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Updated: Sep 20, 2025
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Functional MRI in migraine
Roberta Messina1, Cedric Gollion2,3, Rune Häckert Christensen2
1Neoimaging Research Unit, Division of Neuroscience and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Purpose Of Review:
The underlying mechanisms of migraine are complex and heterogenous. Advances in neuroimaging techniques during the past few decades have contributed to our understanding of migraine pathophysiology. Brain function in migraine patients has been widely explored using functional MRI (fMRI). This review will highlight the major fMRI findings that characterize the different phases of migraine.
Recent Findings:
The migraine attack starts with hypothalamic hyperexcitability and early reorganization of the common ascending pain and central trigeminovascular pathways. Moreover, the visual cortex becomes hyperexcitable during the aura phase. During the headache phase, further disruptions of the pontine, thalamic, sensorimotor and visual networks occur, although the hypothalamic activity and connectivity normalizes. The visual cortex remains hyperexcitable during the postdromal phase. Asymptomatic migraine patients can also experience functional alternations of pain and visual processing brain areas. At present, the heterogeneity of the asymptomatic phase and fMRI findings make it difficult to find common denominator.
Summary:
fMRI studies have captured functional brain changes associated with migraine phases, leading to an improvement of our understanding of migraine pathophysiology. Further MRI studies are needed to disclose whether the migraine attack is triggered by intrinsic brain dysfunction or external factors.
Insights
Functional MRI (fMRI) reveals brain changes during migraine phases, including hyperexcitability in the visual cortex and network disruptions. These findings advance our understanding of migraine pathophysiology.
Area of Science:
- Neuroscience
- Radiology
Background:
- Migraine pathophysiology is complex and heterogeneous.
- Neuroimaging, particularly functional MRI (fMRI), has significantly advanced understanding.
- fMRI explores brain function alterations in migraine patients across different phases.
Purpose of the Study:
- To review major functional MRI findings characterizing migraine phases.
- To elucidate the brain's functional changes during migraine attacks.
- To understand the heterogeneity of brain function in migraine.
Main Methods:
- Review of functional MRI (fMRI) studies on migraine.
- Analysis of brain activity and connectivity patterns during migraine phases.
- Exploration of functional alterations in both symptomatic and asymptomatic migraine patients.
Main Results:
- Hypothalamic hyperexcitability and pathway reorganization initiate migraine attacks.
- Visual cortex hyperexcitability occurs during the aura and postdromal phases.
- Network disruptions in pontine, thalamic, sensorimotor, and visual areas characterize the headache phase.
- Asymptomatic migraine patients show functional alterations in pain and visual processing areas, though findings are heterogeneous.
Conclusions:
- fMRI studies have captured functional brain changes, improving the understanding of migraine pathophysiology.
- Further research is needed to determine if migraine is triggered by intrinsic brain dysfunction or external factors.
- The heterogeneity of fMRI findings, especially in asymptomatic phases, presents challenges in identifying common denominators.
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