, MD, Director of Acute Stroke Service at Massachusetts General Hospital in Boston, who did not participate in the study. During cognitive behavioral therapy, patients may learn biofeedback, as well as mechanisms of distracting or reorienting their attention in the moment of pain.
“This [research] is opening a very interesting segue to studying the dynamic interactions of neurons during migraine,” she added. “We may be moving away from a dogma of neuron, vessel, and particular pain relief medication. I think there’s a way to retrain the brain, and plasticity plays a role in that. Therapies, as well as biofeedback, would play a significant role.”
—Erik Greb
WASHINGTON, DC—Correlations between the cortical thickness of the left superior temporal/inferior parietal region and pain thresholds are abnormal among adults with migraine, compared with healthy controls, according to research presented at the 67th Annual Meeting of the American Academy of Neurology. The absence of the normal correlation in this region, which participates in orienting and attention to painful stimuli, might represent an inability for people with migraine to inhibit pain sensation by shifting their attention away from the pain, said the researchers.
Recent studies have identified correlations between brain structure and pain sensation in healthy adults. Data suggest that people with migraine are hypersensitive and hypervigilant to painful stimuli and have atypical brain processing of pain. Todd Schwedt, MD, Associate Professor of Neurology at Mayo Clinic in Phoenix, Arizona, and colleagues conducted a study to test the hypothesis that people with migraine have aberrant relationships between the cortical thickness of regions that participate in pain processing and pain thresholds.
To compare correlations between cortical thickness and pain thresholds, the investigators studied 31 adults with migraine and 32 healthy controls. Dr. Schwedt and colleagues determined the participants’ pain thresholds using cutaneously applied heat. Participants underwent MRI T1-weighted sequences, and the investigators used the imaging to estimate cortical thickness.
Using a general linear model whole brain vertex-wise analysis, the researchers determined regional correlations between cortical thickness and pain threshold for subjects with migraine and controls separately. They conducted a pain-threshold-by-group interaction analysis to estimate regions where the participants with migraine have alterations in pain-threshold-to-cortical-thickness correlations, compared with healthy controls.
Dr. Schwedt’s group found that healthy controls had negative correlations between pain thresholds and cortical thickness in the left superior temporal/inferior parietal, left inferior temporal, left posterior cingulate/precuneus, right superior temporal, and right inferior parietal regions. Patients with migraine, however, had positive correlations between pain thresholds and cortical thickness in left superior temporal/inferior parietal, left inferior parietal, right precuneus, and right superior temporal/inferior parietal regions. Correlations between cortical thickness and pain threshold differed between migraine and control groups for the left superior temporal/inferior parietal region.
These findings indicate that not only the standard approach, but also techniques such as cognitive behavioral therapy may be useful in migraine treatment, said Natalia S. Rost, MD, Director of Acute Stroke Service at Massachusetts General Hospital in Boston, who did not participate in the study. During cognitive behavioral therapy, patients may learn biofeedback, as well as mechanisms of distracting or reorienting their attention in the moment of pain.
“This [research] is opening a very interesting segue to studying the dynamic interactions of neurons during migraine,” she added. “We may be moving away from a dogma of neuron, vessel, and particular pain relief medication. I think there’s a way to retrain the brain, and plasticity plays a role in that. Therapies, as well as biofeedback, would play a significant role.”
—Erik Greb