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Abstract
Objective The visual system has often been described to be sensitized in migraineurs, with light being perceived as aversive or even painful. One possible explanation for this altered perception is crosslinks between the visual and the trigeminonociceptive system. Visual stimulation in chronic migraineurs on the level of the brainstem might lead to enhanced activity within the spinal trigeminal nucleus (sTN) as the main site of trigeminal pain processing within this area.
Methods Eighteen episodic migraineurs (EM), 17 chronic migraineurs (CM), and 19 healthy controls (HC) underwent one session of high-resolution brainstem imaging during which a rotating checkerboard was presented repeatedly as a visual stimulus. Data were analyzed using SPM12 and MATLAB with the classic first-level–second-level approach of SPM. Analyses of variance were used for group comparisons.
Results CM showed enhanced activation within the sTN as compared to HC. In addition, we observed enhanced activity within the right superior colliculus in CM as compared to HC. When comparing all migraineurs with headaches during scanning with all migraineurs without headaches during scanning and HC, we also found the sTN to be more strongly activated during headaches.
Conclusion Our data provide evidence for the existence of visual–nociceptive integration on brainstem level in chronic migraineurs.
Glossary
- ANOVA=
- analysis of variance;
- CM=
- chronic migraine;
- EM=
- episodic migraine;
- FWE=
- family wise error rate;
- HC=
- healthy control;
- ICHD-3 beta=
- International Classification of Headache Disorders, 3rd edition (beta version);
- sTN=
- spinal trigeminal nuclei
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received April 5, 2018.
- Accepted in final form April 5, 2018.
- © 2018 American Academy of Neurology
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