Hypothalamus Connectivity in Chronic and Episodic Migraine
Condition: Chronic Migraine
MeSH terms: Migraine Disorders
Study type: Interventional

Summary: 
      The purpose is to compare, using functional magnetic resonance imagery in resting-state, the
      connectivity of the hypothalamus in 2 groups of migraineurs. The first group is composed of
      chronic migraineurs, studied outside a migraine attack and is compared to gender- and age-
      matched episodic migraineurs with very few attacks per month and studied in the attack-free
      period. The primary outcome will be the connectivity index of the hypothalamus to brainstem
      areas activated during migraine attacks and to the trigeminal-cervical complex.
    

Detailed description: 
      Functional magnetic resonance imagery allows identification of correlations during rest
      between remote brain areas (functional connectivity) through their highly correlated
      low-frequency spontaneous fluctuations. This technique is interesting because it is
      atraumatic, takes place in resting condition, without administration of substances. Only one
      study of connectivity with functional magnetic resonance imagery in resting state, in
      headache-free period of migraine, has shown differences in the connection of the
      periaqueductal gray matter to the pain matrix in migraineurs and controls. Our region of
      interest is the hypothalamus because our group demonstrated activation in this area during
      migraine attacks and we hypothesised that the hypothalamus could trigger migraine attacks. We
      want to compare 2 groups of migraineurs. The first group is composed of chronic migraineurs
      with >15 days with headache per month, compared to the 2nd group composed of age- and
      gender-matched episodic migraineurs with < 4 days of migraine per month, without prophylactic
      treatment. Our purpose is to study the connectivity of the hypothalamus to midbrain and pons
      areas activated in previous studies using positon emission tomography (PET) in spontaneous
      migraine attacks. The connectivity of the hypothalamus with the trigeminal-cervical complex,
      conveying the pain from cranial vasculature and dura-mater playing a major role in migraine
      attack, has never been studied before, mainly for anatomical reasons. Our secondary purpose
      is to study the connectivity of the hypothalamus with the pain matrix and the possible
      correlations with depression, allodynia and attack treatment overuse.

      The primary outcome is the connectivity index of the hypothalamus to the midbrain and pons
      area known to be activated in migraine attacks and the trigeminal-cervical complex The
      secondary outcome is the connectivity index of the hypothalamus with the pain matrix
      (thalamus, sensitive-motor cortex, cingular cortex) This study is a comparative monocentric
      pathophysiological study of patients with migraine.
    

Intervention name(s): functional Magnetic Resonance Imaging (fMRI)
Intervention type(s): Other
Intervention description(s): both chronic and episodic patients with migraine have a specific functional Magnetic Resonance Imaging (fMRI)
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Basic Science