Functional neuroimaging studies are an indispensable tool in headache research and have greatly contributed to our understanding of migraine pathophysiology. The past two decades have identified the brainstem as the target region of interest in migraine pathophysiology: Recent evidence suggests that certain areas of the central nervous system and especially the brainstem periodically change activity during different stages of the migraine cycle. Additionally, the number of resting-state functional MRI studies in migraine has increased greatly in recent years. Three future trends in migraine neuroimaging can be identified: brainstem optimized functional imaging, longitudinal approaches tracking biological changes through the migraine cycle, and optimized resting-state fMRI. Consequently, we face a lot of difficulties regarding image noise and artifacts, organizational details, and data interpretation. Optimized neuroimaging studies and new approaches will continue to greatly contribute to our pathophysiological understanding of migraine.
