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Toelle, T. R.

Publications and source records attributed to Toelle, T. R..

2 recordsLinked to original sources

Effects of Centrally Acting Analgesics on Resting-State Electroencephalography Biomarker Candidates of Chronic Pain

Resting-state electroencephalography (rsEEG) holds promise as a biomarker of chronic pain. However, the impact of centrally acting analgesics like opioids, antiepileptics, and antidepressants on rsEEG remains unclear. This confounds and limits the interpretability of previous studies and questions the validity of rsEEG biomarker candidates of chronic pain. We, therefore, aimed to elucidate the effects of opioids, antiepileptics, and antidepressants on common rsEEG biomarker candidates of chronic pain. To this end, we analyzed two large, independent rsEEG datasets, including 220 people with chronic pain. We performed preregistered multivariate Bayesian analyses and controlled for the potential confounds of age, pain intensity, and depression. The results predominantly provided evidence against effects of centrally acting analgesics on peak alpha frequency, oscillatory power in different frequency bands, and connectivity-based network measures. Although these findings do not rule out any effects of analgesics on rsEEG, they argue against medium to large effects of centrally acting analgesics on rsEEG. Thus, the findings strengthen the validity of rsEEG biomarker candidates of chronic pain and might thereby help to develop clinically valuable biomarkers of chronic pain.

neuroscience↗

Migraine Attacks as a Result of Hypothalamic Loss of Control

To assess the natural trajectory of brain activity over the migraine cycle, we assessed (1) the cerebral perfusion and (2) the hypothalamic connectivity during spontaneous headache attacks with follow-up recordings towards the next migraine attack. Using pseudo-continuous arterial spin labelling and resting-state functional magnetic resonance imaging, 12 migraine patients were examined in 82 sessions. We detected cyclic changes of brain perfusion in the limbic circuit (insula, hippocampus, and nucleus accumbens), with the highest perfusion during headache attacks. In addition, we found an increase of hypothalamic connectivity to the limbic system over the interictal interval, then collapsing during the headache. Our data provide strong evidence for the predominant role of the hypothalamus as a zeitgeber for generating migraine attacks. Our findings suggest that migraine attacks are the result of the hypothalamus losing control over the limbic system.

neuroscience↗