AUTHOR=Markin Kirill , Trufanov Artem , Frunza Daria , Litvinenko Igor , Tarumov Dmitriy , Krasichkov Alexander , Polyakova Victoria , Efimtsev Alexander , Medvedev Dmitriy 

TITLE=fMRI Findings in Cortical Brain Networks Interactions in Migraine Following Repetitive Transcranial Magnetic Stimulation

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.915346

DOI=10.3389/fneur.2022.915346

ISSN=1664-2295

ABSTRACT=Background: Repetitive transcranial magnetic stimulation (rTMS) is one of high-potential non-pharmacological methods for migraine treatment. The purpose of this study is to define the neuroimaging markers associated with rTMS therapy in patients with migraine based on data from functional magnetic resonance imaging (fMRI).
Methods: 19 patients with migraine without aura underwent a 5-day course of rTMS of the fronto-temporo-parietal junction bilaterally, at 10Hz frequency and 60% of motor threshold response of 900 pulses. Resting-state functional MRI (1.5 T) and battery of tests were carried out for each patient to clarify their diagnosis, qualitative and quantitative characteristics of pain, and associated affective symptoms. Changes in functional connectivity (FC) in the brain’s neural networks before and after the treatment were identified through independent components analysis.
Results: Over the course of therapy, we observed an increase in FC of the default mode network within it, with pain system components and with structures of the visual network. We also noted a decrease in FC of the salience network with sensorimotor and visual networks, as well as an increase in FC of the visual network. Besides, we identified 5 patients who did not have a positive response to one rTMS course after first week of treatment according to the clinical scales results, presumably because of an increased trend to depressive symptoms and neuroimaging criteria for depressive disorder.
Conclusions: Our results show that a 5-day course of rTMS significantly alters the connectivity of brain networks associated with pain and antinociceptive brain systems in about 70% of cases, which may shed light on the neural mechanisms underlying migraine treatment with rTMS.