Resting-state Functional Connectivity Changes During Migraine Treatment

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to determine whether reduced frequency of migraine attacks are associated with signal alternation and connectivity of cerebral cortex.

Detailed Description
-----------------
Patients with migraine show reduced cortical thickness in regions subserving pain processing, and it is related to increasing headache frequency. In the past, only one study has shown a reversibility consequence of chronic nociceptive transmission, which normalizes when the pain is adequately treated. However, little is known whether these changes predispose to migraine or represent the effect of repeated migraine attacks. Our region of interest is reduced frequency of migraine attacks are associated with reversibility of signal alternation and functional connectivity of cerebral cortex. In 30 migraineurs with 8-14days with headache per months who already performed brain magnetic resonance imaging will be recruited. Treatment medications such as frovatriptan and topiramate will be used for 6 months. After 6 months, follow-up brain magnetic resonance imaging will be performed. The primary outcome is the longitudinal changes in functional connectivity in pain-processing/modulating brain regions. The secondary outcome is following: 1)longitudinal changes in structural and morphological alterations in brain regions of pain processing; 2)structural, morphological, and functional correlates of treatment response; 3)changes in monthly migraine days, migraine frequecies, headache days, and headache frequencies after treatment; 4)responses to acute migraine treatment.

Official Title
-----------------
Resting-state Functional Connectivity Changes During Migraine Treatment: a Structural and Functional MRI Follow-up Study

Conditions
-----------------
Migraine Disorders

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Premenopausal Women Aged 18-50 Drug-naïve high frequency episodic migraineurs (8-14 attacks/m) Performed a baseline interictal brain MRI Exclusion Criteria: Medication overuse Chronic pain other than migraine On treatment of major depression, bipolar, schizophrenia, or BDI>25

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| functional MRI imaging changes | temporal changes in BOLD correlations in the regions of most significant correlation with periaqueductal grey; temporal changes in BOLD correlations in the regions of most significant correlation with anterior cingulate cortex; temporal changes in default mode network | 6 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| structural MRI imaging changes | changes in cortical thickness of anterior cingulate, amygdala, periquiductal grey, and sensorimotor cortex | 6 months | 
| Functional and structural correlates of treatment response | >50% reduction of monthly headache days | 6 months | 
| correlation of functional MRI changes with changes in clinical parameters | changes in monthly headache days | 6 months | 
| responses to acute migraine treatment | the Migraine Assessment of Current Therapy (Migraine-ACT) = 4 | 6 months after the first visit |