• Gianluca Coppola, Antonio Di Renzo, Emanuele Tinelli, Cherubino Di Lorenzo, Giorgio Di Lorenzo, Vincenzo Parisi, Mariano Serrao, Jean Schoenen, and Francesco Pierelli.
• From the Research Unit of Neurophysiology of Vision and Neurophthalmology (G.C., A.D.R., V.P.), G.B. Bietti Foundation IRCCS, Rome; Department of Neurology and Psychiatry (E.T.), Neuroradiology Section, "Sapienza" University of Rome; Don Carlo Gnocchi Onlus Foundation (C.D.L.), Milan; Laboratory of Psychophysiology (C.D.L.), Department of Systems Medicine, University of Rome "Tor Vergata"; Department of Medical and Surgical Sciences and Biotechnologies (M.S., F.P.), "Sapienza" University of Rome Polo Pontino, Latina; IRCCS Neuromed (F.P.), Pozzilli (IS), Italy; and Headache Research Unit (J.S.), Department of Neurology-CHR Citadelle, University of Liège, Belgium. gianluca.coppola@gmail.com.
• Neurology. 2016 Nov 15; 87 (20): 2154-2160.

ObjectiveWe used MRI to search for changes in thalamo-cortical networks and thalamic microstructure during spontaneous migraine attacks by studying at the same time structure with diffusion tensor imaging and resting state function in interconnected brain networks with independent component analysis.MethodsThirteen patients with untreated migraine without aura (MI) underwent 3T MRI scans during an attack and were compared to a group of 19 healthy controls (HC). We collected resting state data in 2 selected networks identified using group independent component (IC) analysis. Fractional anisotropy (FA) values of bilateral thalami were calculated in the same participants and correlated with resting state IC z scores.ResultsFunctional connectivity between the executive and the dorso-ventral attention networks was reduced in MI compared to HC. In HC, but not in MI, the higher the IC24 z score, encompassing interconnected areas of the dorso-ventral attention system, the lower the bilateral thalamic FA values. In patients, the higher the executive control network z scores, the lower the number of monthly migraine days.ConclusionsThese results provide evidence for abnormal connectivity between the thalamus and attentional cerebral networks at rest during migraine attacks. This abnormality could subtend the known ictal impairment of cognitive performance and suggests that the latter might worsen with increasing attack frequency.© 2016 American Academy of Neurology.

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