{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:27:16Z","timestamp":1789176436744,"version":"build-2803163510"},"reference-count":65,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000627","name":"Guarantors of Brain","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000627","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000283","name":"Migraine Trust","doi-asserted-by":"publisher","award":["2014\u201020"],"award-info":[{"award-number":["2014\u201020"]}],"id":[{"id":"10.13039\/501100000283","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify changes in regional cerebral blood flow (CBF) associated with premonitory symptoms (PS) of nitroglycerin (NTG)\u2010triggered migraine attacks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>PS could provide insights into attack initiation and alterations in neuronal function prior to headache onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We undertook a functional imaging study using a double\u2010blind placebo\u2010controlled randomized approach in patients with migraine who spontaneously experienced PS, and in whom PS and migraine\u2010like headache could be induced by administration of NTG. All study visits took place in a dedicated clinical research facility housing a monitoring area with clinical beds next to a 3Tesla magnetic resonance imaging scanner. Fifty\u2010three patients with migraine were enrolled; imaging on at least one triggered visit was obtained from 25 patients, with 21 patients completing the entire imaging protocol including a placebo visit. Whole brain CBF maps were acquired using 3D pseudo\u2010continuous arterial spin labeling (3D pCASL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The primary outcome was that patients with migraine not taking preventive treatment (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912) displayed significant increases in CBF in anterior cingulate cortex, caudate, midbrain, lentiform, amygdala and hippocampus (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 family\u2010wise error\u2010corrected) during NTG\u2010induced PS. A separate region of interest analysis revealed significant CBF increases in the region of the hypothalamus (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006, effect size 0.77). Post hoc analyses revealed significant reductions in CBF over the occipital cortices in participants with a history of migraine with underlying aura (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We identified significant regional CBF changes associated with NTG\u2010induced PS, consistent with other investigations and with novel findings, withstanding statistical comparison against placebo. These findings were not present in patients who continually took preventive medication. Additional findings were identified only in participants who experience migraine with aura. Understanding this biological and treatment\u2010related heterogeneity is vital to evaluating functional imaging outcomes in migraine research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14538","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T03:18:15Z","timestamp":1687231095000},"page":"771-787","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Regional cerebral perfusion during the premonitory phase of triggered migraine: A double\u2010blind randomized placebo\u2010controlled functional imaging study using pseudo\u2010continuous arterial spin labeling"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6946-5637","authenticated-orcid":false,"given":"Nazia","family":"Karsan","sequence":"first","affiliation":[{"name":"Headache Group, Wolfson Centre for Age\u2010Related Diseases, Division of Neuroscience, Institute of 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