Altered Functional Network Connectivity in Chronic Migraine: a Replication-Extension Study (4689)

Objective: To replicate the findings of reported functional connectivity (FC) alterations between cortical networks in chronic (CM) compared to controls, extend them to episodic (EM) migraine, and determine associations with headache frequency and severity. Background: There is a growing literature demonstrating resting-state FC alterations in CM. However, mixed methods and patient samples have led to differences in the brain regions/networks implicated. Recently, FC alterations in patients with CM without medication overuse (−MO) were demonstrated in three major cortical networks compared to healthy controls (default mode (DMN), executive control (ECN), and dorsal attention (DAS)) and were associated with headache severity. We aimed to replicate this study in a separate cohort of patients with CM-MO and expand these findings by examining CM patients with MO (+MO) and episodic migraine (EM). Design/Methods: 125 participants (44 CM patients (27 +MO and 17-MO), 44 EM patients, and 37 healthy controls) completed resting-state fMRI scans at 3T to compare FC between cortical networks using independent component analysis. Associations between FC and headache frequency and severity were evaluated. Results: Five cortical networks were identified as having good spatial overlap across groups: DMN, DAS, ECN, visual (VN), and sensorimotor (SMN). Compared to controls, CM patients (+MO and −MO) had lower DMN-SMN FC. Compared to EM, CM patients (−MO only) had greater VN-DAS FC and lower VN-DMN FC. VN-DAS FC was positively associated with headache frequency and VN-DMN FC was negatively associated with headache frequency. Conclusions: We provide evidence for altered cortical network FC in CM patients compared to healthy controls and EM patients; however, we did not replicate previous findings. Our extended findings of CM FC alterations compared to EM were specific to patients −MO and related to headache frequency suggesting distinct correlates of headache changes from patients +MO. Disclosure: Dr. DeSouza has nothing to disclose. Dr. Hindiyeh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Hindiyeh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Hindiyeh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alder/Lundbeck. Dr. Hindiyeh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Bharati Sanjanwala has nothing to disclose. Samuel Krimmel has nothing to disclose. The institution of David Seminowicz has received research support from NIH. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Cowan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for lundbeck. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biohavenn. Dr. Cowan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbviie. Dr. Cowan has received stock or an ownership interest from Percept. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received intellectual property interests from a discovery or technology relating to health care. Dr. Cowan has received publishing royalties from a publication relating to health care.