title: Functional interictal changes of pain processing in migraine with ictal cutaneous allodynia.
abstract: Objective A prospective clinical imaging study has been conducted to investigate pain processing functional pathways during trigeminal heat stimulation (THS) in patients with migraine without aura experiencing ictal cutaneous allodynia (CA) (MwoA CA+). Methods Using whole-brain BOLD-fMRI, functional response to THS at three different intensities (41°, 51° and 53℃) was investigated interictally in 20 adult MwoA CA+ patients compared with 20 MwoA patients without ictal CA (MwoA CA-) and 20 healthy controls (HCs). Secondary analyses evaluated associations between BOLD signal change and clinical features of migraine. Results During moderate-noxious THS (51℃), we observed a significantly greater activation in (a) the anterior cingulate cortex in MwoA CA+ patients compared to HCs and (b) the middle frontal gyrus in MwoA CA+ patients compared to both MwoA CA- patients and HCs. Furthermore, during high-noxious THS (53℃) a significantly decreased activation in the secondary somatosensory cortices was observed in (a) MwoA CA- patients compared to both MwoA CA+ patients and HCs and (b) MwoA CA+ patients compared to HCs. CA severity was positively correlated with the secondary somatosensory cortices activation. Conclusions Our findings suggest that CA may be subtended by both a dysfunctional analgesic compensatory mechanism and an abnormal internal representation of pain in migraine patients.
authors.affiliation: 1 Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.|2 MRI Research Center SUN-FISM, Second University of Naples, Italy.|3 Institute for Diagnosis and Care 'Hermitage Capodimonte', Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.affiliation: 4 Department of Medicine and Surgery, University of Salerno, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Esposito
authors.affiliation: 1 Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Conte
authors.affiliation: 1 Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.|4 Department of Medicine and Surgery, University of Salerno, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Fratello
authors.affiliation: 2 MRI Research Center SUN-FISM, Second University of Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Caiazzo
authors.affiliation: 1 Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Marcuccio
authors.affiliation: 1 Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.|2 MRI Research Center SUN-FISM, Second University of Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Giordano
authors.affiliation: 1 Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.|2 MRI Research Center SUN-FISM, Second University of Naples, Italy.|3 Institute for Diagnosis and Care 'Hermitage Capodimonte', Italy.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Tedeschi
authors.affiliation: 1 Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.|2 MRI Research Center SUN-FISM, Second University of Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tessitore
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D005260:Female; D006358:Hot Temperature; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology*; D010146:Pain / Q000503:physiopathology*; D011446:Prospective Studies
keywords: Migraine; allodynia; fMRI; trigeminal stimulation; volumetric MRI