Evidence map›Paper›PMID 41877006›Full record

ArticleThe journal of headache and pain2026

Posterior insular cortex hyperactivation drives vestibular migraine and comorbid anxiety.

Tianyu Zhang, Yifei Xiang, Bin Huang, Xiaoping Wang, Ping Yang, Baoming He, Nengwei Yu, Jie Liu

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In one paragraph

Article in The journal of headache and pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Tianyu Zhang *Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Section 2, First Ring Road, Chengdu, 610072, China. ztyqi@foxmail.com.
Yifei Xiang *Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Bin HuangDepartment of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Section 2, First Ring Road, Chengdu, 610072, China.
Xiaoping WangDepartment of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Section 2, First Ring Road, Chengdu, 610072, China.
Ping YangDepartment of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Section 2, First Ring Road, Chengdu, 610072, China.
Baoming HeDepartment of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Section 2, First Ring Road, Chengdu, 610072, China.
Nengwei YuDepartment of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Section 2, First Ring Road, Chengdu, 610072, China.
Jie LiuDepartment of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Section 2, First Ring Road, Chengdu, 610072, China. liujiesyy@126.com.

Funding

Chengdu Science and Technology Bureau Technological Innovation Research and Development Project 2024-YF05-01742-SNNational Key Research and Development Program of China 2024YFE0215100Sichuan Provincial Cadre Healthcare Committee Popularization and Application Project 2024-209
6 · The paper itself

Abstract

backgroundVestibular migraine, a debilitating disorder characterized by recurrent episodes of headache and vertigo, is frequently comorbid with persistent anxiety and depression. The neural mechanisms that integrate these disparate sensory and affective symptoms remain elusive.

findingsHere, we combined clinical characterization with a translational mouse model to identify the posterior insular cortex (pIC) as a critical hub driving the pathophysiology of vestibular migraine. In patients, anxiety and depression scores remained elevated interictally, suggesting a trait-like affective disturbance. Using a validated mouse model combining nitroglycerin (NTG) administration and rotarod vestibular stimulation, which recapitulates vestibular migraine-like phenotypes (hyperalgesia, balance deficits, and anxiety-like behaviors), we observed hyperactivity within the pIC. This region responded to both nociceptive and vestibular challenges. Chemogenetic inhibition of the pIC reversed hyperalgesia and vestibular-motor deficits. Notably, while acute inhibition did not affect anxiety-like behaviors, chronic inhibition produced a full rescue, including the affective component, paralleling the clinical persistence of mood symptoms. Conversely, chronic chemogenetic activation of the pIC was sufficient to promote all core phenotypes under a subthreshold NTG regimen combined with rotarod vestibular stimulus. Furthermore, systemic administration of the NMDA receptor antagonist memantine alleviated vestibular migraine-like symptoms and normalized pIC hyperactivity.

conclusionsOur results establish pIC hyperactivation as a causal neural substrate that converges nociceptive, vestibular, and affective processing in vestibular migraine, and identify pIC suppression as a promising therapeutic strategy.

Indexed as

AnxietyInsular CortexVestibular MigraineAnimalsComorbidityDisease Models, AnimalFemaleHumansHyperalgesiaMaleMemantineMiceMice, Inbred C57BLMemantineAnxietyHyperalgesiaMemantinePosterior insular cortexVestibular migraine

Identifiers

PMID41877006
PMCPMC13137624

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.