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Updated: May 29, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Migraine attacks the Basal Ganglia
Nasim Maleki1, Lino Becerra, Lauren Nutile
1Department of Radiology, Children’s Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
Background:
With time, episodes of migraine headache afflict patients with increased frequency, longer duration and more intense pain. While episodic migraine may be defined as 1-14 attacks per month, there are no clear-cut phases defined, and those patients with low frequency may progress to high frequency episodic migraine and the latter may progress into chronic daily headache (> 15 attacks per month). The pathophysiology of this progression is completely unknown. Attempting to unravel this phenomenon, we used high field (human) brain imaging to compare functional responses, functional connectivity and brain morphology in patients whose migraine episodes did not progress (LF) to a matched (gender, age, age of onset and type of medication) group of patients whose migraine episodes progressed (HF).
Results:
In comparison to LF patients, responses to pain in HF patients were significantly lower in the caudate, putamen and pallidum. Paradoxically, associated with these lower responses in HF patients, gray matter volume of the right and left caudate nuclei were significantly larger than in the LF patients. Functional connectivity analysis revealed additional differences between the two groups in regard to response to pain.
Conclusions:
Supported by current understanding of basal ganglia role in pain processing, the findings suggest a significant role of the basal ganglia in the pathophysiology of the episodic migraine.
Insights
Migraine progression involves changes in the basal ganglia, a brain region crucial for pain processing. This study reveals differences in brain structure and function between patients with progressing versus non-progressing episodic migraine.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Episodic migraine attacks can increase in frequency, duration, and intensity over time.
- The progression from episodic to chronic migraine is poorly understood.
- This study investigates brain differences in migraine patients with progressing versus non-progressing disease.
Purpose of the Study:
- To compare functional responses, connectivity, and brain morphology in episodic migraine patients.
- To identify neurobiological differences associated with migraine progression.
Main Methods:
- High-field human brain imaging techniques were employed.
- Functional responses, functional connectivity, and brain morphology were analyzed.
- Patients were grouped into low-frequency (LF) and high-frequency (HF) episodic migraine based on progression.
Main Results:
- High-frequency (HF) episodic migraine patients showed lower pain responses in the caudate, putamen, and pallidum compared to low-frequency (LF) patients.
- HF patients exhibited larger gray matter volume in the caudate nuclei bilaterally.
- Functional connectivity analyses revealed further distinctions between LF and HF groups during pain response.
Conclusions:
- Findings suggest a significant role for the basal ganglia in the pathophysiology of episodic migraine.
- The basal ganglia's involvement in pain processing may be altered in migraine progression.
- These results provide insights into the neurobiological mechanisms underlying migraine chronification.
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