Abstract Details

Title Migraine and Cluster Headache Classification Using a Supervised Machine Learning Approach: A Multimodal MRI Study

Topic Headache

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-016

Objective To identify a magnetic resonance imaging (MRI) pattern that best discriminates migraine, cluster headache patients and controls.

Background Similar alterations in brain regions involved in multisensory processing have been shown in migraine and cluster headache. However, only one neuroimaging study has directly compared migraine and cluster headache patients.

Design/Methods Functional and structural MR modalities were acquired from 20 migraineurs, 20 cluster headache patients and 15 controls. A dual regression analysis was used to study voxel-wise resting state functional connectivity (RS FC) within brain regions involved in headache pathophysiology (thalamus, hypothalamus, dorsal pons and spinal trigeminal nucleus). Feature selection was performed using a probabilistic spatial independent components analysis. Support vector machine algorithms and a stepwise removal research were used to obtain the best accuracy rates for discrimination between patients and controls, and between patients.

Results The overall accuracy for classifying the entire group of headache patients from controls was 82%. The best classification accuracy for discrimination between migraine and controls was 83%, and for cluster headache patients and controls it was 80%. The best classifier yielded an accuracy of 73% in distinguishing cluster headache patients from migraineurs. Distinct functional and structural MRI features contributed to the different classification models. The right thalamic RS FC was the most useful feature between headache and control groups. The right hypothalamic RS FC and the RS FC of the left pons were most important when classifying migraineurs from controls. The right hypothalamic RS FC was also the most important MRI feature in migraine and cluster headache classification.

Conclusions The combination of multiple functional and structural MRI patterns can accurately classify patients with primary headaches from a group of controls. Among the different brain networks involved in primary headaches, the thalamic, hypothalamic and pontine networks play a central role in migraine and cluster headache pathophysiology.

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.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Diana Wei, MD (King's College London)	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.
Peter Goadsby, MD, PhD, FRS (King Abdullah Univeristy of Science and Technology)	Dr. Goadsby has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva Pharmaceuticals. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Goadsby has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CoolTech LLC. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PureTech Health LLC. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Kallyope. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Seaport Therapeutics. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dr Reddy's. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Orion Pharma. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ipsen. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Massachusetts Medical Society. The institution of Dr. Goadsby has received research support from NIHR. Dr. Goadsby has received publishing royalties from a publication relating to health care. Dr. Goadsby has received publishing royalties from a publication relating to health care. Dr. Goadsby has a non-compensated relationship as a Trustee with Migraine Trust that is relevant to AAN interests or activities. Dr. Goadsby has a non-compensated relationship as a Trustee with Organisation for Understanding Cluster Headache (UK) that is relevant to AAN interests or activities.

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