Periaqueductal Gray Functional Connectivity Abnormalities Associated with Acute Post-Traumatic Headache

Motivation: Studying periaqueductal gray (PAG) functional connectivity (FC) and headache improvement in participants with post traumatic headache (PTH) could provide insights into PTH pathophysiology. Goal(s): Investigate PAG FC and headache improvement in participants with PTH due to mild traumatic brain injury (mTBI) compared to healthy controls (HC). Approach: Examined resting state FC differences in PTH participants vs HCs. Results: We observed stronger PAG FC to somatosensory, motor and occipital areas in PTH participants relative to HCs. Participants without headache improvement exhibited stronger FC from the PAG to right temporal and left insula regions relative to the improved group or HCs. Impact: Altered PAG FC could be predictive of PTH outcome at 3 months. The high specificity of the model for predicting PTH improvement implies that persistent PTH could be detectable before it develops, allowing timely treatment and pain management.