title: Altered periaqueductal gray resting state functional connectivity in migraine and the modulation effect of treatment.
abstract: The aims of this study were to 1) compare resting state functional connectivity (rs-fc) of the periaqueductal gray (PAG), a key region in the descending pain modulatory system (DPMS) between migraine without aura (MwoA) patients and healthy controls (HC), and 2) investigate how an effective treatment can influence the PAG rs-fc in MwoA patients. One hundred MwoA patients and forty-six matched HC were recruited. Patients were randomized to verum acupuncture, sham acupuncture, and waiting list groups. Resting state fMRI data were collected and seed based functional connectivity analysis was applied. Compared with HC, MwoA patients showed reduced rs-fc between the PAG and rostral anterior cingulate cortex/medial prefrontal cortex (rACC/mPFC), key regions in the DPMS and other pain related brain regions. The reduced rs-fc between the PAG and rACC/mPFC was associated with increased migraine headache intensity at the baseline. After treatments, rs-fc between the PAG and the rACC in MwoA patients significantly increased. The changes of rs-fc among the PAG, rACC and ventral striatum were significantly associated with headache intensity improvement. Impairment of the DPMS is involved in the neural pathophysiology of migraines. Impaired DPMS in migraine patients can be normalized after effective treatment.
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.|Department of Traditional Chinese Medicine, Medical College of Xiamen University, Xiamen, Fujian, China.
authors.forename: Zhengjie
authors.initials: Z
authors.lastname: Li
authors.affiliation: Acupuncture &Tuina School, Hunan University of Chinese Medicine, Changsha, Hunan, China.
authors.forename: Mailan
authors.initials: M
authors.lastname: Liu
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Lan
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Zeng
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.|Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
authors.forename: Nikos
authors.initials: N
authors.lastname: Makris
authors.affiliation: Neuroscience Program, Wellesley College, Wellesley, MA, USA.
authors.forename: Yilin
authors.initials: Y
authors.lastname: Liang
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Taipin
authors.initials: T
authors.lastname: Guo
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wu
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Gao
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Mingkai
authors.initials: M
authors.lastname: Dong
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Qiyong
authors.initials: Q
authors.lastname: Gong
authors.affiliation: The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Fanrong
authors.initials: F
authors.lastname: Liang
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.|Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
authors.forename: Jian
authors.initials: J
authors.lastname: Kong
mesh_terms: D015670:Acupuncture Therapy; D000293:Adolescent; D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D020326:Migraine without Aura / Q000503:physiopathology / Q000628:therapy*; D010146:Pain / Q000503:physiopathology*; D017288:Pain Threshold; D010487:Periaqueductal Gray / Q000503:physiopathology*; D017397:Prefrontal Cortex / Q000503:physiopathology; D011897:Random Allocation; D055815:Young Adult
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