Abstract Details

Title Resting State Functional Connectivity Changes of the Hypothalamus in Migraine Patients: A Cross-Sectional and Longitudinal Study

Topic Headache

Presentation(s) S1 - Headache 1 (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Background Previous studies support the role of the hypothalamus in the early and interictal phase of the migraine attack.

Objective To explore cross-sectional and longitudinal resting state functional connectivity (RS FC) changes of the hypothalamus in patients with migraine.

Design/Methods Using a 3.0 Tesla scanner, RS functional magnetic resonance imaging (MRI) and 3D T1-weighted scans were acquired from 92 headache-free episodic migraine patients and 73 controls. Twenty-three migraineurs and 23 controls were reexamined after a mean follow-up (FU) of 4 years. RS FC analysis was performed using a seed-region correlation approach and SPM12.

Results At baseline, compared to controls, migraineurs showed a decreased RS FC between the right and left hypothalamus and the right cerebellum, left parahippocampus and bilateral orbitofrontal cortex (OFC). The left hypothalamus had also a decreased RS FC with the left middle frontal gyrus. While, the right hypothalamus had a decreased RS FC with the right inferior temporal gyrus, lingual gyrus and left calcarine cortex. At baseline, the decreased RS FC between the right hypothalamus and the ipsilateral lingual gyrus correlated with higher migraine attack frequency (r=-0.4, p<0.05, FWE corrected). After 4 years, migraine patients developed an increased FC between the hypothalamus and the OFC, bilaterally, while RS FC between the right hypothalamus and the ipsilateral lingual gyrus decreased. RS FC between the right hypothalamus and the ipsilateral OFC correlated with lower migraine attack frequency at year 4 (r=-0.6, p<0.001, uncorrected).

Conclusions During the interictal phase, the hypothalamus modulates the activity of pain and visual processing areas in migraine patients. The recurrent experience of migraine attacks might disrupt the functional interaction between the hypothalamus and high-order visual processing areas. An increased RS FC between the hypothalamus and brain areas belonging to the descending pain-inhibitory pathway might reduced migraine attack frequency over time.

Authors/Disclosures
Roberta Messina, MD, PhD (San Raffaele Hospital) PRESENTER	Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pfizer. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lundbeck. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Organon. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Messina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eli Lilly.
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Paola Valsasina	No disclosure on file
	No disclosure on file
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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