Distinguishing Interictal Neuromagnetic Activity in Migraine With and Without Aura: A Resting-State Magnetoencephalography Study

BACKGROUND: Migraine with aura (MwA) and migraine without aura (MwoA) are believed to have distinct pathophysiological mechanisms. However, differences in their neuromagnetic activity are currently unclear. To address this knowledge gap, this study employed magnetoencephalography (MEG) to examine alterations in magnetic source strength and functional connectivity (FC) between MwA and MwoA patients. METHODS: Resting-state MEG data were recorded for 18 MwA and 18 MwoA patients during the interictal period and compared with 18 matched healthy controls (HCs). The spectral power and FC of the visual network were estimated using minimum norm estimation (MNE) combined with the Welch technique and corrected amplitude envelope correlation. RESULTS: Spectral power analysis revealed distinct frequency-dependent alterations in MwA in the left lateral occipital cortex (LOC), bilateral lingual cortices, and right transverse temporal cortex within the theta band compared with the MwoA and HCs groups. FC analysis revealed a distinct pattern of weakened FC in MwA in the low-frequency band between the visual cortex and several key regions, including the right entorhinal cortex, right rostral anterior cingulate cortex (ACC), right superior parietal cortex (SPC), left precentral cortex, and right precuneus cortex compared with the MwoA and HCs groups. The MwoA group exhibited significantly stronger FC within the ACC-visual cortex circuit in the gamma1 band compared with the MwA and HCs groups. Several abnormal FC metrics were significantly correlated with headache attack frequency in both migraine groups. CONCLUSIONS: This study revealed the distinct neuromagnetic signatures of MwA and MwoA, linking specific connectivity patterns to clinical features. These findings could potentially support the development of subtype-specific, targeted neuromodulation therapies for migraine.