Higher, faster, worse? An event-related potentials study of affective picture processing in migraine

EEG Changes in Migraine-Can EEG Help to Monitor Attack Susceptibility?

Migraine is a highly prevalent brain condition with paroxysmal changes in brain excitability believed to contribute to the initiation of an attack. The attacks and their unpredictability have a major impact on the lives of patients. Clinical management is hampered by a lack of reliable predictors for upcoming attacks, which may help in understanding pathophysiological mechanisms to identify new treatment targets that may be positioned between the acute and preventive possibilities that are currently available. So far, a large range of studies using conventional hospital-based EEG recordings have provided contradictory results, with indications of both cortical hyper- as well as hypo-excitability. These heterogeneous findings may largely be because most studies were cross-sectional in design, providing only a snapshot in time of a patient's brain state without capturing day-to-day fluctuations. The scope of this narrative review is to (i) reflect on current knowledge on EEG changes in the context of migraine, the attack cycle, and underlying pathophysiology; (ii) consider the effects of migraine treatment on EEG features; (iii) outline challenges and opportunities in using EEG for monitoring attack susceptibility; and (iv) discuss future applications of EEG in home-based settings.

Prospective Matched Case-Control Study of Over-Early P100 Wave Latency in Migraine with Aura

A sizable portion of the world's population suffers from migraines with aura. The purpose of this research is to describe the findings of a case-control study that was carried out to gain a better understanding of how migraine with aura manifests. The research looked at the P100 delay of the visual-evoked potential in both eyes of 92 healthy people and 44 patients who suffered from migraines with visual aura. All of the participants in the study were recruited from King Fahad University Hospital in Saudi Arabia. Both sets of people had the same ancestry and originated from the same location. Patients who suffered from migraines with aura exhibited a significantly shorter P100 delay in both eyes compared to healthy controls (p = 0.001), which is evidence that their early visual processing was distinct. In order to arrive at these findings, we compared people who suffer from migraines with aura to people who do not suffer from migraines and used them as subjects. These findings contribute to the ongoing attempts to bring the disease under control and provide vitally significant new information regarding the functioning of headaches with auras. The primary focus of study in the future should be on determining the nature of the connection between issues with early visual processing and headaches with aura.

The Objective Assessment of Event-Related Potentials: An Influence of Chronic Pain on ERP Parameters

The article presents an original method for the automatic assessment of the quality of event-related potentials (ERPs), based on the calculation of the coefficient ε, which describes the compliance of recorded ERPs with some statistically significant parameters. This method was used to analyze the neuropsychological EEG monitoring of patients suffering from migraines. The frequency of migraine attacks was correlated with the spatial distribution of the coefficients ε, calculated for EEG channels. More than 15 migraine attacks per month was accompanied by an increase in calculated values in the occipital region. Patients with infrequent migraines exhibited maximum quality in the frontal areas. The automatic analysis of spatial maps of the coefficient ε demonstrated a statistically significant difference between the two analyzed groups with different means of migraine attack numbers per month.

The ERP and psychophysical changes related to facial emotion perception by expertise in Japanese hospitality, "OMOTENASHI"

We investigated the emotion perception process based on hospitality expertise. Forty subjects were divided into the OMOTENASHI group working at inns considered to represent the spirit of hospitality, OMOTENASHI in Japan, and CONTROL group without experience in the hospitality industry. We presented neutral, happy, and angry faces to investigate P100 and N170 by these faces, and psychophysical changes by the favor rating test to evaluate emotional perception. In the favor rating test, the score was significantly smaller (less favorable) in OMOTENASHI than in CONTROL. Regarding event-related potential components, the maximum amplitude of P100 was significantly larger for a neutral face at the right occipital electrode in OMOTENASHI than in CONTROL, and it was significantly larger for an angry face at both occipital electrodes in OMOTENASHI than in CONTROL. However, the peak latency and maximum amplitude of N170 were not significantly different between OMOTENASHI and CONTROL at both temporal electrodes for each emotion condition. Differences on the favor rating test and P100 in OMOTENASHI suggested that workers at inns may more quickly notice and be more sensitive to the facial emotion of guests due to hospitality training, and/or that hospitality expertise may increase attention to emotion by top-down and/or bottom-up processing.

The Role of Attachment Style, Adverse Childhood Experiences and Dissociation in Migraine

Migraine and chronic migraine are caused by a combination of modifiable and non-modifiable genetic, social, behavioral and environmental risk factors. Further research of possible modifiable risk factors for this headache disorder is merited, given its role as one of the leading causes of years lived with disability per year. The first aim of this online cross-sectional study was to investigate the psychosocial risk factors that predicted chronic migraine and severe migraine-related disability in 507 Irish and UK participants, focusing specifically on childhood maltreatment, attachment and tendency to dissociate, or experience depressed mood and/or anxiety. Additionally, this study aimed to examine variables that mediated the relationships between these psychosocial risk factors and migraine chronicity or severe migraine-related disability. Adjusted binary logistic regression revealed that shutdown dissociation (Odds Ratio [OR] 4.57, 95% Confidence Interval [CI] 2.66-7.85) and severe physical abuse (OR 4.30, 95% CI 1.44-12.83 had significant odds of predicting migraine chronicity, while depression (OR 3.28, 95% CI 1.86-5.77) significantly predicted severe migraine-related disability. Mediation analyses indicated that shutdown dissociation mediated the relationship between seven predictor variables and both chronicity and severe disability including possible predisposing factors emotional abuse, physical neglect, avoidant attachment and anxious attachment. These findings suggest that early life stressors (such as childhood trauma and avoidant attachment style), shutdown dissociation and depression may impact on migraine trajectory. To investigate whether these psychosocial factors are risk factors for migraine chronicity or disability, prospective research should be conducted in this area to account for fluctuations in migraine chronicity over time.

Nonlinear Effects of Linearly Increasing Perceptual Load on ERPs to Emotional Pictures

The prioritized processing of emotional as compared to neutral stimuli is reflected in enlarged event-related potentials (ERPs). However, perceptual load theory proposes that under conditions of high perceptual load, information processing is attenuated or abolished. The parametrical effects of load on ERPs to emotional pictures are unknown. To shed light on this question, the current preregistered ERP study (N = 30) systematically investigated the effects of load on ERPs to task-irrelevant negative, neutral, and positive pictures. Crucially, while perceptual input was held constant, perceptual load was systematically manipulated so that it increased linearly across 4 load levels, which was evident in behavioral data. In contrast, load effects on ERP differences between emotional and neutral stimuli did not follow a linear function. For the N1, early posterior negativity and late positive potential, a nonlinear function with reversed emotion effects at the third load level provided the best fit. These findings do not only show that perceptual load attenuates emotional picture processing but also suggest that active processes are initiated to reduce distraction by emotional information. Moreover, these effects of perceptual load on emotional ERP components appear to deviate from theoretically expected functions.

Pre-attentive dysfunction of processing emotional faces in interictal migraine revealed by expression-related visual mismatch negativity

BACKGROUND

Several investigations have indicated emotional processing impairment in migraineurs, while no report is available considering the automatic processing of emotional information. In this study, we aimed to characterize the pre-attentive processing of facial expressions in migraine sufferers by recording and analyzing expression-related visual mismatch negativity (EMMN).

METHODS

Altogether, 30 migraineurs (19 females) during the interictal period and 30 age-matched healthy controls (17 females) were recruited. An expression-related oddball paradigm was used to investigate automatic emotional processing, and a group of schematic emotional faces (neutral, happy, sad) unrelated to the participant's task were employed in the experiment in order to avoid low-level processing.

RESULTS

There was no significant difference in behavioral performance (the response accuracy and reaction time) between migraine patients and healthy controls. Nevertheless, the mean EMMN amplitudes within the ranges of 150-250 ms and 250-350 ms were markedly attenuated in patients compared with controls, regardless of happy or sad condition (happy minus neutral or sad minus neutral), and sad EMMN was observed to be larger than happy EMMN only in healthy participants. Moreover, these electrophysiological data directly correlated with frequency and duration of migrainous attacks.

CONCLUSIONS

Our findings implied that the pre-attentive dysfunction of processing both happy and sad expressions was demonstrated in interictal migraineurs, without the existence of negative bias (sad superiority) effect. Further studies on the availability of EMMN as an evaluative marker for migraine are warranted.

Differences in early and late pattern-onset visual-evoked potentials between self- reported migraineurs and controls

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Migraineurs had an enhanced N2 evoked by gratings with a spatial frequency of 13 cpd.

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Migraineurs had an attenuated occipital late negativity (LN) for viewing all gratings.

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Hyperexcitable controls showed similar VEP pattern compared to migraineurs.

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Enhanced N2 deflection could be driven by cortical hyperexcitation.

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LN reduction could reflect inhibitory control during processing of aversive stimuli.

Striped patterns have been shown to induce strong visual illusions and discomforts to migraineurs in previous literature. Previous research has suggested that these unusual visual symptoms to be linked with the hyperactivity on the visual cortex of migraine sufferers. The present study searched for evidence supporting this hypothesis by comparing the visual evoked potentials (VEPs) elicited by striped patterns of specific spatial frequencies (0.5, 3, and 13 cycles-per-degree) between a group of 29 migraineurs (17 with aura/12 without) and 31 non-migraineurs. In addition, VEPs to the same stripped patterns were compared between non-migraineurs who were classified as hyperexcitable versus non-hyperexcitable using a previously established behavioural pattern glare task. We found that the migraineurs had a significantly increased N2 amplitude for stimuli with 13 cpd gratings but an attenuated late negativity (LN: 400 – 500 ms after the stimuli onset) for all the spatial frequencies. Interestingly, non-migraineurs who scored as hyperexcitable appeared to have similar response patterns to the migraineurs, albeit in an attenuated form. We propose that the enhanced N2 could reflect disruption of the balance between parvocellular and magnocellular pathway, which is in support of the cortical hyperexcitation hypothesis in migraineurs. In addition, the attenuation of the late negativity could reflect a top-down feedback mechanism to suppress visual processing of an aversive stimulus.

Current understanding of cortical structure and function in migraine

OBJECTIVE

To review and discuss the literature on the role of cortical structure and function in migraine.

DISCUSSION

Structural and functional findings suggest that changes in cortical morphology and function contribute to migraine susceptibility by modulating dynamic interactions across cortical and subcortical networks. The involvement of the cortex in migraine is well established for the aura phase with the underlying phenomenon of cortical spreading depolarization, while increasing evidence suggests an important role for the cortex in perception of head pain and associated sensations. As part of trigeminovascular pain and sensory processing networks, cortical dysfunction is likely to also affect initiation of attacks.

CONCLUSION

Morphological and functional changes identified across cortical regions are likely to contribute to initiation, cyclic recurrence and chronification of migraine. Future studies are needed to address underlying mechanisms, including interactions between cortical and subcortical regions and effects of internal (e.g. genetics, gender) and external (e.g. sensory inputs, stress) modifying factors, as well as possible clinical and therapeutic implications.

Association between migraine frequency and neural response to emotional faces: An fMRI study

Previous studies have demonstrated that migraine is associated with enhanced perception and altered cerebral processing of sensory stimuli. More recently, it has been suggested that this sensory hypersensitivity might reflect a more general enhanced response to aversive emotional stimuli. Using functional magnetic resonance imaging and emotional face stimuli (fearful, happy and sad faces), we compared whole-brain activation between 41 migraine patients without aura in interictal period and 49 healthy controls. Migraine patients showed increased neural activation to fearful faces compared to neutral faces in the right middle frontal gyrus and frontal pole relative to healthy controls. We also found that higher attack frequency in migraine patients was related to increased activation mainly in the right primary somatosensory cortex (corresponding to the face area) to fearful expressions and in the right dorsal striatal regions to happy faces. In both analyses, activation differences remained significant after controlling for anxiety and depressive symptoms. These findings indicate that enhanced response to emotional stimuli might explain the migraine trigger effect of psychosocial stressors that gradually leads to increased somatosensory response to emotional clues and thus contributes to the progression or chronification of migraine.

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First fMRI study to explore neural response to emotional faces in migraine patients

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Migraine patients showed increased activation to fear in the right frontal regions

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Migraine frequency was related to enhanced activation to fearful and happy faces

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Activation in the right S1 and dorsal striatum was linked to migraine frequency

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Sensitivity to emotional stimuli might have a role in triggering migraine

An event-related potential comparison of facial expression processing between cartoon and real faces

Faces play important roles in the social lives of humans. Besides real faces, people also encounter numerous cartoon faces in daily life which convey basic emotional states through facial expressions. Using event-related potentials (ERPs), we conducted a facial expression recognition experiment with 17 university students to compare the processing of cartoon faces with that of real faces. This study used face type (real vs. cartoon), emotion valence (happy vs. angry) and participant gender (male vs. female) as independent variables. Reaction time, recognition accuracy, and the amplitudes and latencies of emotion processing-related ERP components such as N170, VPP (vertex positive potential), and LPP (late positive potential) were used as dependent variables. The ERP results revealed that cartoon faces caused larger N170 and VPP amplitudes as well as a briefer N170 latency than did real faces; that real faces induced larger LPP amplitudes than did cartoon faces. In addition, the results showed a significant difference in the brain regions as reflected in a right hemispheric advantage. The behavioral results showed that the reaction times for happy faces were shorter than those for angry faces; that females showed a higher accuracy than did males; and that males showed a higher recognition accuracy for angry faces than happy faces. Due to the sample size, these results may suggestively but not rigorously demonstrate differences in facial expression recognition and neurological processing between cartoon faces and real faces. Cartoon faces showed a higher processing intensity and speed than real faces during the early processing stage. However, more attentional resources were allocated for real faces during the late processing stage.

Perception of facial expressions of emotion in migraine

Both lower-level perceptual changes and especially higher-level cognitive alterations in individuals with migraine are poorly understood. Here, we behaviorally and electrophysiologically investigated the perception of emotional facial expressions in migraine. Young female individuals with migraine and healthy controls watching neutral faces gradually shifting to either happy, fearful, or angry expressions were asked to classify the facial expressions as quickly and accurately as possible by pressing a corresponding button, and to keep looking at the face until the last frame disappeared. Migraine individuals, compared to healthy controls, had a reduced habituation in the N170 time interval towards a gradually emerging emotional expression. The early P1, the early posterior negativity (EPN), and the late positive potential (LPP) amplitudes were not statistically different between groups and among expressions. The mean reaction time for recognizing an expression did not differ between groups and it was not at a cost of more incorrect responses. Interestingly, the amplitude of the early posterior negativity correlated negatively with the time interval since the last attack. It is concluded that young female individuals with migraine, compared to healthy controls, do not show a biased emotional facial processing toward positive or negative expressions.

Uncensored EEG: The role of DC potentials in neurobiology of the brain

Brain direct current (DC) potentials denote sustained shifts and slow deflections of cerebral potentials superimposed with conventional electroencephalography (EEG) waves and reflect alterations in the excitation level of the cerebral cortex and subcortical structures. Using galvanometers, such sustained displacement of the EEG baseline was recorded in the early days of EEG recordings. To stabilize the EEG baseline and eliminate artefacts, EEG was performed later by voltage amplifiers with high-pass filters that dismiss slow DC potentials. This left slow DC potential recordings as a neglected diagnostic source in the routine clinical setting over the last few decades. Brain DC waves may arise from physiological processes or pathological phenomena. Recordings of DC potentials are fundamental electro-clinical signatures of some neurological and psychological disorders and may serve as diagnostic, prognostic, and treatment monitoring tools. We here review the utility of both physiological and pathological brain DC potentials in different aspects of neurological and psychological disorders. This may enhance our understanding of the role of brain DC potentials and improve our fundamental clinical and research strategies for brain disorders.

Differential effects of face-realism and emotion on event-related brain potentials and their implications for the uncanny valley theory

Cartoon characters are omnipresent in popular media. While few studies have scientifically investigated their processing, in computer graphics, efforts are made to increase realism. Yet, close approximations of reality have been suggested to evoke sometimes a feeling of eeriness, the “uncanny valley” effect. Here, we used high-density electroencephalography to investigate brain responses to professionally stylized happy, angry, and neutral character faces. We employed six face-stylization levels varying from abstract to realistic and investigated the N170, early posterior negativity (EPN), and late positive potential (LPP) event-related components. The face-specific N170 showed a u-shaped modulation, with stronger reactions towards both most abstract and most realistic compared to medium-stylized faces. For abstract faces, N170 was generated more occipitally than for real faces, implying stronger reliance on structural processing. Although emotional faces elicited highest amplitudes on both N170 and EPN, on the N170 realism and expression interacted. Finally, LPP increased linearly with face realism, reflecting activity increase in visual and parietal cortex for more realistic faces. Results reveal differential effects of face stylization on distinct face processing stages and suggest a perceptual basis to the uncanny valley hypothesis. They are discussed in relation to face perception, media design, and computer graphics.

Increased Functional Activation of Limbic Brain Regions during Negative Emotional Processing in Migraine

Pain is both an unpleasant sensory and emotional experience. This is highly relevant in migraine where cortical hyperexcitability in response to sensory stimuli (including pain, light, and sound) has been extensively reported. However, migraine may feature a more general enhanced response to aversive stimuli rather than being sensory-specific. To this end we used functional magnetic resonance imaging to assess neural activation in migraineurs interictaly in response to emotional visual stimuli from the International Affective Picture System. Migraineurs, compared to healthy controls, demonstrated increased neural activity in response to negative emotional stimuli. Most notably in regions overlapping in their involvement in both nociceptive and emotional processing including the posterior cingulate, caudate, amygdala, and thalamus (cluster corrected, p < 0.01). In contrast, migraineurs and healthy controls displayed no and minimal differences in response to positive and neutral emotional stimuli, respectively. These findings support the notion that migraine may feature more generalized altered cerebral processing of aversive/negative stimuli, rather than exclusively to sensory stimuli. A generalized hypersensitivity to aversive stimuli may be an inherent feature of migraine, or a consequential alteration developed over the duration of the disease. This proposed cortical-limbic hypersensitivity may form an important part of the migraine pathophysiology, including psychological comorbidity, and may represent an innate sensitivity to aversive stimuli that underpins attack triggers, attack persistence and (potentially) gradual headache chronification.