Background
What do we already know about this topic?
- Migraine is a symptomatically heterogeneous disorder.
- Non-painful symptoms can be present up to several days before the onset of pain and can persist after headache resolution.
- Understanding the possible changes in brain function during the different phases of the migraine attack is essential to developing disease biomarkers and advancing therapeutics.
- Nitroglycerin has previously been shown to be a potent migraine trigger and can be used alongside resting-state fMRI to study the changes in functional connectivity between brain areas of potential importance in migraine during different phases of the attack.1
How was this study conducted?
- A randomised, double-blind, placebo-controlled study of 53 adult patients, with a history of migraine who were recruited from across the UK and randomised to receive either a 0.5 mcg/kg/min nitroglycerin infusion or placebo over a 20-minute period. All patients were exposed to a nitroglycerin infusion at the screening visit.
- Twenty-one patients consented to participate in imaging visits, structural T1, T2 and FLAIR sequences, and resting state blood oxygen level dependant contrast (rsBOLD) time series were conducted at baseline, and rsBOLD during premonitory symptoms and migraine headache on a 3T General Electric MR750 MRI scanner. For the placebo visit, the imaging was conducted at the same time following infusion in the absence of symptoms.