Functional MRI-BOLD of brainstem structures during visually triggered migraine.

Area of Science:

• Neuroscience
• Medical Imaging

Background:

• Previous studies indicated hyperoxia and increased blood volume in the red nucleus and substantia nigra during spontaneous migraine with aura.
• The role of these brainstem centers in migraine pathophysiology requires further investigation.

Purpose of the Study:

• To investigate the activation of brainstem structures in patients experiencing visually triggered migraine.
• To understand the pathophysiologic role of the red nucleus and substantia nigra in migraine.

Main Methods:

• Blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) was used in 26 migraine patients and 10 controls.
• Repeated checkerboard visual stimulation was employed to trigger migraine symptoms.
• High temporal resolution (3.5 seconds) imaging covered the occipital cortex and brainstem.

Main Results:

• Visual stimulation triggered migraine symptoms in 12 patients.
• In 75% of symptomatic patients, increased signal intensity in the red nucleus and substantia nigra preceded occipital cortex changes or symptom onset.
• Four patients experienced aura or headache onset during or immediately after the experiment.

Conclusions:

• Activation of the red nucleus and substantia nigra is associated with visually triggered migraine symptoms.
• These findings suggest that the red nucleus and substantia nigra are integral components of the neuronal network activated during migraine attacks.