Table 2 Summary of the imaging studies conducted during the symptomatic premonitory phase of pharmacologically provoked migraine attacks
From: Neuroimaging in the pre-ictal or premonitory phase of migraine: a narrative review
Study | Imaging modality | Subject cohort | Study design | Main findings |
|---|---|---|---|---|
Maniyar et al., 2014 [30] | H2 150 PET | Migraine (n = 8) | Three scans per subject; baseline, premonitory and headache during NTG-triggered attacks | Increases in cerebral blood in hypothalamus, midbrain, dorsal pons and cortical areas during PS |
Maniyar et al., 2014 [29] | H2 150 PET | Migraine with premonitory photophobia (n = 5) Migraine without premonitory photophobia (n = 5) | At least one premonitory scan per subject during NTG-triggered attacks | Greater activation of extrastriate visual cortex (BA18) during the premonitory phase in those with photophobia compared to those without relative to baseline |
Maniyar et al., 2014 [31] | H2 150 PET | Migraine with premonitory nausea (n = 3) Migraine without premonitory nausea (n = 7) | Three scans per subject’ baseline, premonitory and headache during NTG-triggered attacks | Activation in rostral dorsal medulla and periaqueductal grey in the nausea group only |
Karsan et al., 2020 [33] | Resting state fMRI with seed-based connectivity analysis | Migraine (n = 21) | Four scans per subject; baseline, premonitory, headache and resolution following NTG and placebo on two visits | Alterations in thalamus and cuneus and precuneus and pontolimbic functional connectivity in the premonitory phase Pontolimbic changes persisted through headache, with other changes involving pons, medulla and cerebellar tonsils |
Martinelli et al., 2021 [35] | Resting state fMRI with seed-based correlation analysis and wavelet coherence analysis | Migraine (n = 5) | Four scans per subject; baseline, premonitory, headache and resolution during NTG-triggered attacks | Connectivity changes between right thalamus and insula, pons and cerebellum in the premonitory phase Loss of synchronisation between the thalami and the salience network |
Karsan et al., 2023 [32] | 3D pCASL | Migraine (n = 21) | Four scans per subject; baseline, premonitory, headache and resolution following NTG and placebo on two visits | Increases in cerebral blood flow in anterior cingulate and frontal cortices, caudate, lentiform, hippocampus and hypothalamus in those not on prevention Reduced occipital perfusion in those with underlying aura irrespective of whether aura was triggered or not |