Nucleus accumbens functional connectivity predicts medication overuse headache
(2014) Human Brain Mapping — Location: Hamburg (8.June.2014)
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- Authors
Torta, Diana 
- Abstract
- Medication-overuse headache (MOH) is a secondary form of headache related to the overuse of acute anti-headaches. A number of studies has suggested that MOH might share the same pathophysiological and behavioral mechanisms that intervene in substance abuse and behavioral addictions (Calabresi Cupini 2008, Ferraro, Grazzi, Muffatti, Nava et al., 2012; Gómez-Beldarrain M, Carrasco M, Bilbao A, García-Moncó, 2011; Radat F, Lanteri-Minet, 2011; Calabresi, Cupini, 2005). Here, we investigated if functional resting state could be used to discriminate MOH from non-MOH migraneurs. For this aim, we used a novel methodological approach, the connectivity-based classification, to test the hypothesis that functional connectivity between the nucleus accumbens, one key structure for reward, motivational and incentive learning networks, and other cortical regions could discriminate the two forms of migraine. Methods We recorded resting state fMRI of two groups of migraine patients, age and education matched, with or without MOH. We explored the whole brain functional connectivity of the nucleus accumbens using seed-voxel correlation (Margulies et al., 2007). We then applied a pattern classification technique to investigate if resting state NAcc functional connectivity is able to discriminate between MOH and non-MOH patients. To inspect the pattern of connections having the highest discriminative power, we employed Multivoxel Pattern Analysis (MVPA). In this multivariate technique, multivoxel patterns of foci were analyzed using a method that combines machine learning with an iterative, multivariate voxel selection algorithm: Recursive Feature Elimination (RFE) (De Martino et al., ) Results Seed-voxel correlations of the resting state activity in the nucleus accumbens were found with the insula bilaterally, orbitofrontal and cingulate cortices, thalamus, basal ganglia, amydgala. We also detected connections between the accumbens and sensorimotor cortices (see Figure 2). Connectivity based classification MVPA approach demonstrated that the two groups can be efficiently discriminated on the basis of the NAcc resting state functional connectivity. Areas that showed the highest discriminative power for MOH patients were prevalently placed in the bilateral anterior and posterior insulae, dorsolateral prefrontal cortices, midcingulate cortices, precuneus, secondary sensorymotor cortices and thalami; Areas that showed the highest discriminative power for non-MOH patients were prevalently placed in sensorimotor and premotor brain areas. To better interpret the findings, we grouped MVPA results into large scale brain networks. This visualization approach showed that discrimination patterns that predict abusers (MOH patients) are prevalently in orbitofrontal cortex (OFC), dorsal attention network (DAN), default model network (DMN), saliency network (SAL), cerebellar, and sensorimotor networks. Conversely, non-abusers (non-MOH patients) were predicted by the ventral attention network (VAN), motor and premotor networks. Conclusion Our data show that MOH patients are characterized by functional alteration of motivational circuits at rest. These peculiarities are sufficiently evident to allow a blind discrimination of MOH and non-MOH patients. Altogether these findings provide important suggestions in the development of novel and objective diagnostic measures.
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Torta, D., Costa, T., Luda, E., Duca, S., Geminiani, G., & Cauda, F. (2014). Nucleus accumbens functional connectivity predicts medication overuse headache. Proceedings of the Human Brain Mapping 2014. Published. Human Brain Mapping, Hamburg. https://hdl.handle.net/2078.5/186036 (Original work published 2014)