Resting State Functional Connectivity Abnormalities in Pediatric Patients with Migraine (S51.007)

OBJECTIVE: To explore abnormalities of resting state (RS) functional connectivity (FC) and functional interaction among networks in pediatric patients with migraine, as well as their correlation with patients' clinical characteristics. BACKGROUND: Previous RS functional magnetic resonance imaging (fMRI) studies in adult migraine patients have demonstrated abnormal RS FC of brain networks involved in pain processing, including the default mode (DMN), the salience (SN) and the fronto-parietal attention (FPN) network. DESIGN/METHODS: Using a 3.0 Tesla scanner, RS fMRI was acquired from 13 pediatric migraine patients and 15 age-matched controls. Independent component analysis and a template-matching procedure were used to identify the DMN, FPN, working memory networks (WMN), SN, sensorimotor (SM), auditory and visual (VN) networks. Within-group and between-group RS FC comparisons were performed using SPM8. The FNC toolbox was used to assess changes of interactions among RS networks. Correlations between RS FC abnormalities and patients' clinical characteristics were also assessed. RESULTS: Compared to controls, pediatric migraine patients had an increased RS FC of the precuneus of the DMN and the dorsolateral prefrontal cortex of the right WMN. They also experienced a decreased RS FC of the anterior cingulum of the SN and the temporo-parietal junction of the left WMN. FNC analysis detected a decreased FC between the DMN and right WMN, and an increased FC between the VN and FPN in migraine patients compared to controls. No significant correlation was found between intra- and inter-network RS FC abnormalities and patients' clinical characteristics. CONCLUSIONS: Significant RS FC abnormalities occur in pain-processing networks of pediatric migraine patients. Brain regions involved in cognition were selectively involved, suggesting that abnormalities of cognitive modulation of pain in migraine patients occur from an early stage of the disease. Moreover, the increased connectivity between the VN and FPN supports an enhanced attention to visual stimuli in these patients.