Disrupted functional network topology in tension-type headache: A cross-sectional magnetoencephalography study

Background Tension-type headache (TTH) is the most common primary headache, yet its neural basis remains unclear. Magnetoencephalography (MEG) combined with graph-theoretical analysis enables precise mapping of functional brain networks. This study aimed to identify network-level connectivity alterations in TTH using resting-state MEG and graph-based metrics. Methods We analyzed resting-state MEG data from 27 TTH patients during the interictal period and 37 age- and gender-matched healthy controls, all with eyes closed. Functional connectivity (FC) across 1–45 Hz was mapped and analyzed using graph theory. Network topology metrics were computed, and their associations with clinical symptoms were assessed. Results TTH patients showed increased FC across 1–45 Hz, notably between the right somatomotor and frontal operculum and insula (FrOperIns), and between the temporo-occipital-parietal (TempOccPar) and visual regions, with the latter positively correlated with Headache Impact Test-6 scores. Frequency-specific increases were observed between the left prefrontal and right orbitofrontal cortices (delta, theta), somatomotor and FrOperIns (theta), and TempOccPar and visual areas (beta). Graph theory analysis revealed nodal abnormalities, particularly in the left precuneus and posterior cingulate and prefrontal cortices, along with elevated local efficiency and clustering coefficient. Conclusions These findings indicate that TTH is associated with frequency-specific alterations in functional connectivity and disrupted network topology, particularly involving regions implicated in pain processing and cognitive control. Graph-theoretical MEG analysis may offer valuable insights into the neural mechanisms of TTH and support the development of network-based biomarkers. Trial Registration: ClinicalTrials.gov Identifier: NCT05334927