Research Information System
2nd Internatonal Medcal Congress of Izmr Democracy Unversty, İzmir, Turkey, 17 - 19 December 2020, pp.799-804, (Full Text)
Migraine is a common disorder characterized by severe headache attacks with vegetative symptoms. In the last 30 years, migraine-specific changes in the brain have been reported with structural and functional magnetic resonance imaging (MRI) studies. The presence of dopaminergic symptoms accompanying migraine, pharmacological, biochemical, and genetic findings indicate that dopamine (DA) and basal ganglia (BG) have an important role in the pathophysiology of migraine. In this study, we reviewed the role of the dopaminergic system in migraine in the light of MRI studies conducted so far. Migraine and the dopaminergic system The relationship between DA and migraine has been suggested since most of the symptoms accompanying migraine attack and the prodromal period can be revealed by DA agonists in healthy volunteers. DA receptors are located in the trigeminovascular system and neuronal firing decreases by stimulation of these receptors with DA agonists. In biochemical studies, changes in DA levels in cerebrospinal fluid, urine, and blood were observed in migraine patients. Besides, a correlation was found between certain dopaminergic genotypes and susceptibility to migraine and drug responses in migraine. BG is an important brain region that is effective on behavior, pain, neurological and psychiatric conditions and processing information between cortical regions and the thalamus. It has been suggested that caudate nuclei play a role in avoiding behavior that develops in response to pain, reducing sensitivity to pain with dopaminergic stimulation, and encoding the intensity of painful thermal stimuli to minimize the harmful effect on the body. The putamen is effective in somatotopic modulation and subjective interpretation of pain. Neuroimaging findings Two recent meta-analyses demonstrated increased functional activation in the BG associated with frequency of migraine attacks. The changes in the BG structures' sizes have been investigated mainly by automated volumetric programs particularly in the second decade of this century. We recently reported larger right caudate volumes by using three quantitative neuroimaging modalities i.e. manual measurements, volBrain, and voxel-based morphometry (VBM). We found a positive relation between the caudate and putamen volumes and attack frequency. The more migraine attacks meant a larger caudate, which was consistent with the findings of Maleki et al.(2011). In the pediatric population, Rocca et al. (2014) detected a negative relation between increased putamen volume and disease duration as the right putamen was increased in the pediatric migraineurs. BG structures are considered to play different roles in pain processing, i.e., sensory, emotional/cognitive, and modulatory. As proposed by Neeb et al. (2017) increases in the sizes of these structures might be the result of plasticity as an adaptive response to repetitive migraine attacks. Contrary to our enlarged caudate finding, Petrusic et al. (2019) recently reported decreased volumes of right globus pallidus, left globus pallidus, and left putamen in migraine patients with aura compared to those of the controls. The BG structures are not only affected in the interictal period but also are activated before the beginning of the migraine attack and are blamed as one of the structures having a role in migraine attack initiation