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Related Experiment Video

Updated: Feb 3, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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Changes in Brainstem Pain Modulation Circuitry Function over the Migraine Cycle.

Kasia K Marciszewski1, Noemi Meylakh1, Flavia Di Pietro1

  • 1Department of Anatomy and Histology, Sydney Medical School, University of Sydney, Sydney, 2006 New South Wales, Australia.

The Journal of Neuroscience : the Official Journal of the Society for Neuroscience
|October 21, 2018
PubMed
Summary
This summary is machine-generated.

Migraine brainstem function fluctuates cyclically. Immediately before a migraine attack, pain sensitivity decreases, suggesting enhanced natural pain relief mechanisms in the brainstem. This challenges existing migraine theories.

Keywords:
brainstem pain modulationfunctional connectivitymigraineorofacial painperiaqueductal gray matterspinal trigeminal nucleus

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Area of Science:

  • Neuroscience
  • Pain Research
  • Medical Imaging

Background:

  • Migraine neural mechanisms remain unclear.
  • Altered brainstem function is hypothesized to be critical for migraine initiation and maintenance.
  • Direct measurement of brainstem pain modulation circuitry in migraineurs before an attack is lacking.

Purpose of the Study:

  • To directly measure brainstem pain modulation circuitry function in migraineurs using fMRI.
  • To assess brainstem function and resting-state functional connectivity at various points in the migraine cycle.
  • To investigate the role of brainstem pain modulation in migraine pathophysiology.

Main Methods:

  • Functional magnetic resonance imaging (fMRI) was performed on 31 controls and 31 migraineurs.
  • Brainstem function was measured during noxious orofacial stimulation.
  • Resting-state functional connectivity was assessed throughout the migraine cycle.

Main Results:

  • Migraineurs showed decreased pain sensitivity immediately before a migraine attack.
  • Increased activation in the spinal trigeminal nucleus and reduced connectivity with the rostral ventromedial medulla were observed before a migraine.
  • Altered activation and connectivity in the midbrain periaqueductal gray matter were noted during the interictal phase.

Conclusions:

  • Brainstem sensitivity fluctuates across the migraine cycle.
  • Immediately before a migraine, endogenous analgesic mechanisms appear enhanced, potentially reducing pain signal transmission.
  • These findings suggest a dynamic role for brainstem circuitry in migraine generation and cyclic sensitivity.