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      P020. No evidence of microstructural changes in visual network in patients with migraine with aura: a diffusion tensor tract-based spatial statistic (TBSS) study

      , , , , , , , , ,

      The Journal of Headache and Pain

      Springer Milan

      Abstracts from the 1st Joint ANIRCEF-SISC Congress

      29-31 October 2015

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          Background Migraine arises from a primary brain dysfunction that leads to episodic activation and sensitization of the trigeminovascular pain pathway. About one third of patients with migraine experiences transient neurological symptoms during attacks, so-called “aura”, among which the most common is visual aura [1]. In our previous fMRI study, we had observed a significantly increased resting-state visual network (RS-VN) functional connectivity in patients with migraine with aura (MwA) compared to patients with migraine without aura (MwoA) during the interictal period [2]. Nevertheless, both whole-brain and visual pathways microstructural white matter (WM) abnormalities in patients with MwA and MwoA is still under debate. Objective To investigate both whole-brain and visual pathways WM microstructural changes in MwA patients, compared to MwoA patients and HC during the interictal period. Methods By using magnetic resonance imaging and diffusion tensor imaging (DTI) with tract-based spatial statistic (TBSS) analysis, we analyzed WM integrity in twenty patients with MwA, compared to twenty patients with MwoA and twenty HC. We performed a TBSS analysis generating fractional anisotropy (FA), mean diffusivity (MD) and radial diffusivity (RD) and axial diffusivity (AD) maps. TBSS was run with FA maps to create the “skeleton”, which represents the center of all fiber bundles in common to all subjects [3]. The resulting statistical maps were thresholded at p < 0.05 corrected for multiple comparisons at a cluster level. Besides whole brain analyses, a region of interest (ROI) analysis was also performed to correlate the TBSS results with both visual pathways standard anatomic ROI data and functional regions that were based on the results of our previous fMRI study. Results Between-groups analyses did not reveal statistically significant differences in both whole-brain and bilateral visual pathways ROI FA, MD, RD and AD values between patients with MwA compared with patients with MwoA and HCs (p < 0.05 corrected). Conclusions Our preliminary data may support the hypothesis that visual pathways functional changes may not be linked to, or alternatively, may precede structural abnormalities in patients with MwA. Furthermore, MwA does not seem to be a risk factor for progressive microstructural WM changes in diffusion tensor tract-based spatial statistic (TBSS) analysis. Written informed consent to publish was obtained from the patient(s).

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          Migraine aura and related phenomena: beyond scotomata and scintillations.

          Migraine affects the cortical physiology and may induce dysfunction both ictally and interictally. Although visual symptoms predominate during aura, other contiguous cortical areas related to less impressive symptoms are also impaired in migraine. Answers from 72.2% migraine with aura and 48.6% of migraine without aura patients on human faces and objects recognition, colour perception, proper names recalling and memory in general showed dysfunctions suggestive of prosopagnosia, dyschromatopsia, ideational apraxia, alien hand syndrome, proper name anomia or aphasia, varying in duration and severity. Symptoms frequently occurred in a successively building-up pattern fitting with the geographical distribution of the various cortical functions. When specifically inquired, migraineurs reveal less evident symptoms that are not usually considered during routine examination. Spreading depression most likely underlies the aura symptoms progression. Interictal involvement indicates that MWA and MWoA are not completely silent outside attacks, and that both subforms of migraine may share common mechanisms.
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            Increased interictal visual network connectivity in patients with migraine with aura

             G Tedeschi,  A Russo,  F Conte (2015)

              Author and article information

              J Headache Pain
              J Headache Pain
              The Journal of Headache and Pain
              Springer Milan (Milan )
              28 September 2015
              28 September 2015
              : 16
              Issue : Suppl 1 Issue sponsor : Publication costs for this supplement were funded by the 1st Joint ANIRCEF-SISC Congress. The Supplement Editors declare that they have no competing interests.
              [ ]Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy
              [ ]MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
              [ ]Institute for Diagnosis and Care “Hermitage Capodimonte”, Naples, Italy
              [ ]Neuroradiology Unit, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy
              [ ]Department of Medicine and Surgery, University of Salerno, Baronissi, SA Italy
              © Russo et al. 2015

              This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

              Abstracts from the 1st Joint ANIRCEF-SISC Congress
              Rome, Italy
              29-31 October 2015
              Poster Presentation
              Custom metadata
              © The Author(s) 2015

              Anesthesiology & Pain management


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