• David M Niddam, Kuan-Lin Lai, Jong-Ling Fuh, Chih-Ying Naomi Chuang, Wei-Ta Chen, and Shuu-Jiun Wang.
• Brain Research Center, National Yang-Ming University, Taiwan Institute of Brain Science, School of Medicine, National Yang-Ming University, Taiwan Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taiwan.
• Cephalalgia. 2016 Jan 1; 36 (1): 53-66.

BackgroundMigraine with visual aura (MA) is associated with distinct visual disturbances preceding migraine attacks, but shares other visual deficits in between attacks with migraine without aura (MO). Here, we seek to determine if abnormalities specific to interictal MA patients exist in functional brain connectivity of intrinsic cognitive networks. In particular, these networks are involved in top-down modulation of visual processing.MethodsUsing resting-state functional magnetic resonance imaging, whole-brain functional connectivity maps were derived from seeds placed in the anterior insula and the middle frontal gyrus, key nodes of the salience and dorsal attention networks, respectively. Twenty-six interictal MA patients were compared with 26 matched MO patients and 26 healthy matched controls.ResultsThe major findings were: connectivity between the anterior insula and occipital areas, including area V3A, was reduced in MA but not in MO. Connectivity changes between the anterior insula and occipital areas further correlated with the headache severity in MA only.ConclusionsThe unique pattern of connectivity changes found in interictal MA patients involved area V3A, an area previously implicated in aura generation. Hypoconnectivity to this and other occipital regions may either represent a compensatory response to occipital dysfunctions or predispose MA patients to the development of aura.© International Headache Society 2015.

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