Association between migraine frequency and neural response to emotional faces: An fMRI study

Previous studies have demonstrated that migraine is associated with enhanced perception and altered cerebralprocessing of sensory stimuli. More recently, it has been suggested that this sensory hypersensitivity mightreflect a more general enhanced response to aversive emotional stimuli. Using functional magnetic resonanceimaging and emotional face stimuli (fearful, happy and sad faces), we compared whole-brain activation between41 migraine patients without aura in interictal period and 49 healthy controls. Migraine patients showed in-creased neural activation to fearful faces compared to neutral faces in the right middle frontal gyrus and frontalpole relative to healthy controls. We also found that higher attack frequency in migraine patients was related toincreased activation mainly in the right primary somatosensory cortex (corresponding to the face area) to fearfulexpressions and in the right dorsal striatal regions to happy faces. In both analyses, activation differences re-mained significant after controlling for anxiety and depressive symptoms. Thesefindings indicate that enhancedresponse to emotional stimuli might explain the migraine trigger effect of psychosocial stressors that graduallyleads to increased somatosensory response to emotional clues and thus contributes to the progression orchronification of migrain