Migraine versus tension-type headache in automatic emotional processing: A visual mismatch negativity study
Yunliang Guo,
Shuo Zhao,
Xunyao Hou,
Song Xu,
Shanjing Nie,
Dong Li,
Ximing Wang,
Chuanchen Zhang,
Xueping Liu,
Zhangyong Xia
Affiliations
Yunliang Guo
Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No 324 Jingwu Road, Huaiyin District, Jinan, Shandong 250021, PR China; Department of Neurology, Liaocheng People's Hospital and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng, Shandong 252000, PR China; Department of Geriatric Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, PR China; Corresponding author at: Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No 324 Jingwu Road, Huaiyin District, Jinan, Shandong 250021, PR China.
Shuo Zhao
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, PR China; Department of Radiology, Liaocheng People's Hospital and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng, Shandong 252000, PR China; Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, PR China
Xunyao Hou
Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No 324 Jingwu Road, Huaiyin District, Jinan, Shandong 250021, PR China
Song Xu
Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No 324 Jingwu Road, Huaiyin District, Jinan, Shandong 250021, PR China
Shanjing Nie
Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No 324 Jingwu Road, Huaiyin District, Jinan, Shandong 250021, PR China
Dong Li
Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, PR China
Ximing Wang
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, PR China
Chuanchen Zhang
Department of Radiology, Liaocheng People's Hospital and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng, Shandong 252000, PR China
Xueping Liu
Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No 324 Jingwu Road, Huaiyin District, Jinan, Shandong 250021, PR China
Zhangyong Xia
Department of Neurology, Liaocheng People's Hospital and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng, Shandong 252000, PR China; Corresponding author at: Department of Neurology, Liaocheng People's Hospital and Liaocheng Hospital Affiliated to Shandong First Medical University, No 67 Dongchang West Road, Dongchangfu District, Liaocheng, Shandong 252000, PR China.
Objective: It is important to discriminate different headaches in clinical practice, and neurocognitive biomarkers may serve as objective tools. Several reports have suggested potential cognitive impairment for primary headaches, whereas cognitions within specific domains remain elusive, e.g., emotional processing. In this study, we aimed to characterize processing of facial expressions in migraine and tension-type headache (TTH) by analyzing expression-related visual mismatch negativity (EMMN) and explored whether their processing patterns were distinct. Methods: Altogether, 73 headache patients (20 migraine with aura (MA), 28 migraine without aura (MwoA), 25 TTH) and 27 age-matched healthy controls were recruited. After a battery of mood/neuropsychological evaluations, an expression-related oddball paradigm containing multiple models of neutral, happy and sad faces was used to investigate automatic emotional processing. Results: We observed cognitive impairment in all headache patients, especially in attention/execution subdomains, but no discrepancy existed among different headaches. Although analyses of P1/N170 did not reach significant levels, amplitude of early and late EMMN was markedly diminished in MA and MwoA compared with controls and TTH, regardless of happy or sad expression. Moreover, sad EMMN was larger (more negative) than happy EMMN only in controls, while not in all headache groups. Conclusions: Our findings implied that migraine, rather than TTH, might lead to more severe impairment of automatic emotional processing, which was manifested as no observable EMMN elicitation and disappearance of negative bias effect. The EMMN component could assist in discrimination of migraine from TTH and diagnosis of undefined headaches, and its availability needed further validations.
