Abstract Details

Title Increased amygdala volume and functional connectivity with large-scale brain networks in chronic migraine: associations with clinical and affective measures

Topic Headache

Presentation(s) Emerging Science (8:00 AM-9:00 AM)

Poster/Presentation
Number 000

Objective

To investigate the role of the amygdala in episodic (EM) and chronic (CM) migraine and evaluate associations with clinical and affective measures.

Background

While clinical and affective symptoms are more severe and disabling in patients with CM versus EM, the neural correlates of these differences are not well known. One brain region of particular interest is the amygdala, given its central functions in pain, sensory, and emotional processing. To understand the role of the amygdala in migraine chronification, we compared amygdala volumetry and resting-state functional connectivity (FC) to three core large-scale brain networks (default mode (DMN), salience (SN), central executive networks (CEN)) in patients with EM and CM and examined associations with clinical and affective measures.

Design/Methods

44 patients with EM and 44 cohort age- and sex-matched patients with CM completed anatomical and resting-state functional MRI scans at 3T to assess amygdala volumes and FC, respectively. Associations between MRI, clinical (headache frequency, headache intensity, somatic symptoms (PHQ-15)), and affective measures (depression (PHQ-9), anxiety (GAD-7), pain catastrophization) were evaluated.

Results

Compared to EM, patients with CM demonstrated increased FC of the left amygdala to the DMN (p-FDR<0.01), which across patients was related to headache frequency (p-FDR=0.022). Additionally, left amygdala FC to the SN was positively associated with headache intensity (p-FDR=0.026) and right amygdala FC to the CEN was positively associated with pain catastrophization (p-FDR=0.035). Patients with CM also had larger amygdala volumes bilaterally, spanning the basolateral and superficial (corticoid) nuclei (per Juelich histological atlas). Right amygdala volumes were positively associated with headache intensity and depression and left volumes with depression (p<0.001).

Conclusions

Patients with CM demonstrated increased amygdala volumes and FC compared to patients with EM. Volume and FC measures positively correlated with measures of migraine severity and negative affect, supporting a role for altered amygdala structure and function in migraine chronification.

Authors/Disclosures
Danielle D. DeSouza, PhD (Stanford University) PRESENTER	Dr. DeSouza has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Addie Peretz, MD (Stanford University)	Dr. Peretz has nothing to disclose.
	No disclosure on file
	No disclosure on file
Robert Cowan, MD, FAAN (Stanford Neurosciences Health Center)	Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for lundbeck. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biohavenn. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbviie. Dr. Cowan has stock in Percept. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received publishing royalties from a publication relating to health care.

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