Increased neural connectivity between the hypothalamus and cortical resting-state functional networks in chronic migraine

Gianluca Coppola, Antonio Di Renzo, Barbara Petolicchio, Emanuele Tinelli, Cherubino Di Lorenzo, Mariano Serrao, Valentina Calistri, Stefano Tardioli, Gaia Cartocci, Vincenzo Parisi, Francesca Caramia, Vittorio Di Piero, Francesco Pierelli

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: The findings of resting-state functional MRI studies have suggested that abnormal functional integration between interconnected cortical networks characterises the brain of patients with migraine. The aim of this study was to investigate the functional connectivity between the hypothalamus, brainstem, considered as the migraine generator, and the following areas/networks that are reportedly involved in the pathophysiology of migraine: default mode network (DMN), executive control network, dorsal attention system, and primary and dorsoventral visual networks.

METHODS: Twenty patients with chronic migraine (CM) without medication overuse and 20 healthy controls (HCs) were prospectively recruited. All study participants underwent 3-T MRI scans using a 7.5-min resting-state protocol. Using a seed-based approach, we performed a ROI-to-ROI analysis selecting the hypothalamus as the seed.

RESULTS: Compared to HCs, patients with CM showed significantly increased neural connectivity between the hypothalamus and brain areas belonging to the DMN and dorsal visual network. We did not detect any connectivity abnormalities between the hypothalamus and the brainstem. The correlation analysis showed that the severity of the migraine headache was positively correlated with the connectivity strength of the hypothalamus and negatively with the connectivity strength of the medial prefrontal cortex, which belongs to the DMN.

CONCLUSION: These data provide evidence for hypothalamic involvement in large-scale reorganisation at the functional-network level in CM and in proportion with the perceived severity of the migraine pain.

Original languageEnglish
Pages (from-to)185-191
Number of pages7
JournalFront. Neurol.
Issue number1
Publication statusPublished - Jan 2020


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