In people with migraine without aura, the default mode network (DMN) shows reduced connectivity in prefrontal and temporal brain regions during resting-state functional MRI, compared to healthy controls. These functional differences were not linked to structural brain changes or to clinical and neuropsychological features of migraine. The findings suggest that DMN dysfunction may reflect a maladaptive response to stress, a behavioral pattern often seen in migraine patients.
Adding mindfulness practice to standard pharmacological treatment for chronic migraine with medication overuse headache led to a significant reduction in headache frequency after one year, while standard treatment alone did not. Mindfulness patients also showed greater functional connectivity between the salience network and the left posterior insula and sensorimotor cortex, increased cortical thickness in the insula and anterior cingulate cortex, and a link between stronger insula-salience network connectivity and improved depression scores. These brain changes may help explain how mindfulness improves pain management and emotional regulation in this condition.
Ergotamine, a drug used for cluster headache and migraine, amplifies the amplitude of circadian clock gene expression in mouse fibroblast cells and trigeminal ganglion explants without altering period length. This effect appears to be mediated through serotonin 1D and 2C receptors. In a mouse model of chronic headache, ergotamine raised hindpaw pain thresholds when administered during the daytime (ZT4) but not at night (ZT16), suggesting a chronotherapeutic benefit. The findings indicate that ergotamine's efficacy may vary with time of day, providing a rationale for timed dosing in migraine treatment.
Periodic alpha-band brain activity, measured with electroencephalography (EEG) before treatment, predicts how well patients with episodic migraine without aura will respond to the preventive drug topiramate. Higher alpha power in specific brain regions—the cuneus, pericalcarine cortex, medial orbitofrontal cortex, frontal pole, and precuneus—indicates a poorer clinical response. A predictive model using these features achieved an area under the receiver operating characteristic curve of 0.859 in identifying treatment responders. The visual network and default mode network together explained 26.1% of the variance in headache improvement. These findings suggest that baseline alpha activity is a strong neurobiological marker for personalizing migraine preventive therapy.