title: Enhanced pain-induced activity of pain-processing regions in a case-control study of episodic migraine.
abstract: OBJECTIVE
  The objective of this study was to identify brain regions having aberrant pain-induced activation in migraineurs, thereby gaining insight into particular aspects of pain processing that are atypical in migraineurs.
  
  
  METHODS
  Functional magnetic resonance imaging assessed whole brain responses to painful heat in 24 adult episodic migraineurs who were at least 48 hours pain free and 27 healthy controls. Regions differentially activated in migraineurs compared to controls were identified. Activation intensities in these regions were correlated with headache frequency, number of migraine years, and time to next migraine attack.
  
  
  RESULTS
  Migraineurs had greater pain-induced activation of lentiform nucleus, fusiform gyrus, subthalamic nucleus, hippocampus, middle cingulate cortex, premotor cortex, somatosensory cortex, and dorsolateral prefrontal cortex, and less activation in precentral gyrus and superior temporal gyrus. There were significant correlations between activation strength and headache frequency for middle cingulate (r = 0.627, p = 0.001), right dorsolateral prefrontal cortex (r = 0.568, p = 0.004), left fusiform gyrus (r = 0.487, p = 0.016), left precentral gyrus (r = 0.415, p = 0.044), and left hippocampus (r = 0.404, p = 0.050) and with number of migraine years for left fusiform gyrus (r = 0.425, p = 0.038). There were no significant correlations between activation strength and time to next migraine attack.
  
  
  CONCLUSIONS
  The majority of regions with enhanced pain-induced activation in headache-free migraineurs participate in cognitive aspects of pain perception such as attending to pain and pain memory. Enhanced cognitive pain processing by migraineurs might reflect cerebral hypersensitivity related to high expectations and hypervigilance for pain.
authors.affiliation: Mayo Clinic, Phoenix, AZ, USA schwedt.todd@mayo.edu.
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Schwedt
authors.affiliation: Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Catherine D
authors.initials: CD
authors.lastname: Chong
authors.affiliation: Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Chia-Chun
authors.initials: CC
authors.lastname: Chiang
authors.affiliation: Barrow Neurological Institute, Phoenix, AZ, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Baxter
authors.affiliation: Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Bradley L
authors.initials: BL
authors.lastname: Schlaggar
authors.affiliation: Mayo Clinic, Phoenix, AZ, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Dodick
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology*; D010146:Pain / Q000503:physiopathology*
keywords: Migraine; cognitive pain processing; functional magnetic resonance imaging; headache; pain