What do we already know about this topic?

• Two-thirds of patients with MwoA report experiencing ictal CA, a perception of skin discomfort induced by trivial stimuli to the skin.
• CA is a known prognostic factor for migraine chronification and for the likelihood that acute treatments will not be effective.
• Microstructural or functional changes of the main cognitive networks (DMN, salience network [SN] and CEN) could predict the development of CA in patients with MwoA.

How was this study conducted?

• A total of 50 drug-naïve patients with MwoA underwent three Tesla MRI brain scans at baseline.
• Following a three-year period, patients were stratified into two groups based on CA development (as assessed by the ASC-12 scale) and compared with 19 matched healthy controls.
• Both groups were analysed for intra- and inter-network functional connectivity differences within the cognitive resting-state networks, and whether differences in cognitive network functional connectivity were related to structural and microstructural abnormalities.
• Logistic regression analysis was used to identify baseline imaging predictors of CA development.