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The effective connectivity (EC) among the regions of interest (ROIs) in the trigeminal vascular system involved in migraine without aura (MWoA) remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study, 48 patients (mean\u2009[SD] age 38.06\u2009[10.35]\u2009years; male, 14\/48 [29%]) with MWoA during the interictal phase and 48 healthy controls of similar age and sex (mean\u2009[SD] age 38.96\u2009[10.96]\u2009years; male, 14\/48 [29%]) underwent resting\u2010state functional magnetic resonance imaging (fMRI). Dynamic causal modeling analysis was conducted to investigate directional EC among ROIs in the trigeminal vascular system including the bilateral brainstem, the primary somatosensory cortex (S1), the thalamus, and the insula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the healthy control group, MWoA represented significantly reduced EC from the left brainstem (Brainstem.L) to the left insula (MWoA: mean\u2009[SD] \u22120.16\u2009[0.36]; healthy controls: mean\u2009[SD] 0.11\u2009[0.41];\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>corrected<\/jats:sub>\n                      \u2009=\u20090.021), reduced EC from the Brainstem.L to the right insula (MWoA: mean\u2009[SD] \u22120.15\u2009[0.39]; healthy controls: mean\u2009[SD] 0.03\u2009[0.35];\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>corrected<\/jats:sub>\n                      \u2009=\u20090.021), and decreased EC from the left thalamus (Thalamus.L) to the Brainstem.L (MWoA: mean\u2009[SD] \u22120.13\u2009[0.56]; healthy controls: mean\u2009[SD] 0.10\u2009[0.45];\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>corrected<\/jats:sub>\n                      \u2009=\u20090.021). Altered EC parameters were not significantly correlated with MWoA clinical data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results further provide increasing evidence that disturbed homeostasis of the trigeminovascular nociceptive pathway is involved in the pathophysiological mechanisms of migraine. Patients with MWoA exhibited a regional interaction distinct from healthy controls in the neural pathway of the Bilateral Insula\u2013Brainstem.L\u2013Thalamus.L, which may shed light on the future understanding of brain mechanisms for MWoA. Future brain\u2010based interventions are suggested to consider the dysregulation in the Bilateral Insula\u2013Brainstem.L\u2013Thalamus.L circuits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14602","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T04:44:06Z","timestamp":1691383446000},"page":"1119-1127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Altered resting\u2010state effective connectivity of trigeminal vascular system in migraine without aura: A spectral dynamic causal modeling study"],"prefix":"10.1111","volume":"63","author":[{"given":"Zhaoxia","family":"Qin","sequence":"first","affiliation":[{"name":"Department of Radiology, Medical Imaging Center The Affiliated Hospital of Yangzhou University, Yangzhou University  Yangzhou 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