J Neurol. 2025 Apr 23;272(5):356. doi: 10.1007/s00415-025-13098-w.
ABSTRACT
BACKGROUND: The purpose of this study was to investigate pain network and periaqueductal gray matter (PAG) functional connectivity (FC) in participants with acute post-traumatic headache (PTH) due to mild traumatic brain injury (mTBI) compared to healthy controls (HC).
METHODS: Ninety-eight participants with acute PTH and 85 HC underwent 3 T magnetic resonance imaging. Static FC among regions of the pain matrix and between PAG to the rest of the brain were examined. Correlations between FC and clinical parameters were investigated using linear regression. PTH outcomes (improved or not improved) were determined at 3 months post-enrollment.
RESULTS: Stronger FC between the PAG and right somatosensory and left lingual areas, and weaker FC between left thalamus and left caudate were found in the PTH group compared to HC. Whole-brain analysis showed increased PAG FC, primarily with somatosensory, motor, and occipital areas of participants with PTH relative to HC. These differences had associations with headache frequency, state anxiety, and time since mTBI. A PAG FC model for PTH improvement at 3 months had a sensitivity of 82% and a specificity of 100%. Participants with PTH who did not improve at 3 months had stronger baseline FC from the PAG to the right temporal region and the left insula relative to the improved group or to HC.
CONCLUSION: PAG FC could serve as an early biomarker identifying participants with acute PTH at risk of developing persistent PTH.
PMID:40266360 | DOI:10.1007/s00415-025-13098-w
