Central executive network-related neuromagnetic abnormalities in chronic and episodic migraine: a resting-state magnetoencephalography study

Abstract

Background Chronic migraine (CM) is more disabling than episodic migraine (EM), but the neurophysiological mechanisms underlying migraine chronification remain incompletely understood. We investigated central executive network (CEN)-related neuromagnetic abnormalities in CM and EM. Methods The original cohort included 22 patients with CM, 20 with EM, and 25 healthy controls (HCs). An independent validation cohort included 30 patients with CM and 30 with EM. Source-space analyses focused on 10 predefined CEN-related regions from the Desikan–Killiany atlas. Relative power spectral density (PSD) across six frequency bands and functional connectivity using corrected amplitude envelope correlation and network-based statistics were assessed. An exploratory support vector machine (SVM) analysis evaluated the discriminative value of CEN-related spectral and connectivity features. Results PSD abnormalities were mainly observed in the theta, beta, and gamma1 bands and were largely driven by CM. Compared with HCs, CM showed increased theta-band relative power in left frontal CEN-related regions and reduced beta- and gamma1-band relative power in right frontal regions. Compared with EM, CM showed increased theta-band relative power in left frontal regions. Functional connectivity analysis revealed frequency-specific subnetworks in the theta, beta, delta, and gamma1 bands. Compared with HCs, CM showed increased theta- and gamma1-band connectivity and reduced beta-band connectivity, whereas EM showed more limited reductions in beta- and gamma1-band connectivity. CM also showed stronger delta- and gamma1-band connectivity than EM, predominantly involving prefrontal regions. The SVM combining two PSD and eight connectivity features achieved an accuracy of 90.48% and an AUC of 0.9773 (95% CI: 0.93–1.00) in the original cohort, and an accuracy of 86.67% and an AUC of 0.8322 (95% CI: 0.76–0.95) in the independent validation cohort. Conclusion CM is associated with more extensive and frequency-specific CEN-related neuromagnetic abnormalities than EM, particularly within prefrontal–frontoparietal circuits. These findings suggest altered executive-control-related cortical dynamics during migraine chronification, while combined spectral and connectivity features may help differentiate CM from EM.