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In migraine patients, the individual differences in brain function
and pain modulation help to determine cognitive-behavioral therapy (CBT)
responsiveness, and is associated with clinical improvements.
A recent study illustrated that after CBT, the headache mitigation was considerably linked with right amygdala connectivity with frontal and sensorimotor regions at baseline as well as baseline pain alteration capacities. Thus, the individual differences in brain function and pain modulation help with the determination of CBT responsiveness and can be linked with clinical improvements.
CBT, a promising psychological intervention, involves developing coping strategies to alleviate the pain experience. Though in patients with migraine, it can reduce headache days, but it may not be useful for all patients. Identifying markers could predict which patients will effectively respond to the CBT session.
In adolescents with migraine, a study was carried out to explore if the baseline brain function and amygdalar connectivity, evaluated by functional magnetic resonance imaging (fMRI), or pain modulation capacities, assessed by the conditioned pain modulation (CPM) response, can forecast alleviation in headache days after CBT sessions.
Notably, 20 patients with migraine (age: 10-17 years) completed eight weekly CBT sessions.
In the leg and trapezius, the CPM response was determined. After CBT, the headache days remarkably declined.
Greater functional connectivity before CBT between the right amygdala and frontal gyrus, anterior cingulate cortex, and precentral gyrus was remarkably linked to significant headache mitigation after CBT. After the CBT session, a greater decline in headache days was substantially linked with less efficient CPM response before CBT at the trapezius but not at the leg.
Thus, after CBT, the headache relief is substantially associated with right amygdala connectivity with frontal and sensorimotor regions at baseline as well as baseline pain alteration capacities.
Pain
https://journals.lww.com/pain/Abstract/9000/Identification_of_neural_and_psychophysical.98307.aspx#
Identification of neural and psychophysical predictors of headache reduction following cognitive behavioral therapy in adolescents with migraine
Nahman-Averbuch, Hadas
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