PMID- 24962460 OWN - NLM STAT- MEDLINE DCOM- 20141018 LR - 20240323 IS - 1940-087X (Electronic) IS - 1940-087X (Linking) IP - 88 DP - 2014 Jun 2 TI - 3D-neuronavigation in vivo through a patient's brain during a spontaneous migraine headache. LID - 10.3791/50682 [doi] LID - 50682 AB - A growing body of research, generated primarily from MRI-based studies, shows that migraine appears to occur, and possibly endure, due to the alteration of specific neural processes in the central nervous system. However, information is lacking on the molecular impact of these changes, especially on the endogenous opioid system during migraine headaches, and neuronavigation through these changes has never been done. This study aimed to investigate, using a novel 3D immersive and interactive neuronavigation (3D-IIN) approach, the endogenous micro-opioid transmission in the brain during a migraine headache attack in vivo. This is arguably one of the most central neuromechanisms associated with pain regulation, affecting multiple elements of the pain experience and analgesia. A 36 year-old female, who has been suffering with migraine for 10 years, was scanned in the typical headache (ictal) and nonheadache (interictal) migraine phases using Positron Emission Tomography (PET) with the selective radiotracer [(11)C]carfentanil, which allowed us to measure micro-opioid receptor availability in the brain (non-displaceable binding potential - microOR BPND). The short-life radiotracer was produced by a cyclotron and chemical synthesis apparatus on campus located in close proximity to the imaging facility. Both PET scans, interictal and ictal, were scheduled during separate mid-late follicular phases of the patient's menstrual cycle. During the ictal PET session her spontaneous headache attack reached severe intensity levels; progressing to nausea and vomiting at the end of the scan session. There were reductions in microOR BPND in the pain-modulatory regions of the endogenous micro-opioid system during the ictal phase, including the cingulate cortex, nucleus accumbens (NAcc), thalamus (Thal), and periaqueductal gray matter (PAG); indicating that microORs were already occupied by endogenous opioids released in response to the ongoing pain. To our knowledge, this is the first time that changes in microOR BPND during a migraine headache attack have been neuronavigated using a novel 3D approach. This method allows for interactive research and educational exploration of a migraine attack in an actual patient's neuroimaging dataset. FAU - DaSilva, Alexandre F AU - DaSilva AF AD - Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry; Michigan Center for Oral Health Research (MCOHR), University of Michigan School of Dentistry; Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan; adasilva@umich.edu. FAU - Nascimento, Thiago D AU - Nascimento TD AD - Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry. FAU - Love, Tiffany AU - Love T AD - Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan. FAU - DosSantos, Marcos F AU - DosSantos MF AD - Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry. FAU - Martikainen, Ilkka K AU - Martikainen IK AD - Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry; Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan. FAU - Cummiford, Chelsea M AU - Cummiford CM AD - Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan. FAU - DeBoer, Misty AU - DeBoer M AD - Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry. FAU - Lucas, Sarah R AU - Lucas SR AD - Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry. FAU - Bender, MaryCatherine A AU - Bender MA AD - Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry. FAU - Koeppe, Robert A AU - Koeppe RA AD - PET Physics Section, Division of Nuclear Medicine, Radiology Department, University of Michigan. FAU - Hall, Theodore AU - Hall T AD - 3DLab, University of Michigan. FAU - Petty, Sean AU - Petty S AD - 3DLab, University of Michigan. FAU - Maslowski, Eric AU - Maslowski E AD - 3DLab, University of Michigan. FAU - Smith, Yolanda R AU - Smith YR AD - Department of Obstetrics and Gynecology, University of Michigan. FAU - Zubieta, Jon-Kar AU - Zubieta JK AD - Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan. LA - eng GR - K23 NS062946/NS/NINDS NIH HHS/United States PT - Case Reports PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Video-Audio Media DEP - 20140602 PL - United States TA - J Vis Exp JT - Journal of visualized experiments : JoVE JID - 101313252 RN - 0 (Receptors, Opioid, mu) SB - IM MH - Adult MH - Brain/*metabolism/pathology MH - Female MH - Humans MH - Migraine Disorders/diagnosis/*metabolism/pathology MH - Neuronavigation/*methods MH - Receptors, Opioid, mu/analysis/metabolism PMC - PMC4186390 EDAT- 2014/06/26 06:00 MHDA- 2014/10/19 06:00 PMCR- 2014/06/02 CRDT- 2014/06/26 06:00 PHST- 2014/06/26 06:00 [entrez] PHST- 2014/06/26 06:00 [pubmed] PHST- 2014/10/19 06:00 [medline] PHST- 2014/06/02 00:00 [pmc-release] AID - 50682 [pii] AID - 10.3791/50682 [doi] PST - epublish SO - J Vis Exp. 2014 Jun 2;(88):50682. doi: 10.3791/50682.