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Comparative Study
. 2017 Jun;29(6):10.1111/nmo.13004.
doi: 10.1111/nmo.13004. Epub 2016 Dec 1.

Cyclic Vomiting Syndrome Is Characterized by Altered Functional Brain Connectivity of the Insular Cortex: A Cross-Comparison With Migraine and Healthy Adults

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Free PMC article
Comparative Study

Cyclic Vomiting Syndrome Is Characterized by Altered Functional Brain Connectivity of the Insular Cortex: A Cross-Comparison With Migraine and Healthy Adults

D-M Ellingsen et al. Neurogastroenterol Motil. .
Free PMC article

Abstract

Cyclic Vomiting Syndrome (CVS) has been linked to episodic migraine, yet little is known about the precise brain-based mechanisms underpinning CVS, and whether these associated conditions share similar pathophysiology. We investigated the functional integrity of salience (SLN) and sensorimotor (SMN) intrinsic connectivity networks in CVS, migraine and healthy controls using brain functional Magnetic Resonance Imaging. CVS, relative to both migraine and controls, showed increased SLN connectivity to middle/posterior insula, a key brain region for nausea and viscerosensory processing. In contrast, this same region showed diminished SMN connectivity in both CVS and migraine. These results highlight both unique and potentially shared pathophysiology between these conditions, and suggest a potential target for therapeutics in future studies.

Keywords: Cyclic Vomiting Syndrome; brain imaging; functional Magnetic Resonance; imaging; migraine.

Conflict of interest statement

Disclosures: No conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Altered functional connectivity of middle/posterior insula (m/pINS) with salience (SLN) and somatosensory (SMN) processing brain networks in cyclic vomiting syndrome (CVS), episodic migraine (MIG), and healthy controls (HC). (A) A whole-brain voxelwise analysis found that CVS, relative to HC, showed increased resting SLN functional connectivity to m/pINS. (B) A follow-up Region Of Interest (ROI) analysis found that CVS also showed increased m/pINS connectivity with SLN compared to interictal MIG. (C) A ROI analysis also indicated similarity between CVS and MIG, in that both showed diminished m/pINS connectivity to SMN, relative to HC. Error bars represent standard errors of the mean. *p<0.05; **p<0.01.

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