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J Vis Exp. 2014 Jun 2;(88). doi: 10.3791/50682.

3D-neuronavigation in vivo through a patient's brain during a spontaneous migraine headache.

Author information

1
Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry; Michigan Center for Oral Health Research (MCOHR), University of Michigan School of Dentistry; Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan; adasilva@umich.edu.
2
Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry.
3
Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan.
4
Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry; Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan.
5
PET Physics Section, Division of Nuclear Medicine, Radiology Department, University of Michigan.
6
3DLab, University of Michigan.
7
Department of Obstetrics and Gynecology, University of Michigan.

Abstract

A growing body of research, generated primarily from MRI-based studies, shows that migraine appears to occur, and possibly endure, due to the alteration of specific neural processes in the central nervous system. However, information is lacking on the molecular impact of these changes, especially on the endogenous opioid system during migraine headaches, and neuronavigation through these changes has never been done. This study aimed to investigate, using a novel 3D immersive and interactive neuronavigation (3D-IIN) approach, the endogenous µ-opioid transmission in the brain during a migraine headache attack in vivo. This is arguably one of the most central neuromechanisms associated with pain regulation, affecting multiple elements of the pain experience and analgesia. A 36 year-old female, who has been suffering with migraine for 10 years, was scanned in the typical headache (ictal) and nonheadache (interictal) migraine phases using Positron Emission Tomography (PET) with the selective radiotracer [(11)C]carfentanil, which allowed us to measure µ-opioid receptor availability in the brain (non-displaceable binding potential - µOR BPND). The short-life radiotracer was produced by a cyclotron and chemical synthesis apparatus on campus located in close proximity to the imaging facility. Both PET scans, interictal and ictal, were scheduled during separate mid-late follicular phases of the patient's menstrual cycle. During the ictal PET session her spontaneous headache attack reached severe intensity levels; progressing to nausea and vomiting at the end of the scan session. There were reductions in µOR BPND in the pain-modulatory regions of the endogenous µ-opioid system during the ictal phase, including the cingulate cortex, nucleus accumbens (NAcc), thalamus (Thal), and periaqueductal gray matter (PAG); indicating that µORs were already occupied by endogenous opioids released in response to the ongoing pain. To our knowledge, this is the first time that changes in µOR BPND during a migraine headache attack have been neuronavigated using a novel 3D approach. This method allows for interactive research and educational exploration of a migraine attack in an actual patient's neuroimaging dataset.

PMID:
24962460
PMCID:
PMC4186390
DOI:
10.3791/50682
[Indexed for MEDLINE]
Free PMC Article

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