Migraine patients recruit a pain-responsive claustrum circuit during pain-free cognitive task performance

Poster Session B - Sunday, April 14, 2024, 8:00 – 10:00 am EDT, Sheraton Hall ABC

Brent W. Stewart¹ (brent.stewart@som.umaryland.edu), Michael L. Keaser¹, Hwiyoung Lee², Sarah M. Margerison¹, Matthew A. Cormie³, Massieh Moayedi³, Martin A. Lindquist⁴, Shuo Chen², Brian N. Mathur¹, David A. Seminowicz^1,5; ¹University of Maryland Baltimore, ²Maryland Psychiatric Research Center, ³University of Toronto, ⁴Johns Hopkins University, ⁵University of Western Ontario

Executive dysfunction and aberrant cognitive network activity are established features of chronic pain, but their mechanisms require elucidation. Difficult cognitive tasks and acute pain have been observed to elicit responses in the human claustrum, which is hypothesized to modulate cortical network activity for cognitive control. fMRI data from healthy participants (n = 35) and migraine patients (n = 112) during cognitive task and acute pain conditions were analyzed to see if claustrum activity is associated with activation of cognitive control network regions, and if this association is altered in chronic pain. Greater intensity and wider spatial spread of BOLD signal increases during cognitive task performance were observed in patients than controls, and a region was identified in the right dorsolateral prefrontal cortex recruited only by patients. Pain scan data revealed this region to be pain-responsive in healthy participants and to display significantly greater pain-induced activity in patients. Increased pain-induced activity in patients was also found in the right claustrum. Human Connectome Project diffusion weighted imaging (n = 174) verified structural connectivity between these right claustrum and right dorsolateral prefrontal cortex nodes. Dynamic causal modeling indicated bidirectional connectivity in this circuit during acute pain in both groups and increased effective connectivity during difficult cognitive task performance in patients compared to controls, consistent with a causal influence of the claustrum on activity in a pain responsive region during cognitive task processing in migraine patients.

Topic Area: EXECUTIVE PROCESSES: Other