The anterior cingulate cortex (ACC) and visual cortex are integral components of the neurophysiological mechanisms underlying migraine, yet the impact of altered connectivity patterns between these regions on migraine treatment remains unknown. To elucidate this issue, we investigated the abnormal causal connectivity between the ACC and visual cortex in patients with migraine without aura (MwoA), based on the resting-state functional magnetic resonance imaging data, and its predictive ability for the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs). The results revealed increased causal connectivity from the bilateral ACC to the lingual gyrus (LG) and decreased connectivity in the opposite direction in nonresponders compared with the responders. Moreover, compared with the healthy controls, nonresponders exhibited heightened causal connectivity from the ACC to the LG, right inferior occipital gyrus (IOG) and left superior occipital gyrus, while connectivity patterns from the LG and right IOG to the ACC were diminished. Based on the observed abnormal connectivity patterns, the support vector machine (SVM) models showed that the area under the receiver operator characteristic curves for the ACC to LG, LG to ACC and bidirectional models were 0.857, 0.898, and 0.939, respectively. These findings indicate that neuroimaging markers of abnormal causal connectivity in the ACC-visual cortex circuit may facilitate clinical decision-making regarding NSAIDs administration for migraine management.

中文翻译：

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前扣带皮层-视觉皮层回路异常因果连接与非甾体抗炎药治疗偏头痛的疗效相关

前扣带皮层 (ACC) 和视觉皮层是偏头痛神经生理机制的组成部分，但这些区域之间连接模式改变对偏头痛治疗的影响仍不清楚。为了阐明这个问题，我们根据静息态功能磁共振成像数据，研究了无先兆偏头痛 (MwoA) 患者 ACC 和视觉皮层之间的异常因果连接，及其对非甾体抗药疗效的预测能力。炎症药物（NSAID）。结果显示，与有反应者相比，无反应者从双侧 ACC 到舌回 (LG) 的因果连接增加，而相反方向的连接减少。此外，与健康对照组相比，无反应者表现出从 ACC 到 LG、右枕下回 (IOG) 和左上枕回的因果连接性增强，而从 LG 和右 IOG 到 ACC 的连接模式则减弱。基于观察到的异常连接模式，支持向量机 (SVM) 模型显示 ACC 到 LG、LG 到 ACC 和双向模型的接收者算子特征曲线下面积分别为 0.857、0.898 和 0.939。这些发现表明 ACC-视觉皮层回路中异常因果连接的神经影像标记可能有助于关于使用 NSAID 治疗偏头痛的临床决策。