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O'Hare L, Tarasi L, Asher JM, Hibbard PB, Romei V. Excitation-Inhibition Imbalance in Migraine: From Neurotransmitters to Brain Oscillations. Int J Mol Sci 2023; 24:10093. [PMID: 37373244 DOI: 10.3390/ijms241210093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Migraine is among the most common and debilitating neurological disorders typically affecting people of working age. It is characterised by a unilateral, pulsating headache often associated with severe pain. Despite the intensive research, there is still little understanding of the pathophysiology of migraine. At the electrophysiological level, altered oscillatory parameters have been reported within the alpha and gamma bands. At the molecular level, altered glutamate and GABA concentrations have been reported. However, there has been little cross-talk between these lines of research. Thus, the relationship between oscillatory activity and neurotransmitter concentrations remains to be empirically traced. Importantly, how these indices link back to altered sensory processing has to be clearly established as yet. Accordingly, pharmacologic treatments have been mostly symptom-based, and yet sometimes proving ineffective in resolving pain or related issues. This review provides an integrative theoretical framework of excitation-inhibition imbalance for the understanding of current evidence and to address outstanding questions concerning the pathophysiology of migraine. We propose the use of computational modelling for the rigorous formulation of testable hypotheses on mechanisms of homeostatic imbalance and for the development of mechanism-based pharmacological treatments and neurostimulation interventions.
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Affiliation(s)
- Louise O'Hare
- Division of Psychology, Nottingham Trent University, Nottingham NG1 4FQ, UK
| | - Luca Tarasi
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum-Università di Bologna, Campus di Cesena, Via Rasi e Spinelli, 176, 47521 Cesena, Italy
| | - Jordi M Asher
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK
| | - Paul B Hibbard
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK
| | - Vincenzo Romei
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum-Università di Bologna, Campus di Cesena, Via Rasi e Spinelli, 176, 47521 Cesena, Italy
- Facultad de Lenguas y Educación, Universidad Antonio de Nebrija, 28015 Madrid, Spain
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Abstract
This study aims to investigate whether intranetwork dynamic functional connectivity and causal interactions of the salience network is altered in the interictal term of migraine. Thirty-two healthy controls, 37 migraineurs without aura, and 20 migraineurs with aura were recruited. Participants underwent a T1-weighted scan and resting-state fMRI protocol inside a 1.5T MR scanner. We obtained average spatial maps of resting-state networks using group independent component analysis, which yielded subject-specific time series through a dual regression approach. Salience network regions of interest (bilateral insulae and prefrontal cortices, dorsal anterior cingulate cortex) were obtained from the group average map through cluster-based thresholding. To describe intranetwork connectivity, average and dynamic conditional correlation was calculated. Causal interactions between the default-mode, dorsal attention, and salience network were characterised by spectral Granger's causality. Time-averaged correlation was lower between the right insula and prefrontal cortex in migraine without aura vs with aura and healthy controls (P < 0.038, P < 0.037). Variance of dynamic conditional correlation was higher in migraine with aura vs healthy controls and migraine with aura vs without aura between the right insula and dorsal anterior cingulate cortex (P < 0.011, P < 0.026), and in migraine with aura vs healthy controls between the dorsal anterior cingulate and left prefrontal cortex (P < 0.021). Causality was weaker in the <0.05 Hz frequency range between the salience and dorsal attention networks in migraine with aura (P < 0.032). Overall, migraineurs with aura exhibit more fluctuating connections in the salience network, which also affect network interactions, and could be connected to altered cortical excitability and increased sensory gain.
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Jia T, Cao L, Ye X, Wei Q, Xie W, Cai C, Dong Y, Xia C, Tian Y, Wang K. Difference in binocular rivalry rate between major depressive disorder and generalized anxiety disorder. Behav Brain Res 2020; 391:112704. [PMID: 32461128 DOI: 10.1016/j.bbr.2020.112704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 04/28/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
Binocular rivalry (BR) occurs when monocular images are presented simultaneously to corresponding regions of the two eyes. Rather than forming a stable composite, perception alternates spontaneously between each monocular view. Over recent decades, considerable interest in examining BR in psychiatric populations has demonstrated clear differences in the dynamics of BR when compared to healthy populations. However, the available data with respect to rivalry rates in depression and anxiety are limited, and previous studies have shown inconsistent results. Also, depression and anxiety are highly comorbid and can be difficult to distinguish. Therefore, we aimed to investigate whether patients with depression and anxiety have abnormal rivalry rates and whether rivalry rates differ between these conditions. Thirty-five patients with major depressive disorder (MDD), 30 patients with generalized anxiety disorder (GAD), and 30 control participants matched on sex, age and education were recruited. Our results showed MDD participants had slower BR rates than controls and GAD, and controls were significantly slower than GAD. Our findings raise prospects that BR could be a promising behavioral tool to differentiate depressive and anxiety disorders.
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Affiliation(s)
- Ting Jia
- Department of Neurology, Nanjing Pukou Central Hospital, Nanjing, Jiangsu Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China
| | - Lihua Cao
- Department of Neurology, Nanjing Pukou Central Hospital, Nanjing, Jiangsu Province, China
| | - Xing Ye
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China
| | - Qiang Wei
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China
| | - Wen Xie
- Department of Psychiatry, Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Chunlan Cai
- Department of Psychiatry, Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Yi Dong
- Department of Psychiatry, Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Chengcai Xia
- Department of Neurology, Nanjing Pukou Central Hospital, Nanjing, Jiangsu Province, China
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China.
| | - Kai Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, Anhui Province, China.
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Chan YM, Pitchaimuthu K, Wu QZ, Carter OL, Egan GF, Badcock DR, McKendrick AM. Relating excitatory and inhibitory neurochemicals to visual perception: A magnetic resonance study of occipital cortex between migraine events. PLoS One 2019; 14:e0208666. [PMID: 31291247 PMCID: PMC6619596 DOI: 10.1371/journal.pone.0208666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 06/06/2019] [Indexed: 01/03/2023] Open
Abstract
Certain perceptual measures have been proposed as indirect assays of brain neurochemical status in people with migraine. One such measure is binocular rivalry, however, previous studies have not measured rivalry characteristics and brain neurochemistry together in people with migraine. This study compared spectroscopy-measured levels of GABA and Glx (glutamine and glutamate complex) in visual cortex between 16 people with migraine and 16 non-headache controls, and assessed whether the concentration of these neurochemicals explains, at least partially, inter-individual variability in binocular rivalry perceptual measures. Mean Glx level was significantly reduced in migraineurs relative to controls, whereas mean occipital GABA levels were similar between groups. Neither GABA levels, nor Glx levels correlated with rivalry percept duration. Our results thus suggest that the previously suggested relationship between rivalry percept duration and GABAergic inhibitory neurotransmitter concentration in visual cortex is not strong enough to enable rivalry percept duration to be reliably assumed to be a surrogate for GABA concentration, at least in the context of healthy individuals and those that experience migraine.
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Affiliation(s)
- Yu Man Chan
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kabilan Pitchaimuthu
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Qi-Zhu Wu
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Olivia L. Carter
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Gary F. Egan
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - David R. Badcock
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Allison M. McKendrick
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
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Ye X, Zhu RL, Zhou XQ, He S, Wang K. Slower and Less Variable Binocular Rivalry Rates in Patients With Bipolar Disorder, OCD, Major Depression, and Schizophrenia. Front Neurosci 2019; 13:514. [PMID: 31164802 PMCID: PMC6536692 DOI: 10.3389/fnins.2019.00514] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 05/06/2019] [Indexed: 01/12/2023] Open
Abstract
When two different images are presented to the two eyes dichoptically, observers usually experience a perceptual alternation between the two images. This phenomenon, known as binocular rivalry, has been used as a powerful tool to investigate mechanisms of visual awareness. It was also found that the rates of perceptual alternation are slower in patients with bipolar disorder than in healthy controls (Pettigrew and Miller, 1998; Miller et al., 2003). To investigate the broader clinical relevance of binocular rivalry in psychiatric disorders, we measured the perceptual alternation rates during rivalry in healthy controls (n = 39) and in patients with different types of psychiatric disorders, including bipolar disorder type I (BD, n = 28), obsessive-compulsive disorder (OCD, n = 22), major depression (MD, n = 50), schizophrenia (SCZ, n = 44), and first-degree relatives (FDRs) of SCZ patients (n = 32). Participants viewed competing red-green images on a computer monitor through red-green anaglyph glasses and pressed buttons to record their perceptual alternations. The distributions of the rivalry rates were well described by a lognormal function in all groups. Critically, the median rate of perceptual alternation was 0.27 Hz for BD patients, 0.26 Hz for the OCD patients, 0.25 Hz for the MD patients, and 0.23 Hz and 0.27 Hz for the SCZ patients and their FDRs, respectively. All of which were significantly slower than the rate of 0.41 Hz obtained for the healthy controls, suggesting there may be shared genotypes between these different disorders. While rivalry alternations were generally slower in different types of psychiatric disorders compared to healthy controls, adding variance of rivalry rates in the analysis helped to partially separate among the different patient groups. Our results suggest that the slowing of binocular rivalry is likely due to certain common factors among the patient groups, but more subtle differences between different patient groups could be revealed when additional properties of rivalry dynamics are considered.
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Affiliation(s)
- Xing Ye
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Ruo-Lin Zhu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | | | - Sheng He
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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6
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McKendrick AM, Chan YM, Tien M, Millist L, Clough M, Mack H, Fielding J, White OB. Behavioral measures of cortical hyperexcitability assessed in people who experience visual snow. Neurology 2017; 88:1243-1249. [DOI: 10.1212/wnl.0000000000003784] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/06/2017] [Indexed: 11/15/2022] Open
Abstract
Objective:To determine whether visual perceptual measures in people who experience visual snow are consistent with an imbalance between inhibition and excitation in visual cortex.Methods:Sixteen patients with visual snow and 18 controls participated. Four visual tasks were included: center-surround contrast matching, luminance increment detection in noise, and global form and global motion coherence thresholds. Neuronal architecture capable of encoding the luminance and contrast stimuli is present within primary visual cortex, whereas the extraction of global motion and form signals requires extrastriate processing. All these tasks have been used previously to investigate the balance between inhibition and excitation within the visual system in both healthy and diseased states.Results:The visual snow group demonstrated reduced center-surround contrast suppression (p = 0.03) and elevated luminance increment thresholds in noise (p = 0.02). Groups did not differ on the global form or global motion task.Conclusion:Our study demonstrates that visual perceptual measures involving the suprathreshold processing of contrast and luminance are abnormal in a group of individuals with visual snow. Our data are consistent with elevated excitability in primary visual cortex; however, further research is required to provide more direct evidence for this proposed mechanism. The ability to measure perceptual differences in visual snow reveals promise for the future development of clinical tests to assist in visual snow diagnosis and possibly a method for quantitatively assaying any benefits of treatments.
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Felix RA, Elde CJ, Nevue AA, Portfors CV. Serotonin modulates response properties of neurons in the dorsal cochlear nucleus of the mouse. Hear Res 2016; 344:13-23. [PMID: 27838373 DOI: 10.1016/j.heares.2016.10.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 10/10/2016] [Accepted: 10/26/2016] [Indexed: 01/15/2023]
Abstract
The neurochemical serotonin (5-hydroxytryptamine, 5-HT) is involved in a variety of behavioral functions including arousal, reward, and attention, and has a role in several complex disorders of the brain. In the auditory system, 5-HT fibers innervate a number of subcortical nuclei, yet the modulatory role of 5-HT in nearly all of these areas remains poorly understood. In this study, we examined spiking activity of neurons in the dorsal cochlear nucleus (DCN) following iontophoretic application of 5-HT. The DCN is an early site in the auditory pathway that receives dense 5-HT fiber input from the raphe nuclei and has been implicated in the generation of auditory disorders marked by neuronal hyperexcitability. Recordings from the DCN in awake mice demonstrated that iontophoretic application of 5-HT had heterogeneous effects on spiking rate, spike timing, and evoked spiking threshold. We found that 56% of neurons exhibited increases in spiking rate during 5-HT delivery, while 22% had decreases in rate and the remaining neurons had no change. These changes were similar for spontaneous and evoked spiking and were typically accompanied by changes in spike timing. Spiking increases were associated with lower first spike latencies and jitter, while decreases in spiking generally had opposing effects on spike timing. Cases in which 5-HT application resulted in increased spiking also exhibited lower thresholds compared to the control condition, while cases of decreased spiking had no threshold change. We also found that the 5-HT2 receptor subtype likely has a role in mediating increased excitability. Our results demonstrate that 5-HT can modulate activity in the DCN of awake animals and that it primarily acts to increase neuronal excitability, in contrast to other auditory regions where it largely has a suppressive role. Modulation of DCN function by 5-HT has implications for auditory processing in both normal hearing and disordered states.
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Affiliation(s)
- Richard A Felix
- School of Biological Sciences and Integrative Physiology and Neuroscience, Washington State University, Vancouver, WA, USA.
| | - Cameron J Elde
- School of Biological Sciences and Integrative Physiology and Neuroscience, Washington State University, Vancouver, WA, USA
| | - Alexander A Nevue
- School of Biological Sciences and Integrative Physiology and Neuroscience, Washington State University, Vancouver, WA, USA
| | - Christine V Portfors
- School of Biological Sciences and Integrative Physiology and Neuroscience, Washington State University, Vancouver, WA, USA
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Nguyen BN, Lek JJ, Vingrys AJ, McKendrick AM. Clinical impact of migraine for the management of glaucoma patients. Prog Retin Eye Res 2015; 51:107-24. [PMID: 26232725 DOI: 10.1016/j.preteyeres.2015.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 12/19/2022]
Abstract
Migraine is a common and debilitating primary headache disorder that affects 10-15% of the general population, particularly people of working age. Migraine is relevant to providers of clinical eye-care because migraine attacks are associated with a range of visual sensory symptoms, and because of growing evidence that the results of standard tests of visual function necessary for the diagnosis and monitoring of glaucoma (visual fields, electrophysiology, ocular imaging) can be abnormal due to migraine. These abnormalities are measureable in-between migraine events (the interictal period), despite patients being asymptomatic and otherwise healthy. This picture is further complicated by epidemiological data that suggests an increased prevalence of migraine in patients with glaucoma, particularly in patients with normal tension glaucoma. We discuss how migraine, as a co-morbidity, can confound the results and interpretation of clinical tests that form part of contemporary glaucoma evaluation, and provide practical evidence-based recommendations for the clinical testing and management of patients with migraine who attend eye-care settings.
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Affiliation(s)
- Bao N Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia.
| | - Jia Jia Lek
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Algis J Vingrys
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Allison M McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
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Brascamp JW, Klink PC, Levelt WJM. The 'laws' of binocular rivalry: 50 years of Levelt's propositions. Vision Res 2015; 109:20-37. [PMID: 25749677 DOI: 10.1016/j.visres.2015.02.019] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 02/13/2015] [Accepted: 02/19/2015] [Indexed: 11/26/2022]
Abstract
It has been fifty years since Levelt's monograph On Binocular Rivalry (1965) was published, but its four propositions that describe the relation between stimulus strength and the phenomenology of binocular rivalry remain a benchmark for theorists and experimentalists even today. In this review, we will revisit the original conception of the four propositions and the scientific landscape in which this happened. We will also provide a brief update concerning distributions of dominance durations, another aspect of Levelt's monograph that has maintained a prominent presence in the field. In a critical evaluation of Levelt's propositions against current knowledge of binocular rivalry we will then demonstrate that the original propositions are not completely compatible with what is known today, but that they can, in a straightforward way, be modified to encapsulate the progress that has been made over the past fifty years. The resulting modified, propositions are shown to apply to a broad range of bistable perceptual phenomena, not just binocular rivalry, and they allow important inferences about the underlying neural systems. We argue that these inferences reflect canonical neural properties that play a role in visual perception in general, and we discuss ways in which future research can build on the work reviewed here to attain a better understanding of these properties.
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Affiliation(s)
- J W Brascamp
- Helmholtz Institute and Division of Experimental Psychology, Department of Psychology, Utrecht University, Utrecht, The Netherlands.
| | - P C Klink
- Vision & Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts & Sciences, Amsterdam, The Netherlands; Neuromodulation & Behaviour, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts & Sciences, Amsterdam, The Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
| | - W J M Levelt
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
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Scocchia L, Valsecchi M, Triesch J. Top-down influences on ambiguous perception: the role of stable and transient states of the observer. Front Hum Neurosci 2014; 8:979. [PMID: 25538601 PMCID: PMC4259127 DOI: 10.3389/fnhum.2014.00979] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 11/16/2014] [Indexed: 11/27/2022] Open
Abstract
The world as it appears to the viewer is the result of a complex process of inference performed by the brain. The validity of this apparently counter-intuitive assertion becomes evident whenever we face noisy, feeble or ambiguous visual stimulation: in these conditions, the state of the observer may play a decisive role in determining what is currently perceived. On this background, ambiguous perception and its amenability to top-down influences can be employed as an empirical paradigm to explore the principles of perception. Here we offer an overview of both classical and recent contributions on how stable and transient states of the observer can impact ambiguous perception. As to the influence of the stable states of the observer, we show that what is currently perceived can be influenced (1) by cognitive and affective aspects, such as meaning, prior knowledge, motivation, and emotional content and (2) by individual differences, such as gender, handedness, genetic inheritance, clinical conditions, and personality traits and by (3) learning and conditioning. As to the impact of transient states of the observer, we outline the effects of (4) attention and (5) voluntary control, which have attracted much empirical work along the history of ambiguous perception. In the huge literature on the topic we trace a difference between the observer's ability to control dominance (i.e., the maintenance of a specific percept in visual awareness) and reversal rate (i.e., the switching between two alternative percepts). Other transient states of the observer that have more recently drawn researchers' attention regard (6) the effects of imagery and visual working memory. (7) Furthermore, we describe the transient effects of prior history of perceptual dominance. (8) Finally, we address the currently available computational models of ambiguous perception and how they can take into account the crucial share played by the state of the observer in perceiving ambiguous displays.
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Affiliation(s)
- Lisa Scocchia
- Milan Center for Neuroscience, Department of Psychology, University of Milano-BicoccaMilan, Italy
| | | | - Jochen Triesch
- Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe UniversityFrankfurt am Main, Germany
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Miller EE, Grosberg BM, Crystal SC, Robbins MS. Auditory hallucinations associated with migraine: Case series and literature review. Cephalalgia 2014; 35:923-30. [DOI: 10.1177/0333102414563088] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 11/10/2014] [Indexed: 01/03/2023]
Abstract
Objective The objective of this review is to describe auditory hallucinations (paracusias) associated with migraine attacks to yield insights into their clinical significance and pathogenesis. Background Isolated observations have documented rare associations of migraine with auditory hallucinations. Unlike visual, somatosensory, language, motor, and brainstem symptoms, paracusias with acute headache attacks are not a recognized aura symptom by the International Headache Society, and no systematic review has addressed this association. Methods We retrospectively studied patients experiencing paracusias associated with migraine at our center and in the literature. Results We encountered 12 patients (our center = 5, literature = 7), 58% were female, and 75% had typical migraine aura. Hallucinations most commonly featured voices (58%), 75% experienced them during headache, and the duration was most often <1 hour (67%). No patients described visual aura evolving to paracusias. Most patients (50%) had either a current or previous psychiatric disorder, most commonly depression (67%). The course of headache and paracusias were universally congruent, including improvement with headache prophylaxis (58%). Conclusion Paracusias uncommonly co-occur with migraine and usually feature human voices. Their timing and high prevalence in patients with depression may suggest that paracusias are not necessarily a form of migraine aura, though could be a migraine trait symptom. Alternative mechanisms include perfusion changes in primary auditory cortex, serotonin-related ictal perceptual changes, or a release phenomenon in the setting of phonophobia with avoidance of a noisy environment.
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Affiliation(s)
| | - Brian M Grosberg
- Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, USA
| | - Sara C Crystal
- New York University Langone Medical Center, Department of Neurology, USA
| | - Matthew S Robbins
- Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, USA
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Dichoptic Viewing Methods for Binocular Rivalry Research: Prospects for Large-Scale Clinical and Genetic Studies. Twin Res Hum Genet 2013; 16:1033-78. [DOI: 10.1017/thg.2013.76] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Binocular rivalry (BR) is an intriguing phenomenon that occurs when two different images are presented, one to each eye, resulting in alternation orrivalrybetween the percepts. The phenomenon has been studied for nearly 200 years, with renewed and intensive investigation over recent decades. Therateof perceptual switching has long been known to vary widely between individuals but to be relatively stable within individuals. A recent twin study demonstrated that individual variation in BR rate is under substantial genetic control, a finding that also represented the first report, using a large study, of genetic contribution for any post-retinal visual processing phenomenon. The twin study had been prompted by earlier work showing BR rate was slow in the heritable psychiatric condition, bipolar disorder (BD). Together, these studies suggested that slow BR may represent an endophenotype for BD, and heralded the advent of modern clinical and genetic studies of rivalry. This new focus has coincided with rapid advances in 3D display technology, but despite such progress, specific development of technology for rivalry research has been lacking. This review therefore compares different display methods for BR research across several factors, including viewing parameters, image quality, equipment cost, compatibility with other investigative methods, subject group, and sample size, with a focus on requirements specific to large-scale clinical and genetic studies. It is intended to be a resource for investigators new to BR research, such as clinicians and geneticists, and to stimulate the development of 3D display technology for advancing interdisciplinary studies of rivalry.
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Abstract
Migraine is a collection of perplexing neurological conditions in which the brain and its associated tissues have been implicated as major players during an attack. Once considered exclusively a disorder of blood vessels, compelling evidence has led to the realization that migraine represents a highly choreographed interaction between major inputs from both the peripheral and central nervous systems, with the trigeminovascular system and the cerebral cortex among the main players. Advances in in vivo and in vitro technologies have informed us about the significance to migraine of events such as cortical spreading depression and activation of the trigeminovascular system and its constituent neuropeptides, as well as about the importance of neuronal and glial ion channels and transporters that contribute to the putative cortical excitatory/inhibitory imbalance that renders migraineurs susceptible to an attack. This review focuses on emerging concepts that drive the science of migraine in both a mechanistic direction and a therapeutic direction.
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Affiliation(s)
- Daniela Pietrobon
- Department of Biomedical Sciences, University of Padova, Padova, Italy.
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Vecchia D, Pietrobon D. Migraine: a disorder of brain excitatory-inhibitory balance? Trends Neurosci 2012; 35:507-20. [PMID: 22633369 DOI: 10.1016/j.tins.2012.04.007] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 04/12/2012] [Accepted: 04/20/2012] [Indexed: 01/17/2023]
Abstract
Migraine is a common disabling brain disorder whose key manifestations are recurrent attacks of unilateral headache and interictal hypersensitivity to sensory stimuli. Migraine arises from a primary brain dysfunction that leads to episodic activation and sensitization of the trigeminovascular pain pathway and as a consequence to headache. Major open issues concern the molecular and cellular mechanisms of the primary brain dysfunction(s) and of migraine pain. We review here our current understanding of these mechanisms, focusing on recent advances regarding migraine genetics, headache mechanisms, and the primary brain dysfunction(s) underlying migraine onset and susceptibility to cortical spreading depression, the neurophysiological correlate of migraine aura. We also discuss insights obtained from the functional analysis of familial hemiplegic migraine mouse models.
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Affiliation(s)
- Dania Vecchia
- Department of Biomedical Sciences, University of Padova, 35121 Padova, Italy
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Perceptual illusions provide clues to excitatory–inhibitory balance in migraine neocortex. Cephalalgia 2011; 31:1155-7. [DOI: 10.1177/0333102411411205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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