Hypothalamic structural integrity and temporal complexity of cortical information processing at rest in migraine...

Area of Science:

• Neuroimaging
• Neuroscience
• Medical Imaging

Background:

• The hypothalamus plays a role in migraine premonitory phases, but its interictal function and relation to neurocognitive networks are unclear.
• Understanding these interictal changes is crucial for elucidating migraine pathophysiology.

Purpose of the Study:

• To investigate hypothalamic microstructure alterations during the interictal period in migraine without aura.
• To explore the coexistence of these changes with aberrant cortical connectivity.
• To correlate neuroimaging findings with clinical migraine features.

Main Methods:

• Multimodal MRI (DTI and resting-state fMRI) was used in 20 migraine patients without aura (MO) and 20 healthy controls (HC).
• Diffusion tensor imaging (DTI) assessed hypothalamic fractional anisotropy (FA), mean (MD), radial (RD), and axial diffusivity (AD).
• Resting-state fMRI measured Higuchi's fractal dimension (FD) in brain networks; findings were correlated with migraine severity.

Main Results:

• MO patients exhibited higher hypothalamic MD, AD, and RD, and lower posterior FA compared to HC.
• Migraine patients showed higher FD in the salience network (SN) and cerebellum, and lower FD in the primary visual (PV) network.
• Cerebellar and SN FD positively correlated with migraine severity.

Conclusions:

• Hypothalamic abnormalities during the interictal period may contribute to migraine predisposition and attack onset.
• Altered fractal dimensionality in the PV, SN, and cerebellum suggests inefficient brain network function related to sensory, emotional, and cognitive integration.
• These findings highlight the hypothalamus and specific brain networks as potential targets for migraine management.