Altered network homogeneity of the default mode network in patients with tension-type headache

Objective: Dysfunction of the default mode network (DMN) is strongly linked to pain processing, as well as onset and progression of chronic pain disorders; however, its specific role in the pathogenesis of tension-type headache (TTH) remains incompletely understood. This study aims to explore the network homogeneity (NH) of the DMN in the pathophysiological mechanisms underlying TTH.

Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) and clinical headache scale assessments were conducted on 68 patients with TTH and 63 healthy controls (HCs). Independent component analysis and NH analysis were used to evaluate the neuroimaging data.

Results: Patients with TTH exhibited decreased NH values in the right posterior cingulate cortex (PCC) and increased NH values in the right medial superior frontal gyrus (SFGmed), bilateral angular gyrus (AG), and left precuneus (PCu), compared to HCs. Additionally, the NH values of right AG, left AG and right PCC were positively correlated with Headache Impact Test-6 (HIT-6), Migraine Disability Assessment Test (MIDAS) scores and headache intensity. Furthermore, support vector machine (SVM) analysis revealed that NH values in the right PCC could distinguish TTH patients from HCs with an accuracy of 75.57%, sensitivity of 84.13%, specificity of 70.59%, and an AUC of 0.7156.

Conclusion: This study demonstrates altered network homogeneity (NH) within the DMN in patients with TTH. Furthermore, the NH value of the right PCC showed discriminative potential to distinguish TTH patients from healthy controls via SVM classification.