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Conti M, Bovenzi R, Palmieri MG, Placidi F, Stefani A, Mercuri NB, Albanese M. Early effect of onabotulinumtoxinA on EEG-based functional connectivity in patients with chronic migraine: A pilot study. Headache 2024; 64:825-837. [PMID: 38837259 DOI: 10.1111/head.14750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE In this pilot prospective cohort study, we aimed to evaluate, using high-density electroencephalography (HD-EEG), the longitudinal changes in functional connectivity (FC) in patients with chronic migraine (CM) treated with onabotulinumtoxinA (OBTA). BACKGROUND OBTA is a treatment for CM. Several studies have shown the modulatory action of OBTA on the central nervous system; however, research on migraine is limited. METHODS This study was conducted at the Neurology Unit of "Policlinico Tor Vergata," Rome, Italy, and included 12 adult patients with CM treated with OBTA and 15 healthy controls (HC). Patients underwent clinical scales at enrollment (T0) and 3 months (T1) from the start of treatment. HD-EEG was recorded using a 64-channel system in patients with CM at T0 and T1. A source reconstruction method was used to identify brain activity. FC in δ-θ-α-β-low-γ bands was analyzed using the weighted phase-lag index. FC changes between HCs and CM at T0 and T1 were assessed using cross-validation methods to estimate the results' reliability. RESULTS Compared to HCs at T0, patients with CM showed hyperconnected networks in δ (p = 0.046, area under the receiver operating characteristic curve [AUC: 0.76-0.98], Cohen's κ [0.65-0.93]) and β (p = 0.031, AUC [0.68-0.95], Cohen's κ [0.51-0.84]), mainly involving orbitofrontal, occipital, temporal pole and orbitofrontal, superior temporal, occipital, cingulate areas, and hypoconnected networks in α band (p = 0.029, AUC [0.80-0.99], Cohen's κ [0.42-0.77]), predominantly involving cingulate, temporal pole, and precuneus. Patients with CM at T1, compared to T0, showed hypoconnected networks in δ band (p = 0.032, AUC [0.73-0.99], Cohen's κ [0.53-0.90]) and hyperconnected networks in α band (p = 0.048, AUC [0.58-0.93], Cohen's κ [0.37-0.78]), involving the sensorimotor, orbitofrontal, cingulate, and temporal cortex. CONCLUSION These preliminary results showed that patients with CM presented disrupted EEG-FC compared to controls restored by a single session of OBTA treatment, suggesting a primary central modulatory action of OBTA.
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Affiliation(s)
- Matteo Conti
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Roberta Bovenzi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Fabio Placidi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Alessandro Stefani
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Maria Albanese
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Neurology Unit, Regional Referral Headache Center, University of Rome "Tor Vergata", Rome, Italy
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2
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Cho LY, Bell TK, Craddock L, Godfrey KJ, Hershey AD, Kuziek J, Stokoe M, Millar K, Orr SL, Harris AD. Region-specific changes in brain glutamate and gamma-aminobutyric acid across the migraine attack in children and adolescents. Pain 2024:00006396-990000000-00619. [PMID: 38833578 DOI: 10.1097/j.pain.0000000000003289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/21/2024] [Indexed: 06/06/2024]
Abstract
ABSTRACT In patients with migraine, an excitation-inhibition imbalance that fluctuates relative to attack onset has been proposed to contribute to the underlying pathophysiology of migraine, but this has yet to be explored in children and adolescents. This prospective, observational, cohort study examined glutamate and gamma-aminobutyric acid (GABA) levels across the phases of a migraine attack and interictally in children and adolescents using magnetic resonance spectroscopy. Macromolecule-suppressed GABA (sensorimotor cortex and thalamus) and glutamate (occipital cortex, sensorimotor cortex, and thalamus) were measured in children and adolescents (10-17 years) with a migraine diagnosis with or without aura 4 times over 2 weeks. Linear mixed-effects models examined changes in glutamate and GABA during the 72 hours leading up to, and after the onset of an attack. We found significant region-specific changes in glutamate and GABA. Specifically, sensorimotor GABA significantly increased leading up to the headache phase, whereas glutamate significantly decreased following the headache onset in the occipital cortex and the thalamus. Post hoc analyses examined the 24 hours leading up to or following the onset of the headache phase. In the 24 hours before the headache onset, sensorimotor glutamate, occipital glutamate, and thalamic GABA decreased. In the 24 hours post headache onset, sensorimotor glutamate continued to decrease. Our results suggest changes in glutamate and GABA that are consistent with the thalamocortical dysrhythmia hypothesis. These findings provide insight into developmental migraine pathophysiology and may open future avenues for treatment targets specific to children and adolescents.
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Affiliation(s)
- Lydia Y Cho
- Department of Radiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Tiffany K Bell
- Department of Radiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Lindsay Craddock
- Vi Riddell Pain and Rehab Center, Alberta Children's Hospital Calgary, Canada
- Department of Nursing, University of Calgary, Calgary, Canada
| | - Kate J Godfrey
- Department of Radiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Andrew D Hershey
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, United States
| | - Jonathan Kuziek
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Departments of Pediatrics, Community Health Sciences, and Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - Mehak Stokoe
- Department of Radiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Kayla Millar
- Department of Radiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Serena L Orr
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Departments of Pediatrics, Community Health Sciences, and Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - Ashley D Harris
- Department of Radiology, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
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3
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Stern JI, Robertson CE. Visual Snow: Updates and Narrative Review. Curr Pain Headache Rep 2024; 28:55-63. [PMID: 38079073 DOI: 10.1007/s11916-023-01186-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 02/22/2024]
Abstract
PURPOSE OF REVIEW Visual snow (VS) involves visualization of innumerable dots throughout the visual field, sometimes resembling "TV static." Patients who experience this symptom may also have additional visual symptoms (e.g., photophobia, palinopsia, floaters, and nyctalopia) with a pattern now defined as visual snow syndrome (VSS). This manuscript describes both VS and VSS in detail and provides an updated review on the clinical features, pathophysiology, and optimal management strategies for these symptoms. RECENT FINDINGS VS/VSS may be primary or secondary to a variety of etiologies, including ophthalmologic or brain disorders, systemic disease, and medication/hallucinogen exposure. Evaluation involves ruling out secondary causes and mimics of VS. Increasing evidence suggests that VSS is a widespread process extending beyond the visual system. Pathophysiology may involve cortical hyperexcitability or dysfunctional connectivity of thalamocortical or attention/salience networks. VSS is typically a benign, non-progressive syndrome and can be managed with non-medicine strategies. Though no medication provides complete relief, some may provide partial improvement in severity of VS.
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Affiliation(s)
- Jennifer I Stern
- Neurology Department, Mayo Clinic College of Medicine and Science, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Carrie E Robertson
- Neurology Department, Mayo Clinic College of Medicine and Science, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
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4
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Dai W, Qiu E, Lin X, Zhang S, Zhang M, Han X, Jia Z, Su H, Bian X, Zang X, Li M, Zhang Q, Ran Y, Gong Z, Wang X, Wang R, Tian L, Dong Z, Yu S. Abnormal Thalamo-Cortical Interactions in Overlapping Communities of Migraine: An Edge Functional Connectivity Study. Ann Neurol 2023; 94:1168-1181. [PMID: 37635687 DOI: 10.1002/ana.26783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/24/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Migraine has been demonstrated to exhibit abnormal functional connectivity of large-scale brain networks, which is closely associated with its pathophysiology and has not yet been explored by edge functional connectivity. We used an edge-centric approach combined with motif analysis to evaluate higher-order communication patterns of brain networks in migraine. METHODS We investigated edge-centric metrics in 108 interictal migraine patients and 71 healthy controls. We parcellated the brain into networks using independent component analysis. We applied edge graph construction, k-means clustering, community overlap detection, graph-theory-based evaluations, and clinical correlation analysis. We conducted motif analysis to explore the interactions among regions, and a classification model to test the specificity of edge-centric results. RESULTS The normalized entropy of lateral thalamus was significantly increased in migraine, which was positively correlated with the baseline headache duration, and negatively correlated with headache duration reduction following preventive medications at 3-month follow-up. Network-wise entropy of the sensorimotor network was significantly elevated in migraine. The community similarity between lateral thalamus and postcentral gyrus was enhanced in migraine. Migraine patients showed overrepresented L-shape and diverse motifs, and underrepresented forked motifs with lateral thalamus serving as the reference node. Furthermore, migraine patients presented with overrepresented L-shape triads, where the postcentral gyrus shared different edges with the lateral thalamus. The classification model showed that entropy of the lateral thalamus had the highest discriminative power, with an area under the curve of 0.86. INTERPRETATION Our findings indicated an abnormal higher-order thalamo-cortical communication pattern in migraine patients. The thalamo-cortical-somatosensory disturbance of concerted working may potentially lead to aberrant information flow and deficit pain processing of migraine. ANN NEUROL 2023;94:1168-1181.
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Affiliation(s)
- Wei Dai
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Enchao Qiu
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Xiaoxue Lin
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shuhua Zhang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Mingjie Zhang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xun Han
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhihua Jia
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hui Su
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiangbing Bian
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiao Zang
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Meng Li
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qingkui Zhang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ye Ran
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zihua Gong
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaolin Wang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Rongfei Wang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lixia Tian
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China
| | - Zhao Dong
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China
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5
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Sebastianelli G, Casillo F, Abagnale C, Renzo AD, Cioffi E, Parisi V, Lorenzo CD, Fazio F, Petricola F, Mattia C, Serrao M, Schoenen J, Coppola G. Central sensitization mechanisms in chronic migraine with medication overuse headache: a study of thalamocortical activation and lateral cortical inhibition. Cephalalgia 2023; 43:3331024231202240. [PMID: 37795647 DOI: 10.1177/03331024231202240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND It is unclear whether cortical hyperexcitability in chronic migraine with medication overuse headache (CM-MOH) is due to increased thalamocortical drive or aberrant cortical inhibitory mechanisms. METHODS Somatosensory evoked potentials (SSEP) were performed by electrical stimulation of the median nerve (M), ulnar nerve (U) and simultaneous stimulation of both nerves (MU) in 27 patients with CM-MOH and, for comparison, in 23 healthy volunteers (HVs) of a comparable age distribution. We calculated the degree of cortical lateral inhibition using the formula: 100 - [MU/(M + U) × 100] and the level of thalamocortical activation by analyzing the high frequency oscillations (HFOs) embedded in parietal N20 median SSEPs. RESULTS Compared to HV, CM-MOH patients showed higher lateral inhibition (CM-MOH 52.2% ± 15.4 vs. HV 40.4% ± 13.3; p = 0.005), which positively correlated with monthly headache days, and greater amplitude of pre-synaptic HFOs (p = 0.010) but normal post-synaptic HFOs (p = 0.122). CONCLUSION Our findings suggest that central neuronal circuits are highly sensitized in CM-MOH patients, at both thalamocortical and cortical levels. The observed changes could be due to the combination of dysfunctional central pain control mechanisms, hypersensitivity and hyperresponsiveness directly linked to the chronic intake of acute migraine drugs.
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Affiliation(s)
- Gabriele Sebastianelli
- Sapienza University of Rome Polo Pontino ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Francesco Casillo
- Sapienza University of Rome Polo Pontino ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Chiara Abagnale
- Sapienza University of Rome Polo Pontino ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | | | - Ettore Cioffi
- Sapienza University of Rome Polo Pontino ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | | | - Cherubino Di Lorenzo
- Sapienza University of Rome Polo Pontino ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Federica Fazio
- Specialization School in Medicine and Palliative Care, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy
| | - Fausto Petricola
- Specialization School in Medicine and Palliative Care, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy
| | - Consalvo Mattia
- Specialization School in Medicine and Palliative Care, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy
| | - Mariano Serrao
- Sapienza University of Rome Polo Pontino ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Jean Schoenen
- CHU de Liège, Neurology, Headache Research Unit, Citadelle Hospital, Liège, Belgium
| | - Gianluca Coppola
- Sapienza University of Rome Polo Pontino ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
- Specialization School in Medicine and Palliative Care, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy
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6
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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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Mykland MS, Uglem M, Bjørk MH, Matre D, Sand T, Omland PM. Effects of insufficient sleep on sensorimotor processing in migraine: A randomised, blinded crossover study of event related beta oscillations. Cephalalgia 2023; 43:3331024221148398. [PMID: 36786371 DOI: 10.1177/03331024221148398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Migraine has a largely unexplained connection with sleep and is possibly related to a dysfunction of thalamocortical systems and cortical inhibition. In this study we investigate the effect of insufficient sleep on cortical sensorimotor processing in migraine. METHODS We recorded electroencephalography during a sensorimotor task from 46 interictal migraineurs and 28 controls after two nights of eight-hour habitual sleep and after two nights of four-hour restricted sleep. We compared changes in beta oscillations of the sensorimotor cortex after the two sleep conditions between migraineurs, controls and subgroups differentiating migraine subjects usually having attacks starting during sleep and not during sleep. We included preictal and postictal recordings in a secondary analysis of temporal changes in relation to attacks. RESULTS Interictally, we discovered lower beta synchronisation after sleep restriction in sleep related migraine compared to non-sleep related migraine (p=0.006) and controls (p=0.01). No differences were seen between controls and the total migraine group in the interictal phase. After migraine attacks, we observed lower beta synchronisation (p<0.001) and higher beta desynchronisation (p=0.002) after sleep restriction closer to the end of the attack compared to later after the attack. CONCLUSION The subgroup with sleep related migraine had lower sensorimotor beta synchronisation after sleep restriction, possibly related to dysfunctional GABAergic inhibitory systems. Sufficient sleep during or immediately after migraine attacks may be of importance for maintaining normal cortical excitability.
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Affiliation(s)
- Martin Syvertsen Mykland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
- Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
| | - Martin Uglem
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
- Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
| | - Marte-Helene Bjørk
- Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Dagfinn Matre
- Division of Research, National Institute of Occupational Health, Oslo, Norway
| | - Trond Sand
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
- Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
| | - Petter Moe Omland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
- Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
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8
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Mykland MS, Uglem M, Stovner LJ, Brenner E, Snoen MS, Gravdahl GB, Sand T, Omland PM. Insufficient sleep may alter cortical excitability near the migraine attack: A blinded TMS crossover study. Cephalalgia 2023; 43:3331024221148391. [PMID: 36786296 DOI: 10.1177/03331024221148391] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Migraine is a brain disorder with a multifaceted and unexplained association to sleep. Brain excitability likely changes periodically throughout the migraine cycle. In this study we examine the effect of insufficient sleep on neuronal excitability during the course of the migraine cycle. METHODS We examined 54 migraine patients after two nights of eight-hour habitual sleep and two nights of four-hour restricted sleep in a randomised, blinded crossover study. We performed transcranial magnetic stimulation and measured cortical silent period, short- and long-interval intracortical inhibition, intracortical facilitation and short-latency afferent inhibition. We analysed how responses changed before and after attacks with linear mixed models. RESULTS Short- interval intracortical inhibition was more reduced after sleep restriction compared to habitual sleep the shorter the time that had elapsed since the attack (p = 0.041), and specifically in the postictal phase (p = 0.013). Long-interval intracortical inhibition was more increased after sleep restriction with time closer before the attack (p = 0.006), and specifically in the preictal phase (p = 0.034). Short-latency afferent inhibition was more decreased after sleep restriction with time closer to the start of the attack (p = 0.026). CONCLUSION Insufficient sleep in the period leading up to a migraine attack may cause dysfunction in cortical GABAergic inhibition. The results also suggest that migraine patients may have increased need for sufficient sleep during a migraine attack to maintain normal neurological function after the attack.
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Affiliation(s)
- Martin Syvertsen Mykland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway.,Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
| | - Martin Uglem
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway.,Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
| | - Lars Jacob Stovner
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Eiliv Brenner
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway.,Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
| | - Mari Storli Snoen
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Gøril Bruvik Gravdahl
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Trond Sand
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway.,Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
| | - Petter Moe Omland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway.,Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
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9
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Coppola G, Ambrosini A. What has neurophysiology revealed about migraine and chronic migraine? HANDBOOK OF CLINICAL NEUROLOGY 2023; 198:117-133. [PMID: 38043957 DOI: 10.1016/b978-0-12-823356-6.00003-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Since the first electroencephalographic recordings obtained by Golla and Winter in 1959, researchers have used a variety of neurophysiological techniques to determine the mechanisms underlying recurrent migraine attacks. Neurophysiological methods have shown that the brain during the interictal phase of an episodic migraine is characterized by a general hyperresponsiveness to sensory stimuli, a malfunction of the monoaminergic brainstem circuits, and by functional alterations of the thalamus and thalamocortical loop. All of these alterations vary plastically during the phases of the migraine cycle and interictally with the days following the attack. Both episodic migraineurs recorded during an attack and chronic migraineurs are characterized by a general increase in the cortical amplitude response to peripheral sensory stimuli; this is an electrophysiological hallmark of a central sensitization process that is further reinforced through medication overuse. Considering the large-scale functional involvement and the main roles played by the brainstem-thalamo-cortical network in selection, elaboration, and learning of relevant sensory information, future research should move from searching for one specific primary site of dysfunction at the macroscopic level, to the chronic, probably genetically determined, molecular dysfunctions at the synaptic level, responsible for short- and long-term learning mechanisms.
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Affiliation(s)
- Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino - I.C.O.T., Latina, Italy
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10
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Zhang X, Wang W, Bai X, Zhang Y, Yuan Z, Tang H, Zhang X, Li Z, Zhang P, Hu Z, Zhang Y, Yu X, Man X, Sui B, Wang Y. Changes in gamma-aminobutyric acid and glutamate/glutamine levels in the right thalamus of patients with episodic and chronic migraine: A proton magnetic resonance spectroscopy study. Headache 2023; 63:104-113. [PMID: 36651572 DOI: 10.1111/head.14449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To explore gamma-aminobutyric acid (GABA) and glutamate/glutamine (Glx) levels in the right thalamus of patients with episodic migraine (EM) and chronic migraine (CM) and their effects on the chronification of migraine. BACKGROUND Migraine affects approximately 1 billion people worldwide, with 2.5%-3% of people with EM progressing to CM each year. Magnetic resonance spectroscopy studies have revealed altered GABA and Glx levels in the thalamus of patients with migraine without aura, but these neurometabolic concentrations are underexplored in the thalamus of patients with CM. METHODS In this cross-sectional study, patients with EM and CM were recruited. Mescher-Garwood point resolved spectroscopy sequence was used to acquire neurotransmitter concentrations in the right thalamus of patients with EM and CM and matched healthy controls (HCs). RESULTS A total of 26 patients (EM, n = 11; CM, n = 15) and 16 age- and sex-matched HCs were included in the analysis. There were significantly lower GABA+/Water levels in the right thalamus of the CM group (mean ± standard deviation: 2.27 ± 0.4 [institutional units]) than that of the HC group (2.74 ± 0.4) (p = 0.026; mean difference [MD] = -0.5 [i.u.]), and lower Glx/Cr levels in the EM group (mean ± SD: 0.11 ± < 0.1) than in the HCs (0.13 ± < 0.1) and CM group (0.13 ± < 0.1) (p = 0.023, MD < -0.1, and p = 0.034, MD < -0.1, respectively). The GABA+/Glx ratio was lower in the CM group (mean ± SD: 0.38 ± 0.1) compared to the EM group (0.47 ± 0.1) (p = 0.024; MD = -0.1). The area under the curve for GABA+/Water levels in differentiating patients with CM from HCs was 0.83 (95% confidence interval 0.68, 0.98; p = 0.004). Correlation analyses within the migraine group revealed no significant correlation between metabolite concentration levels and headache characteristics after Bonferroni correction. CONCLUSION Reduced GABA+/Water levels and imbalance of excitation/inhibition in the right thalamus may contribute to migraine chronification.
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Affiliation(s)
- Xueyan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoyan Bai
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yingkui Zhang
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Ziyu Yuan
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hefei Tang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Zhang
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhiye Li
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhangxuan Hu
- GE Healthcare, MR Research China, Beijing, China
| | - Yaqing Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xueying Yu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Man
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yonggang Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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11
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Abbas Abdulhussein M, Alyasseri ZAA, Mohammed HJ, An X. Lack of Habituation in Migraine Patients Based on High-Density EEG Analysis Using the Steady State of Visual Evoked Potential. ENTROPY (BASEL, SWITZERLAND) 2022; 24:1688. [PMID: 36421543 PMCID: PMC9689466 DOI: 10.3390/e24111688] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Migraine is a periodic disorder in which a patient experiences changes in the morphological and functional brain, leading to the abnormal processing of repeated external stimuli in the inter-ictal phase, known as the habituation deficit. This is a significant feature clinically of migraine in both two types with aura or without aura and plays an essential role in studying pathophysiological differences between these two groups. Several studies indicated that the reason for migraine aura is cortical spreading depression (CSD) but did not clarify its impact on migraine without aura and lack of habituation. In this study, 22 migraine patients (MWA, N = 13), (MWoA, N = 9), and healthy controls (HC, N = 19) were the participants. Participants were exposed to the steady state of visual evoked potentials also known as (SSVEP), which are the signals for a natural response to the visual motivation at four Hz or six Hz for 2 s followed by the inter-stimulus interval that varies between 1 and 1.5 s. The order of the temporal frequencies was randomized, and each temporal frequency was shown 100 times. We recorded from 128 customized electrode locations using high-density electroencephalography (HD-EEG) and measured amplitude and habituation for the N1-P1 and P1-N2 from the first to the sixth blocks of 100 sweep features in patients and healthy controls. Using the entropy, a decrease in amplitude and SSVEP N1-P1 habituation between the first and the sixth block appeared in both MWA and MWoA (p = 0.0001, Slope = -0.4643), (p = 0.065, Slope = 0.1483), respectively, compared to HC. For SSVEP P1-N2 between the first and sixth block, it is varied in both MWA (p = 0.0029, Slope = -0.3597) and MWoA (p = 0.027, Slope = 0.2010) compared to HC. Therefore, migraine patients appear amplitude decrease and habituation deficit but with different rates between MWA, and MWoA compared to HCs. Our findings suggest this disparity between MWoA and MWA in the lack of habituation and amplitude decrease in the inter-ictal phase has a close relationship with CSD. In light of the fact that CSD manifests during the inter-ictal phase of migraine with aura, which is when migraine seizures are most likely to occur, multiple researchers have lately reached this conclusion. This investigation led us to the conclusion that CSD during the inter-ictal phase and migraine without aura are associated. In other words, even if previous research has not demonstrated it, CSD is the main contributor to both types of migraine (those with and without aura).
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Affiliation(s)
- Msallam Abbas Abdulhussein
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin 300072, China
- Faculty of Computer Science and Mathematics, University of Kufa, Najaf 54001, Iraq
| | - Zaid Abdi Alkareem Alyasseri
- ECE Department, Faculty of Engineering, University of Kufa, Najaf 54001, Iraq
- College of Engineering, University of Warith Al-Anbiyaa, Karbala 63514, Iraq
- Information Technology Research and Development Centre, University of Kufa, Najaf 54001, Iraq
| | - Husam Jasim Mohammed
- Department of Business Administration, College of Administration and Financial Sciences, Imam Ja’afar Al-Sadiq University, Baghdad 10001, Iraq
| | - Xingwei An
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China
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12
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Chen Y, Liu Y, Song Y, Zhao S, Li B, Sun J, Liu L. Therapeutic applications and potential mechanisms of acupuncture in migraine: A literature review and perspectives. Front Neurosci 2022; 16:1022455. [PMID: 36340786 PMCID: PMC9630645 DOI: 10.3389/fnins.2022.1022455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/30/2022] [Indexed: 11/16/2022] Open
Abstract
Acupuncture is commonly used as a treatment for migraines. Animal studies have suggested that acupuncture can decrease neuropeptides, immune cells, and proinflammatory and excitatory neurotransmitters, which are associated with the pathogenesis of neuroinflammation. In addition, acupuncture participates in the development of peripheral and central sensitization through modulation of the release of neuronal-sensitization-related mediators (brain-derived neurotrophic factor, glutamate), endocannabinoid system, and serotonin system activation. Clinical studies have demonstrated that acupuncture may be a beneficial migraine treatment, particularly in decreasing pain intensity, duration, emotional comorbidity, and days of acute medication intake. However, specific clinical effectiveness has not been substantiated, and the mechanisms underlying its efficacy remain obscure. With the development of biomedical and neuroimaging techniques, the neural mechanism of acupuncture in migraine has gained increasing attention. Neuroimaging studies have indicated that acupuncture may alter the abnormal functional activity and connectivity of the descending pain modulatory system, default mode network, thalamus, frontal-parietal network, occipital-temporal network, and cerebellum. Acupuncture may reduce neuroinflammation, regulate peripheral and central sensitization, and normalize abnormal brain activity, thereby preventing pain signal transmission. To summarize the effects and neural mechanisms of acupuncture in migraine, we performed a systematic review of literature about migraine and acupuncture. We summarized the characteristics of current clinical studies, including the types of participants, study designs, and clinical outcomes. The published findings from basic neuroimaging studies support the hypothesis that acupuncture alters abnormal neuroplasticity and brain activity. The benefits of acupuncture require further investigation through basic and clinical studies.
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13
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Kalita J, Misra UK, Kumar M, Bansal R, Uniyal R. Is Palinopsia in Migraineurs a Phenomenon of Impaired Habituation of Visual Cortical Neurons? Clin EEG Neurosci 2022; 53:196-203. [PMID: 33646059 DOI: 10.1177/1550059421991707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Palinopsia in migraine has been reported recently, which may be due to the dysexcitability of visual cortical neurons. In this cross-sectional study, we report the correlation of neuronal dysexcitability with palinopsia using pattern shift visual evoked potential (PSVEP) in 91 migraineurs and 25 healthy controls. The presence of palinopsia was evaluated using a novel objective method, and revealed more frequent palinopsia in the migraineurs compared to the controls (53 of 91 [58.2%] vs 3 of 25 [12%]; P < .001). Five consecutive blocks of PSVEP were recorded for the evaluation of sensitization and impaired habituation. Amplitudes of N75 and P100 in block 1 were considered for sensitization. Impaired habituation of N75 and P100 was considered if any amplitudes in blocks 2 to 5 were higher than block 1. Impaired habituation was more frequent in migraineurs compared with the controls, and was more marked in wave N75 (81.3% vs 32%; P < .001) than wave P100 (63.7% vs 44%; P = .12). Impaired habituations of wave N75 (81.7% vs 58.9%; P = .008) and wave P100 (71.7% vs 46.4%; P = .008) were more frequent in those with palinopsia compared with those without. There was a lack of suppression of P100 amplitude in block 3 in the palinopsia group compared to the controls. The duration of palinopsia correlated with the extent of impaired habituation of N75. It can be concluded that the impaired habituation of PSVEP waveforms is a biomarker of palinopsia in migraine.
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Affiliation(s)
- Jayantee Kalita
- 30093Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Usha K Misra
- 30093Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | | | - Robin Bansal
- 30093Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Ravi Uniyal
- 30093Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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14
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Syvertsen Mykland M, Uglem M, Petter Neverdahl J, Rystad Øie L, Wergeland Meisingset T, Dodick DW, Tronvik E, Engstrøm M, Sand T, Moe Omland P. Sleep restriction alters cortical inhibition in migraine: A transcranial magnetic stimulation study. Clin Neurophysiol 2022; 139:28-42. [DOI: 10.1016/j.clinph.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/22/2022] [Accepted: 04/05/2022] [Indexed: 11/28/2022]
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15
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Sebastianelli G, Abagnale C, Casillo F, Cioffi E, Parisi V, Di Lorenzo C, Serrao M, Porcaro C, Schoenen J, Coppola G. Bimodal sensory integration in migraine: A study of the effect of visual stimulation on somatosensory evoked cortical responses. Cephalalgia 2022; 42:654-662. [PMID: 35166155 DOI: 10.1177/03331024221075073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Merging of sensory information is a crucial process for adapting the behaviour to the environment in all species. It is not known if this multisensory integration might be dysfunctioning interictally in migraine without aura, where sensory stimuli of various modalities are processed abnormally when delivered separately. To investigate this question, we compared the effects of a concomitant visual stimulation on conventional low-frequency somatosensory evoked potentials and embedded high-frequency oscillations between migraine patients and healthy volunteers. METHODS We recorded somatosensory evoked potentials in 19 healthy volunteers and in 19 interictal migraine without aura patients before, during, and 5 min after (T2) simultaneous synchronous pattern-reversal visual stimulation. At each time point, we measured amplitude and habituation of the N20-P25 low-frequency-somatosensory evoked potentials component and maximal peak-to-peak amplitude of early and late bursts of high-frequency oscillations. RESULTS In healthy volunteers, the bimodal stimulation significantly reduced low-frequency-somatosensory evoked potentials habituation and tended to reduce early high-frequency oscillations that reflect thalamocortical activity. By contrast, in migraine without aura patients, bimodal stimulation significantly increased low-frequency-somatosensory evoked potentials habituation and early high-frequency oscillations. At T2, all visual stimulation-induced changes of somatosensory processing had vanished. CONCLUSION These results suggest a malfunctioning multisensory integration process, which could be favoured by an abnormal excitability level of thalamo-cortical loops.
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Affiliation(s)
- Gabriele Sebastianelli
- Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Chiara Abagnale
- Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Francesco Casillo
- Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Ettore Cioffi
- Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | | | - Cherubino Di Lorenzo
- Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Mariano Serrao
- Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Camillo Porcaro
- Department of Neuroscience and Padova Neuroscience Center (PNC), University of Padova, Padova, Italy.,Institute of Cognitive Sciences and Technologies (ISTC) - National Research Council (CNR), Rome, Italy.,Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, UK
| | - Jean Schoenen
- Headache Research Unit, University Department of Neurology CHR, Citadelle Hospital. University of Liège, Liège, Belgium
| | - Gianluca Coppola
- Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
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16
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Hsiao FJ, Chen WT, Pan LLH, Liu HY, Wang YF, Chen SP, Lai KL, Coppola G, Wang SJ. Dynamic brainstem and somatosensory cortical excitability during migraine cycles. J Headache Pain 2022; 23:21. [PMID: 35123411 PMCID: PMC8903675 DOI: 10.1186/s10194-022-01392-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/20/2022] [Indexed: 11/22/2022] Open
Abstract
Abstract Background Migraine has complex pathophysiological characteristics and episodic attacks. To decipher the cyclic neurophysiological features of migraine attacks, in this study, we compared neuronal excitability in the brainstem and primary somatosensory (S1) region between migraine phases for 30 consecutive days in two patients with episodic migraine. Methods Both patients underwent EEG recording of event-related potentials with the somatosensory and paired-pulse paradigms for 30 consecutive days. The migraine cycle was divided into the following phases: 24–48 h before headache onset (Pre2), within 24 h before headache onset (Pre1), during the migraine attack (Ictal), within 24 h after headache offset (Post1), and the interval of ˃48 h between the last and next headache phase (Interictal). The normalised current intensity in the brainstem and S1 and gating ratio in the S1 were recorded and examined. Results Six migraine cycles (three for each patient) were analysed. In both patients, the somatosensory excitability in the brainstem (peaking at 12–14 ms after stimulation) and S1 (peaking at 18–19 ms after stimulation) peaked in the Pre1 phase. The S1 inhibitory capability was higher in the Ictal phase than in the Pre1 phase. Conclusion This study demonstrates that migraine is a cyclic excitatory disorder and that the neural substrates involved include the somatosensory system, starting in the brainstem and spanning subsequently to the S1 before the migraine occurs. Further investigations with larger sample sizes are warranted.
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Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan. .,Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan.
| | - Li-Ling Hope Pan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Yu Liu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan
| | - Kuan-Lin Lai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan.
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17
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Dai W, Liu RH, Qiu E, Liu Y, Chen Z, Chen X, Ao R, Zhuo M, Yu S. Cortical mechanisms in migraine. Mol Pain 2021; 17:17448069211050246. [PMID: 34806494 PMCID: PMC8606910 DOI: 10.1177/17448069211050246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Migraine is the second most prevalent disorder in the world; yet, its underlying mechanisms are still poorly understood. Cumulative studies have revealed pivotal roles of cerebral cortex in the initiation, propagation, and termination of migraine attacks as well as the interictal phase. Investigation of basic mechanisms of the cortex in migraine not only brings insight into the underlying pathophysiology but also provides the basis for designing novel treatments. We aim to summarize the current research literatures and give a brief overview of the cortex and its role in migraine, including the basic structure and function; structural, functional, and biochemical neuroimaging; migraine-related genes; and theories related to cortex in migraine pathophysiology. We propose that long-term plasticity of synaptic transmission in the cortex encodes migraine.
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Affiliation(s)
- Wei Dai
- Department of Neurology, Chinese PLA General Hospital, Beijing, China.,Chinese PLA Medical School, Beijing, China
| | - Ren-Hao Liu
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, 12480Xi'an Jiaotong University, Xi'an, China
| | - Enchao Qiu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Yinglu Liu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Zhiye Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, China.,Department of Radiology, Chinese PLA General Hospital, Beijing, China
| | - Xiaoyan Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Ran Ao
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Min Zhuo
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, 12480Xi'an Jiaotong University, Xi'an, China.,International Institute for Brain Research, Qingdao International Academician Park, Qingdao, China.,Department of Physiology, 1 King's College Circle, University of Toronto, Toronto, ON, Canada
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
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18
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Mehta DG, Garza I, Robertson CE. Two hundred and forty-eight cases of visual snow: A review of potential inciting events and contributing comorbidities. Cephalalgia 2021; 41:1015-1026. [PMID: 33615842 DOI: 10.1177/0333102421996355] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To review characteristics and outcomes of all cases of visual snow seen at our institution, with attention to possible triggering events or comorbidities. METHODS This is a retrospective case series of patients seen at our tertiary care center from January 1994 to January 2020. Charts were reviewed if they contained the term "visual snow". RESULTS Of the 449 charts reviewed, 248 patients described seeing visual snow in part or all of their vision. Thirty-eight reported transient visual snow as their typical migraine aura. Of the remaining 210 patients, 89 were reported to have either an inciting event or contributing comorbidity for their visual snow symptoms, including: Post-concussion (n = 15), dramatic change in migraine or aura (n = 14), post-infection (n = 13), hallucinogen persisting perception disorder (n = 10), ocular abnormalities (n = 7), idiopathic intracranial hypertension (n = 4), neoplastic (n = 1), and posterior cortical atrophy (n = 1). Some patients had partial improvement with benzodiazepines (n = 6), lamotrigine (n = 5), topiramate (n = 3) and acetazolamide (n = 3). Presenting characteristics were similar, but patients with visual snow attributed to an inciting event or contributing comorbidity were more likely to have some improvement in their symptoms by last follow-up compared to spontaneous visual snow (p < .001). CONCLUSIONS Though most cases of visual snow are spontaneous, potential secondary causes should be recognized by clinicians. Patients who develop visual snow after an inciting event or related to an underlying comorbidity may have a better prognosis than those in whom it develops spontaneously. In select cases, treatment of the suspected underlying cause may significantly alleviate the otherwise typical intractable visual disturbances associated with visual snow.
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Affiliation(s)
- Dev G Mehta
- Department of Neurology, 6915Mayo Clinic, Rochester, MN, USA
| | - Ivan Garza
- Department of Neurology, 6915Mayo Clinic, Rochester, MN, USA
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19
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Bell T, Khaira A, Stokoe M, Webb M, Noel M, Amoozegar F, Harris AD. Age-related differences in resting state functional connectivity in pediatric migraine. J Headache Pain 2021; 22:65. [PMID: 34229614 PMCID: PMC8259418 DOI: 10.1186/s10194-021-01274-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migraine affects roughly 10% of youth aged 5-15 years, however the underlying mechanisms of migraine in youth are poorly understood. Multiple structural and functional alterations have been shown in the brains of adult migraine sufferers. This study aims to investigate the effects of migraine on resting-state functional connectivity during the period of transition from childhood to adolescence, a critical period of brain development and the time when rates of pediatric chronic pain spikes. METHODS Using independent component analysis, we compared resting state network spatial maps and power spectra between youth with migraine aged 7-15 and age-matched controls. Statistical comparisons were conducted using a MANCOVA analysis. RESULTS We show (1) group by age interaction effects on connectivity in the visual and salience networks, group by sex interaction effects on connectivity in the default mode network and group by pubertal status interaction effects on connectivity in visual and frontal parietal networks, and (2) relationships between connectivity in the visual networks and the migraine cycle, and age by cycle interaction effects on connectivity in the visual, default mode and sensorimotor networks. CONCLUSIONS We demonstrate that brain alterations begin early in youth with migraine and are modulated by development. This highlights the need for further study into the neural mechanisms of migraine in youth specifically, to aid in the development of more effective treatments.
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Affiliation(s)
- Tiffany Bell
- Department of Radiology, University of Calgary, Calgary, AB, Canada. .,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada. .,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
| | - Akashroop Khaira
- Department of Radiology, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Mehak Stokoe
- Department of Radiology, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Megan Webb
- Department of Radiology, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Melanie Noel
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.,Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Farnaz Amoozegar
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Ashley D Harris
- Department of Radiology, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
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20
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Impaired short-term visual paired associative plasticity in patients with migraine between attacks. Pain 2021; 162:803-810. [PMID: 33136981 DOI: 10.1097/j.pain.0000000000002085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/16/2020] [Indexed: 01/11/2023]
Abstract
ABSTRACT A common experimental neurophysiological method to study synaptic plasticity is pairing activity of somatosensory afferents and motor cortical circuits, so-called paired associative stimulation (PAS). Dysfunctional inhibitory and excitatory PAS mechanisms within the sensorimotor system were described in patients with migraine without aura (MO) between attacks. We have recently observed that the same bidirectional PAS rules also apply to the visual system. Here, we have tested whether dysfunctioning associative plasticity might characterize the visual system of patients with MO. In 14 patients with MO between attacks and in 15 healthy volunteers, we performed a previously validated visual PAS (vPAS) protocol by coupling 90 black-and-white checkerboard reversals with low-frequency transcranial magnetic stimulation pulses over the occipital cortex at 2 interstimulus intervals of -25/+25 ms around the visual-evoked potential (VEP) P1 latency. We recorded VEPs (600 sweeps) before, immediately after, and 10 min after each vPAS session. We analysed VEP N1-P1 amplitude and delayed habituation. Although vPAS-25 significantly enhanced and vPAS + 25 reduced VEP amplitude habituation in healthy volunteers, the same protocols did not significantly change VEP amplitude habituation in MO between attacks. We provide evidence for lack of habituation enhancing and habituation suppressing visual PAS mechanisms within the visual system in interictal migraine. This finding, in combination with those previously obtained studying the sensorimotor system, leads us to argue that migraine disease-related dysrhythmic thalamocortical activity prevents the occurrence of physiological bidirectional synaptic plasticity induced by vPAS.
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21
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Mastria G, Viganò A, Corrado A, Mancini V, Pirillo C, Badini S, Petolicchio B, Toscano M, Altieri M, Delle Chiaie R, Di Piero V. Chronic Migraine Preventive Treatment by Prefrontal-Occipital Transcranial Direct Current Stimulation (tDCS): A Proof-of-Concept Study on the Effect of Psychiatric Comorbidities. Front Neurol 2021; 12:654900. [PMID: 34079513 PMCID: PMC8166222 DOI: 10.3389/fneur.2021.654900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/29/2021] [Indexed: 12/26/2022] Open
Abstract
Chronic migraine (CM) is often complicated by medication overuse headache (MOH) and psychiatric comorbidities that may influence the clinical outcome. This study aimed to investigate the relationship between psychiatric comorbidities and the effect of transcranial direct current stimulation (tDCS) in patients with CM with or without MOH. We recruited 16 consecutive CM patients who had an unsatisfactory response to at least three pharmacological preventive therapies. They were treated with anodal right-prefrontal and cathodal occipital tDCS (intensity: 2 mA, time: 20 min) three times per week for 4 weeks. All patients underwent a psychopathological assessment before and after treatment, and five of them were diagnosed with bipolar disorder (BD). After treatment, all the patients showed a significant decrease of severe and overall headache days per month. Despite having a higher migraine burden at baseline, patients with CM and BD showed a significantly greater reduction of severe headaches and psychiatric symptoms. Overall, tDCS seems to be effective in the treatment of CM patients with a poor response to different classes of pharmacological therapies, whereas BD status positively influences the response of migraineurs to tDCS.
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Affiliation(s)
- Giulio Mastria
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy.,My Space Lab, Department of Clinical Neuroscience, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
| | | | - Alessandra Corrado
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy
| | - Valentina Mancini
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy.,Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Cristina Pirillo
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy
| | - Simone Badini
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy
| | | | - Massimiliano Toscano
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy.,Department of Neurology-Fatebenefratelli Hospital, Rome, Italy
| | - Marta Altieri
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy
| | | | - Vittorio Di Piero
- Department of Human Neurosciences, Sapienza-University of Rome, Rome, Italy.,University Consortium for Adaptive Disorders and Head Pain-UCADH, Pavia, Italy
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22
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Chamanzar A, Haigh SM, Grover P, Behrmann M. Abnormalities in cortical pattern of coherence in migraine detected using ultra high-density EEG. Brain Commun 2021; 3:fcab061. [PMID: 34258580 PMCID: PMC8269966 DOI: 10.1093/braincomms/fcab061] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Individuals with migraine generally experience photophobia and/or phonophobia during and between migraine attacks. Many different mechanisms have been postulated to explain these migraine phenomena including abnormal patterns of connectivity across the cortex. The results, however, remain contradictory and there is no clear consensus on the nature of the cortical abnormalities in migraine. Here, we uncover alterations in cortical patterns of coherence (connectivity) in interictal migraineurs during the presentation of visual and auditory stimuli and during rest. We used a high-density EEG system, with 128 customized electrode locations, to compare inter- and intra-hemispheric coherence in the interictal period from 17 individuals with migraine (12 female) and 18 age- and gender-matched healthy control subjects. During presentations of visual (vertical grating pattern) and auditory (modulated tone) stimulation which varied in temporal frequency (4 and 6 Hz), and during rest, participants performed a colour detection task at fixation. Analyses included characterizing the inter- and intra-hemisphere coherence between the scalp EEG channels over 2-s time intervals and over different frequency bands at different spatial distances and spatial clusters. Pearson's correlation coefficients were estimated at zero-lag. Repeated measures analyses-of-variance revealed that, relative to controls, migraineurs exhibited significantly (i) faster colour detection performance, (ii) lower spatial coherence of alpha-band activity, for both inter- and intra-hemisphere connections, and (iii) the reduced coherence occurred predominantly in frontal clusters during both sensory conditions, regardless of the stimulation frequency, as well as during the resting-state. The abnormal patterns of EEG coherence in interictal migraineurs during visual and auditory stimuli, as well as at rest (eyes open), may be associated with the cortical hyper-responsivity that is characteristic of abnormal sensory processing in migraineurs.
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Affiliation(s)
- Alireza Chamanzar
- Department of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Sarah M Haigh
- Department of Psychology, University of Nevada, Reno, NV 89557, USA
- Institute for Neuroscience, University of Nevada, Reno, NV 89557, USA
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Pulkit Grover
- Department of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Marlene Behrmann
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
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23
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Coppola G, Di Lorenzo C, Di Lenola D, Serrao M, Pierelli F, Parisi V. Visual Evoked Potential Responses after Photostress in Migraine Patients and Their Correlations with Clinical Features. J Clin Med 2021; 10:jcm10050982. [PMID: 33801187 PMCID: PMC7957878 DOI: 10.3390/jcm10050982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 11/16/2022] Open
Abstract
In the past few years, researchers have detected subtle macular vision abnormalities using different psychophysical experimental tasks in patients with migraine. Recording of visual evoked potential (VEP) after photostress (PS) represents an objective way to verify the integrity of the dynamic properties of macular performance after exposure to intense light. VEPs were recorded before and after PS in 51 patients with migraine (19 with aura (MA) and 22 without aura (MO) between attacks, and 10 recorded during an attack (MI)) and 14 healthy volunteers. All study participants were exposed to 30 s of PS through the use of a 200-watt bulb lamp. The P100 implicit time and N75-P100 amplitude of the baseline VEP were compared with those collected every 20 s up to 200 s after PS. VEP parameters recorded at baseline did not differ between groups. In all groups, the VEP recordings exhibited a significant increase in implicit times and a reduction in amplitude at 20 s after the PS. In migraine, the percentage decrease in amplitudes observed at 20 s after photostress was significantly lower than in healthy volunteers, in both MO and MA patients, but not in MI patients. When data for MO and MA patients were combined, the percentage of amplitude change at 20 s was negatively correlated with the number of days that had elapsed since the last migraine attack, and positive correlated with attack frequency. We showed dynamic changes of recovery of VEP after PS depending on the migraine cycle. This finding, in conjunction with those previously attained with other neuromodulatory interventions using VEPs, leads us to argue that migraine-disease-related dysrhythmic thalamocortical activity precludes amplitude suppression by PS.
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Affiliation(s)
- Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
- Correspondence: ; Tel.: +39-0773-6513337; Fax: +39-0773-651230
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
| | - Davide Di Lenola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy; (C.D.L.); (D.D.L.); (M.S.); (F.P.)
- IRCCS—Neuromed, Headache Center, Via Atinense 18, 86077 Pozzilli, IS, Italy
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De Luca C, Gori S, Mazzucchi S, Dini E, Cafalli M, Siciliano G, Papa M, Baldacci F. Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the Disease. J Clin Med 2021; 10:jcm10040769. [PMID: 33671875 PMCID: PMC7918918 DOI: 10.3390/jcm10040769] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/31/2021] [Accepted: 02/11/2021] [Indexed: 12/15/2022] Open
Abstract
Migraine is a primary headache with high prevalence among the general population, characterized by functional hypersensitivity to both exogenous and endogenous stimuli particularly affecting the nociceptive system. The hyperresponsivity of cortical neurons could be due to a disequilibrium in the excitatory/inhibitory signaling. This study aimed to investigate the anatomo-functional pathway from the retina to the primary visual cortex using visual evoked potentials (VEP). Contrast gain protocol was used in 15 patients diagnosed with migraine without aura (at baseline and after 3 months of topiramate therapy) and 13 controls. A saturation (S) index was assessed to monitor the response of VEP’s amplitude to contrast gain. Non-linear nor monotone growth of VEP (S < 0.95) was defined as supersaturation. A greater percentage of migraine patients (53%) relative to controls (7%) showed this characteristic. A strong inverse correlation was found between the S index and the number of days separating the registration of VEP from the next migraine attack. Moreover, allodynia measured through the Allodynia Symptoms Check-list (ASC-12) correlates with the S index both at baseline and after 3 months of topiramate treatment. Other clinical characteristics were not related to supersaturation. Topiramate therapy, although effective, did not influence electrophysiological parameters suggesting a non-intracortical nor retinal origin of the supersaturation (with possible involvement of relay cells from the lateral geniculate nucleus). In conclusion, the elaboration of visual stimuli and visual cortex activity is different in migraine patients compared to controls. More data are necessary to confirm the potential use of the S index as a biomarker for the migraine cycle (association with the pain-phase) and cortical sensitization (allodynia).
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Affiliation(s)
- Ciro De Luca
- Laboratory of Morphology of Neuronal Network, Department of Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy;
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.G.); (S.M.); (E.D.); (G.S.); (F.B.)
- Correspondence:
| | - Sara Gori
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.G.); (S.M.); (E.D.); (G.S.); (F.B.)
| | - Sonia Mazzucchi
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.G.); (S.M.); (E.D.); (G.S.); (F.B.)
| | - Elisa Dini
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.G.); (S.M.); (E.D.); (G.S.); (F.B.)
| | - Martina Cafalli
- Unit of Neurorehabilitation, Department of Medical Specialties, University Hospital of Pisa, 56126 Pisa, Italy;
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.G.); (S.M.); (E.D.); (G.S.); (F.B.)
| | - Michele Papa
- Laboratory of Morphology of Neuronal Network, Department of Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy;
- SYSBIO Centre of Systems Biology ISBE.ITALY, University of Milano-Bicocca, 20126 Milano, Italy
| | - Filippo Baldacci
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.G.); (S.M.); (E.D.); (G.S.); (F.B.)
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Lim M, Jassar H, Kim DJ, Nascimento TD, DaSilva AF. Differential alteration of fMRI signal variability in the ascending trigeminal somatosensory and pain modulatory pathways in migraine. J Headache Pain 2021; 22:4. [PMID: 33413090 PMCID: PMC7791681 DOI: 10.1186/s10194-020-01210-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/10/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The moment-to-moment variability of resting-state brain activity has been suggested to play an active role in chronic pain. Here, we investigated the regional blood-oxygen-level-dependent signal variability (BOLDSV) and inter-regional dynamic functional connectivity (dFC) in the interictal phase of migraine and its relationship with the attack severity. METHODS We acquired resting-state functional magnetic resonance imaging from 20 migraine patients and 26 healthy controls (HC). We calculated the standard deviation (SD) of the BOLD time-series at each voxel as a measure of the BOLD signal variability (BOLDSV) and performed a whole-brain voxel-wise group comparison. The brain regions showing significant group differences in BOLDSV were used to define the regions of interest (ROIs). The SD and mean of the dynamic conditional correlation between those ROIs were calculated to measure the variability and strength of the dFC. Furthermore, patients' experimental pain thresholds and headache pain area/intensity levels during the migraine ictal-phase were assessed for clinical correlations. RESULTS We found that migraineurs, compared to HCs, displayed greater BOLDSV in the ascending trigeminal spinal-thalamo-cortical pathways, including the spinal trigeminal nucleus, pulvinar/ventral posteromedial (VPM) nuclei of the thalamus, primary somatosensory cortex (S1), and posterior insula. Conversely, migraine patients exhibited lower BOLDSV in the top-down modulatory pathways, including the dorsolateral prefrontal (dlPFC) and inferior parietal (IPC) cortices compared to HCs. Importantly, abnormal interictal BOLDSV in the ascending trigeminal spinal-thalamo-cortical and frontoparietal pathways were associated with the patient's headache severity and thermal pain sensitivity during the migraine attack. Migraineurs also had significantly lower variability and greater strength of dFC within the thalamo-cortical pathway (VPM-S1) than HCs. In contrast, migraine patients showed greater variability and lower strength of dFC within the frontoparietal pathway (dlPFC-IPC). CONCLUSIONS Migraine is associated with alterations in temporal signal variability in the ascending trigeminal somatosensory and top-down modulatory pathways, which may explain migraine-related pain and allodynia. Contrasting patterns of time-varying connectivity within the thalamo-cortical and frontoparietal pathways could be linked to abnormal network integrity and instability for pain transmission and modulation.
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Affiliation(s)
- Manyoel Lim
- Headache and Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, 1011 N. University Ave, Room 1014A, Ann Arbor, MI 48109-1078 USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109 USA
| | - Hassan Jassar
- Headache and Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, 1011 N. University Ave, Room 1014A, Ann Arbor, MI 48109-1078 USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109 USA
| | - Dajung J. Kim
- Headache and Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, 1011 N. University Ave, Room 1014A, Ann Arbor, MI 48109-1078 USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109 USA
| | - Thiago D. Nascimento
- Headache and Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, 1011 N. University Ave, Room 1014A, Ann Arbor, MI 48109-1078 USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109 USA
| | - Alexandre F. DaSilva
- Headache and Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, 1011 N. University Ave, Room 1014A, Ann Arbor, MI 48109-1078 USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109 USA
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Bell T, Stokoe M, Khaira A, Webb M, Noel M, Amoozegar F, Harris AD. GABA and glutamate in pediatric migraine. Pain 2021; 162:300-308. [PMID: 33326202 PMCID: PMC7737876 DOI: 10.1097/j.pain.0000000000002022] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 12/17/2022]
Abstract
Migraine is one of the top 5 most prevalent childhood diseases; however, effective treatment strategies for pediatric migraine are limited. For example, standard adult pharmaceutical therapies are less effective in children and can carry undesirable side effects. To develop more effective treatments, improved knowledge of the biology underlying pediatric migraine is necessary. One theory is that migraine results from an imbalance in cortical excitability. Magnetic resonance spectroscopy (MRS) studies show changes in GABA and glutamate levels (the primary inhibitory and excitatory neurotransmitters in the brain, respectively) in multiple brain regions in adults with migraine; however, they have yet to be assessed in children with migraine. Using MRS and GABA-edited MRS, we show that children (7-13 years) with migraine and aura had significantly lower glutamate levels in the visual cortex compared to controls, the opposite to results seen in adults. In addition, we found significant correlations between metabolite levels and migraine characteristics; higher GABA levels were associated with higher migraine burden. We also found that higher glutamate in the thalamus and higher GABA/Glx ratios in the sensorimotor cortex were associated with duration since diagnosis, i.e., having migraines longer. Lower GABA levels in the sensorimotor cortex were associated with being closer to their next migraine attack. Together, this indicates that GABA and glutamate disturbances occur early in migraine pathophysiology and emphasizes that evidence from adults with migraine cannot be immediately translated to pediatric sufferers. This highlights the need for further mechanistic studies of migraine in children, to aid in development of more effective treatments.
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Affiliation(s)
- Tiffany Bell
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Mehak Stokoe
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Akashroop Khaira
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Megan Webb
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Melanie Noel
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Farnaz Amoozegar
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Ashley D. Harris
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
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Shepherd AJ. Tracking the Migraine Cycle Using Visual Tasks. Vision (Basel) 2020; 4:vision4020023. [PMID: 32365776 PMCID: PMC7355979 DOI: 10.3390/vision4020023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 12/14/2022] Open
Abstract
There are a number of reports that perceptual, electrophysiological and imaging measures can track migraine periodicity. As the electrophysiological and imaging research requires specialist equipment, it has few practical applications. This study sought to track changes in performance on four visual tasks over the migraine cycle. Coherence thresholds were measured for two motion and two orientation tasks. The first part of the study confirmed that the data obtained from an online study produced comparable results to those obtained under controlled laboratory conditions. Thirteen migraine with aura, 12 without aura, and 12 healthy controls participated. The second part of the study showed that thresholds for discriminating vertical coherent motion varied with the migraine cycle for a majority of the participants who tested themselves multiple times (four with aura, seven without). Performance improved two days prior to a migraine attack and remained improved for two days afterwards. This outcome is as expected from an extrapolation of earlier electrophysiological research. This research points to the possibility of developing sensitive visual tests that patients can use at home to predict an impending migraine attack and so take steps to try to abort it or, if it is inevitable, to plan their lives around it.
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Affiliation(s)
- A J Shepherd
- Department of Psychological Sciences, Birkbeck, University of London, London WC1E 7HX, UK
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28
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Coppola G, Di Lenola D, Abagnale C, Ferrandes F, Sebastianelli G, Casillo F, Di Lorenzo C, Serrao M, Evangelista M, Schoenen J, Pierelli F. Short-latency afferent inhibition and somato-sensory evoked potentials during the migraine cycle: surrogate markers of a cycling cholinergic thalamo-cortical drive? J Headache Pain 2020; 21:34. [PMID: 32299338 PMCID: PMC7164277 DOI: 10.1186/s10194-020-01104-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/07/2020] [Indexed: 12/21/2022] Open
Abstract
Background Short-latency afferent inhibition (SAI) consists of motor cortex inhibition induced by sensory afferents and depends on the excitatory effect of cholinergic thalamocortical projections on inhibitory GABAergic cortical networks. Given the electrophysiological evidence for thalamo-cortical dysrhythmia in migraine, we studied SAI in migraineurs during and between attacks and searched for correlations with somatosensory habituation, thalamocortical activation, and clinical features. Methods SAI was obtained by conditioning the transcranial magnetic stimulation-induced motor evoked potential (MEP) with an electric stimulus on the median nerve at the wrist with random stimulus intervals corresponding to the latency of individual somatosensory evoked potentials (SSEP) N20 plus 2, 4, 6, or 8 ms. We recruited 30 migraine without aura patients, 16 between (MO), 14 during an attack (MI), and 16 healthy volunteers (HV). We calculated the slope of the linear regression between the unconditioned MEP amplitude and the 4-conditioned MEPs as a measure of SAI. We also measured SSEP amplitude habituation, and high-frequency oscillations (HFO) as an index of thalamo-cortical activation. Results Compared to HV, SAI, SSEP habituation and early SSEP HFOs were significantly reduced in MO patients between attacks, but enhanced during an attack. There was a positive correlation between degree of SAI and amplitude of early HFOs in HV, but not in MO or MI. Conclusions The migraine cycle-dependent variations of SAI and SSEP HFOs are further evidence that facilitatory thalamocortical activation (of GABAergic networks in the motor cortex for SAI), likely to be cholinergic, is reduced in migraine between attacks, but increased ictally.
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Affiliation(s)
- Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.
| | - Davide Di Lenola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Chiara Abagnale
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Fabio Ferrandes
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Gabriele Sebastianelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Francesco Casillo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Maurizio Evangelista
- Università Cattolica del Sacro Cuore/CIC, Istituto di Anestesiologia, Rianimazione e Terapia del Dolore, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Jean Schoenen
- Headache Research Unit, University Department of Neurology CHR, Citadelle Hospital. University of Liège, Boulevard du Douzième de Ligne 1, 4000, Liège, Belgium
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.,IRCCS - Neuromed, via Atinense, 18, 86077, Pozzilli, IS, Italy
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The function of the lateral inhibitory mechanisms in the somatosensory cortex is normal in patients with chronic migraine. Clin Neurophysiol 2020; 131:880-886. [DOI: 10.1016/j.clinph.2020.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 12/06/2019] [Accepted: 01/01/2020] [Indexed: 01/06/2023]
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Tu Y, Zeng F, Lan L, Li Z, Maleki N, Liu B, Chen J, Wang C, Park J, Lang C, Yujie G, Liu M, Fu Z, Zhang Z, Liang F, Kong J. An fMRI-based neural marker for migraine without aura. Neurology 2020; 94:e741-e751. [PMID: 31964691 PMCID: PMC7176301 DOI: 10.1212/wnl.0000000000008962] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 08/29/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To identify and validate an fMRI-based neural marker for migraine without aura (MwoA) and to examine its association with treatment response. METHODS We conducted cross-sectional studies with resting-state fMRI data from 230 participants and machine learning analyses. In studies 1 through 3, we identified, cross-validated, independently validated, and cross-sectionally validated an fMRI-based neural marker for MwoA. In study 4, we assessed the relationship between the neural marker and treatment responses in migraineurs who received a 4-week real or sham acupuncture treatment, or were waitlisted, in a registered clinical trial. RESULTS In study 1 (n = 116), we identified a neural marker with abnormal functional connectivity within the visual, default mode, sensorimotor, and frontal-parietal networks that could discriminate migraineurs from healthy controls (HCs) with 93% sensitivity and 89% specificity. In study 2 (n = 38), we investigated the generalizability of the marker by applying it to an independent cohort of migraineurs and HCs and achieved 84% sensitivity and specificity. In study 3 (n = 76), we verified the specificity of the marker with new datasets of migraineurs and patients with other chronic pain disorders (chronic low back pain and fibromyalgia) and demonstrated 78% sensitivity and 76% specificity for discriminating migraineurs from nonmigraineurs. In study 4 (n = 116), we found that the changes in the marker responses showed significant correlation with the changes in headache frequency in response to real acupuncture. CONCLUSION We identified an fMRI-based neural marker that captures distinct characteristics of MwoA and can link disease pattern changes to brain changes.
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Affiliation(s)
- Yiheng Tu
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Fang Zeng
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Lei Lan
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Zhengjie Li
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Nasim Maleki
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Bo Liu
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Jun Chen
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Chenchen Wang
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Joel Park
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Courtney Lang
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Gao Yujie
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Mailan Liu
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Zening Fu
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Zhiguo Zhang
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Fanrong Liang
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China
| | - Jian Kong
- From the Department of Psychiatry (Y.T., N.M., J.P., C.L., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Third Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Sichuan; Department of Radiology (B.L., J.C.), Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Center for Complementary and Integrative Medicine (C.W.), Division of Rheumatology, Tufts Medical Center, Boston, MA; Traditional Chinese Medicine School (G.Y), Ningxia Medical University, Yinchuan; The Acupuncture and Tuina School (M.L.), Hunan University of Traditional Chinese Medicine, Changsha, China; The Mind Research Network (Z.F.), Albuquerque, NM; and School of Biomedical Engineering (Z.Z.), Health Science Center, Shenzhen University, China.
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Coppola G, Parisi V, Di Renzo A, Pierelli F. Cortical pain processing in migraine. J Neural Transm (Vienna) 2019; 127:551-566. [DOI: 10.1007/s00702-019-02089-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/28/2019] [Indexed: 12/17/2022]
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Haigh SM, Chamanzar A, Grover P, Behrmann M. Cortical Hyper‐Excitability in Migraine in Response to Chromatic Patterns. Headache 2019; 59:1773-1787. [DOI: 10.1111/head.13620] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Sarah M. Haigh
- Department of Psychology, Institute for Neuroscience University of Nevada Reno NV USA
- Department of Psychology, Center for the Neural Basis of Cognition Carnegie Mellon University Pittsburgh PA USA
| | - Alireza Chamanzar
- Department of Electrical and Computer Engineering Carnegie Mellon University Pittsburgh PA USA
| | - Pulkit Grover
- Department of Electrical and Computer Engineering Carnegie Mellon University Pittsburgh PA USA
| | - Marlene Behrmann
- Department of Psychology, Center for the Neural Basis of Cognition Carnegie Mellon University Pittsburgh PA USA
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Mykland MS, Bjørk MH, Stjern M, Omland PM, Uglem M, Sand T. Fluctuations of sensorimotor processing in migraine: a controlled longitudinal study of beta event related desynchronization. J Headache Pain 2019; 20:77. [PMID: 31288756 PMCID: PMC6734210 DOI: 10.1186/s10194-019-1026-8] [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: 01/24/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
Background The migraine brain seems to undergo cyclic fluctuations of sensory processing. For instance, during the preictal phase, migraineurs experience symptoms and signs of altered pain perception as well as other well-known premonitory CNS-symptoms. In the present study we measured EEG-activation to non-painful motor and sensorimotor tasks in the different phases of the migraine cycle by longitudinal measurements of beta event related desynchronization (beta-ERD). Methods We recorded electroencephalography (EEG) of 41 migraine patients and 31 healthy controls. Each subject underwent three EEG recordings on three different days with classification of each EEG recording according to the actual migraine phase. During each recording, subjects performed one motor and one sensorimotor task with the flexion-extension movement of the right wrist. Results Migraine patients had significantly increased beta-ERD and higher baseline beta power at the contralateral C3 electrode overlying the primary sensorimotor cortex in the preictal phase compared to the interictal phase. We found no significant differences in beta-ERD or baseline beta power between interictal migraineurs and controls. Conclusion Increased preictal baseline beta activity may reflect a decrease in pre-activation in the sensorimotor cortex. Altered pre-activation may lead to changes in thresholds for inhibitory responses and increased beta-ERD response, possibly reflecting a generally increased preictal cortical responsivity in migraine. Cyclic fluctuations in the activity of second- and third-order afferent somatosensory neurons, and their associated cortical and/or thalamic interneurons, may accordingly also be a central part of the migraine pathophysiology.
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Affiliation(s)
- Martin Syvertsen Mykland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
| | - Marte Helene Bjørk
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Marit Stjern
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Petter Moe Omland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Martin Uglem
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Trond Sand
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
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Alaydin HC, Vuralli D, Keceli Y, Can E, Cengiz B, Bolay H. Reduced Short‐Latency Afferent Inhibition Indicates Impaired Sensorimotor Integrity During Migraine Attacks. Headache 2019; 59:906-914. [DOI: 10.1111/head.13554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Halil Can Alaydin
- Department of Neurology, Faculty of Medicine Gazi University Ankara Turkey
| | - Doga Vuralli
- Department of Neurology, Faculty of Medicine Gazi University Ankara Turkey
- Division of Algology, Department of Neurology, Faculty of Medicine Gazi University Ankara Turkey
| | - Yeliz Keceli
- Department of Neurology, Faculty of Medicine Gazi University Ankara Turkey
| | - Ezgi Can
- Department of Neurology, Faculty of Medicine Gazi University Ankara Turkey
| | - Bulent Cengiz
- Department of Neurology, Faculty of Medicine Gazi University Ankara Turkey
- Division of Clinical Neurophysiology, Department of Neurology, Faculty of Medicine Gazi University Ankara Turkey
| | - Hayrunnisa Bolay
- Department of Neurology, Faculty of Medicine Gazi University Ankara Turkey
- Division of Algology, Department of Neurology, Faculty of Medicine Gazi University Ankara Turkey
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Tu Y, Fu Z, Zeng F, Maleki N, Lan L, Li Z, Park J, Wilson G, Gao Y, Liu M, Calhoun V, Liang F, Kong J. Abnormal thalamocortical network dynamics in migraine. Neurology 2019; 92:e2706-e2716. [PMID: 31076535 DOI: 10.1212/wnl.0000000000007607] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 02/01/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the dynamic functional connectivity of thalamocortical networks in interictal migraine patients and whether clinical features are associated with abnormal connectivity. METHODS We investigated dynamic functional network connectivity (dFNC) of the migraine brain in 89 interictal migraine patients and 70 healthy controls. We focused on the temporal properties of thalamocortical connectivity using sliding window cross-correlation, clustering state analysis, and graph-theory methods. Relationships between clinical symptoms and abnormal dFNC were evaluated using a multivariate linear regression model. RESULTS Five dFNC brain states were identified to characterize and compare dynamic functional connectivity patterns. We demonstrated that migraineurs spent more time in a strongly interconnected between-network state, but they spent less time in a sparsely connected state. Interestingly, we found that abnormal posterior thalamus (pulvinar nucleus) dFNC with the visual cortex and the precuneus were significantly correlated with headache frequency of migraine. Further topologic measures revealed that migraineurs had significantly lower efficiency of information transfer in both global and local dFNC. CONCLUSION Our results demonstrated a transient pathologic state with atypical thalamocortical connectivity in migraineurs and extended current findings regarding abnormal thalamocortical networks and dysrhythmia in migraine.
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Affiliation(s)
- Yiheng Tu
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Zening Fu
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Fang Zeng
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Nasim Maleki
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Lei Lan
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Zhengjie Li
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Joel Park
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Georgia Wilson
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Yujie Gao
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Mailan Liu
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Vince Calhoun
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China
| | - Fanrong Liang
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China.
| | - Jian Kong
- From the Department of Psychiatry (Y.T., N.M., J.P., G.W., J.K.), Massachusetts General Hospital and Harvard Medical School, Charlestown; The Mind Research Network (Z.F., V.C.), Albuquerque, NM; Acupuncture and Tuina School/3rd Teaching Hospital (F.Z., L.L., Z.L., F.L.), Chengdu University of Traditional Chinese Medicine, Chengdu; Traditional Chinese Medicine School (Y.G.), Ningxia Medical University, Yinchuan; and The Acupuncture and Tuina School (M.L.), Hunan University of Chinese Medicine, Changsha, China.
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Zhu B, Coppola G, Shoaran M. Migraine classification using somatosensory evoked potentials. Cephalalgia 2019; 39:1143-1155. [DOI: 10.1177/0333102419839975] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective The automatic detection of migraine states using electrophysiological recordings may play a key role in migraine diagnosis and early treatment. Migraineurs are characterized by a deficit of habituation in cortical information processing, causing abnormal changes of somatosensory evoked potentials. Here, we propose a machine learning approach to utilize somatosensory evoked potential-based biomarkers for migraine classification in a noninvasive setting. Methods Forty-two migraine patients, including 29 interictal and 13 ictal, were recruited and compared with 15 healthy volunteers of similar age and gender distribution. The right median nerve somatosensory evoked potentials were collected from all subjects. State-of-the-art machine learning algorithms including random forest, extreme gradient-boosting trees, support vector machines, K-nearest neighbors, multilayer perceptron, linear discriminant analysis, and logistic regression were used for classification and were built upon somatosensory evoked potential features in time and frequency domains. A feature selection method was employed to assess the contribution of features and compare it with previous clinical findings, and to build an optimal feature set by removing redundant features. Results Using a set of relevant features and different machine learning models, accuracies ranging from 51.2% to 72.4% were achieved for the healthy volunteers-ictal-interictal classification task. Following model and feature selection, we successfully separated the three groups of subjects with an accuracy of 89.7% for the healthy volunteers-ictal, 88.7% for healthy volunteers-interictal, 80.2% for ictal-interictal, and 73.3% for healthy volunteers-ictal-interictal classification tasks, respectively. Conclusion Our proposed model suggests the potential use of somatosensory evoked potentials as a prominent and reliable signal in migraine classification. This non-invasive somatosensory evoked potential-based classification system offers the potential to reliably separate migraine patients in ictal and interictal states from healthy controls.
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Affiliation(s)
- Bingzhao Zhu
- School of Electrical and Computer Engineering, Cornell University, Ithaca, NY, USA
- School of Applied and Engineering Physics, Cornell University, Ithaca, NY, USA
| | - Gianluca Coppola
- Research Unit of Neurophysiology of Vision and Neurophthalmology, IRCCS-Fondazione Bietti, Rome, Italy
| | - Mahsa Shoaran
- School of Electrical and Computer Engineering, Cornell University, Ithaca, NY, USA
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Viganò A, Toscano M, Puledda F, Di Piero V. Treating Chronic Migraine With Neuromodulation: The Role of Neurophysiological Abnormalities and Maladaptive Plasticity. Front Pharmacol 2019; 10:32. [PMID: 30804782 PMCID: PMC6370938 DOI: 10.3389/fphar.2019.00032] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 01/14/2019] [Indexed: 12/20/2022] Open
Abstract
Chronic migraine (CM) is the most disabling form of migraine, because pharmacological treatments have low efficacy and cumbersome side effects. New evidence has shown that migraine is primarily a disorder of brain plasticity and migraine chronification depends on a maladaptive process favoring the development of a brain state of hyperexcitability. Due to the ability to induce plastic changes in the brain, researchers started to look at Non-Invasive Brain Stimulation (NIBS) as a possible therapeutic option in migraine field. On one side, NIBS techniques induce changes of neural plasticity that outlast the period of the stimulation (a fundamental prerequisite of a prophylactic migraine treatment, concurrently they allow targeting neurophysiological abnormalities that contribute to the transition from episodic to CM. The action may thus influence not only the cortex but also brainstem and diencephalic structures. Plus, NIBS is not burdened by serious medication side effects and drug–drug interactions. Although the majority of the studies reported somewhat beneficial effects in migraine patients, no standard intervention has been defined. This may be due to methodological differences regarding the used techniques (e.g., transcranial magnetic stimulation, transcranial direct current stimulation), the brain regions chosen as targets, and the stimulation types (e.g., the use of inhibitory and excitatory stimulations on the basis of opposite rationales), and an intrinsic variability of stimulation effect. Hence, it is difficult to draw a conclusion on the real effect of neuromodulation in migraine. In this article, we first will review the definition and mechanisms of brain plasticity, some neurophysiological hallmarks of migraine, and migraine chronification-related (dys)plasticity. Secondly, we will review available results from therapeutic and physiological studies using neuromodulation in CM. Lastly we will discuss the results obtained in these preventive trials in the light of a possible effect on brain plasticity.
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Affiliation(s)
- Alessandro Viganò
- Headache Research Centre and Neurocritical Care Unit, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.,Molecular and Cellular Networks Lab, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Toscano
- Headache Research Centre and Neurocritical Care Unit, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.,Department of Neurology, Fatebenefratelli Hospital, Rome, Italy
| | - Francesca Puledda
- Headache Group, Department of Basic and Clinical Neuroscience, King's College Hospital, King's College London, London, United Kingdom
| | - Vittorio Di Piero
- Headache Research Centre and Neurocritical Care Unit, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.,University Consortium for Adaptive Disorders and Head Pain - UCADH, Pavia, Italy
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Russo A, Coppola G, Pierelli F, Parisi V, Silvestro M, Tessitore A, Tedeschi G. Pain Perception and Migraine. Front Neurol 2018; 9:576. [PMID: 30116215 PMCID: PMC6082953 DOI: 10.3389/fneur.2018.00576] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/26/2018] [Indexed: 12/20/2022] Open
Abstract
Background: It is well-known that both inter- and intra-individual differences exist in the perception of pain; this is especially true in migraine, an elusive pain disorder of the head. Although electrophysiology and neuroimaging techniques have greatly contributed to a better understanding of the mechanisms involved in migraine during recent decades, the exact characteristics of pain threshold and pain intensity perception remain to be determined, and continue to be a matter of debate. Objective: The aim of this review is to provide a comprehensive overview of clinical, electrophysiological, and functional neuroimaging studies investigating changes during various phases of the so-called “migraine cycle” and in different migraine phenotypes, using pain threshold and pain intensity perception assessments. Methods: A systematic search for qualitative studies was conducted using search terms “migraine,” “pain,” “headache,” “temporal summation,” “quantitative sensory testing,” and “threshold,” alone and in combination (subject headings and keywords). The literature search was updated using the additional keywords “pain intensity,” and “neuroimaging” to identify full-text papers written in English and published in peer-reviewed journals, using PubMed and Google Scholar databases. In addition, we manually searched the reference lists of all research articles and review articles. Conclusion: Consistent data indicate that pain threshold is lower during the ictal phase than during the interictal phase of migraine or healthy controls in response to pressure, cold and heat stimuli. There is evidence for preictal sub-allodynia, whereas interictal results are conflicting due to either reduced or no observed difference in pain threshold. On the other hand, despite methodological limitations, converging observations support the concept that migraine attacks may be characterized by an increased pain intensity perception, which normalizes between episodes. Nevertheless, future studies are required to longitudinally evaluate a large group of patients before and after pharmacological and non-pharmacological interventions to investigate phases of the migraine cycle, clinical parameters of disease severity and chronic medication usage.
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Affiliation(s)
- Antonio Russo
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences, Headache Center, University of Campania "Luigi Vanvitelli, ", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Gianluca Coppola
- Research Unit of Neurophysiology of Vision and Neuro-Ophthalmology, G. B. Bietti Foundation-IRCCS, Rome, Italy
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Vincenzo Parisi
- Research Unit of Neurophysiology of Vision and Neuro-Ophthalmology, G. B. Bietti Foundation-IRCCS, Rome, Italy
| | - Marcello Silvestro
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences, Headache Center, University of Campania "Luigi Vanvitelli, ", Naples, Italy
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences, Headache Center, University of Campania "Luigi Vanvitelli, ", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Gioacchino Tedeschi
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences, Headache Center, University of Campania "Luigi Vanvitelli, ", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli,", Naples, Italy.,Institute for Diagnosis and Care "Hermitage Capodimonte," Naples, Italy
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Marucco E, Lisicki M, Magis D. Electrophysiological Characteristics of the Migraine Brain: Current Knowledge and Perspectives. Curr Med Chem 2018; 26:6222-6235. [PMID: 29956611 DOI: 10.2174/0929867325666180627130811] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/16/2018] [Accepted: 03/27/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Despite pain being its most prominent feature, migraine is primarily a disorder of sensory processing. Electrophysiology-based research in the field has consistently developed over the last fifty years. OBJECTIVE To summarize the current knowledge on the electrophysiological characteristics of the migraine brain, and discuss perspectives. METHODS We critically reviewed the literature on the topic to present and discuss articles selected on the basis of their significance and/or novelty. RESULTS Physiologic fluctuations within time, between-subject differences, and methodological issues account as major limitations of electrophysiological research in migraine. Nonetheless, several abnormalities revealed through different approaches have been described in the literature. Altogether, these results are compatible with an abnormal state of sensory processing. PERSPECTIVES The greatest contribution of electrophysiological testing in the future will most probably be the characterization of sub-groups of migraine patients sharing specific electrophysiological traits. This should serve as strategy towards personalized migraine treatment. Incorporation of novel methods of analysis would be worthwhile.
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Affiliation(s)
- Erica Marucco
- University of Liege - Headache Research Unit Liege, Liege, Belgium
| | - Marco Lisicki
- University of Liege - Headache Research Unit Liege, Liege, Belgium
| | - Delphine Magis
- Centre Hospitalier Universitaire de Liege - Headache Research Unit Liege, Liege, Belgium
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40
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Abstract
Migraine is a chronic paroxysmal neurological disorder characterised by multiphase attacks of head pain and a myriad of neurological symptoms. The underlying genetic and biological underpinnings and neural networks involved are coming sharply into focus. This progress in the fundamental understanding of migraine has led to novel, mechanism-based and disease-specific therapeutics. In this Seminar, the clinical features and neurobiology of migraine are reviewed, evidence to support available treatment options is provided, and emerging drug, device, and biological therapies are discussed.
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Comparison of somatosensory cortex excitability between migraine and “strict-criteria” tension-type headache: a magnetoencephalographic study. Pain 2018; 159:793-803. [DOI: 10.1097/j.pain.0000000000001151] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Mykland MS, Bjørk MH, Stjern M, Sand T. Alterations in post-movement beta event related synchronization throughout the migraine cycle: A controlled, longitudinal study. Cephalalgia 2017; 38:718-729. [PMID: 28478712 DOI: 10.1177/0333102417709011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The migraine brain is believed to have altered cortical excitability compared to controls and between migraine cycle phases. Our aim was to evaluate post-activation excitability through post-movement beta event related synchronization (PMBS) in sensorimotor cortices with and without sensory discrimination. Subjects and methods We recorded EEG of 41 migraine patients and 31 healthy controls on three different days with classification of days in relation to migraine phases. During each recording, subjects performed one motor and one sensorimotor task with the right wrist. Controls and migraine patients in the interictal phase were compared with repeated measures (R-) ANOVA and two sample Student's t-test. Migraine phases were compared to the interictal phase with R-ANOVA and paired Student's t-test. Results The difference between PMBS at the contralateral and ipsilateral sensorimotor cortex was altered throughout the migraine cycle. Compared to the interictal phase, we found decreased PMBS at the ipsilateral sensorimotor cortex in the ictal phase and increased PMBS in the preictal phase. Lower ictal PMBS was found in bilateral sensorimotor cortices in patients with right side headache predominance. Conclusion The cyclic changes of PMBS in migraine patients may indicate that a dysfunction in deactivation and interhemispheric inhibition of the sensorimotor cortex is involved in the migraine attack cascade.
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Affiliation(s)
- Martin Syvertsen Mykland
- 1 Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Marte Helene Bjørk
- 2 Department of Clinical Medicine, University of Bergen, Bergen, Norway
- 3 Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Marit Stjern
- 1 Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- 4 Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Trond Sand
- 1 Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- 4 Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
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43
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The sensorimotor network dysfunction in migraineurs without aura: a resting-state fMRI study. J Neurol 2017; 264:654-663. [PMID: 28154971 DOI: 10.1007/s00415-017-8404-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 01/13/2017] [Accepted: 01/23/2017] [Indexed: 01/03/2023]
Abstract
Migraine is a common recurrent neurological disorder combining nausea, vomiting, and hypersensitivities to visual, auditory, olfactory and somatosensory stimuli. However, the dysfunction of the sensorimotor network in migraineurs has not been well clarified. In the present study, we evaluated the dysfunction of the sensorimotor network in 30 migraineurs without aura and in 31 controls by combining regional homogeneity (ReHo), amplitudes of low-frequency fluctuation (ALFF) and degree centrality (DC) analysis methods based on resting-state fMRI. A seed-based functional connectivity (FC) analysis was used to investigate whether the dysfunctional areas within the sensorimotor network exhibited abnormal FC with other brain areas. Compared to the controls, the migraineurs without aura exhibited significantly smaller ReHo, ALFF and DC values in the primary somatosensory cortex (S1) and right premotor cortex (PMC). The migraineurs showed weaker FC between the S1 and brain areas within the pain intensity and spatial discrimination pathways and trigemino-thalamo-cortical nociceptive pathway. We proposed that the dysfunction of the S1 and PMC and the decreased FC between the S1 and brain areas in migraineurs without aura may disrupt the discrimination of sensory features of pain and affect nociception pathways, and would be involved in the dysfunctional mechanism in migraine.
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Cortese F, Coppola G, Di Lenola D, Serrao M, Di Lorenzo C, Parisi V, Pierelli F. Excitability of the motor cortex in patients with migraine changes with the time elapsed from the last attack. J Headache Pain 2017; 18:2. [PMID: 28063106 PMCID: PMC5218956 DOI: 10.1186/s10194-016-0712-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 12/09/2016] [Indexed: 12/03/2022] Open
Abstract
Background Motor-evoked potentials (MEPs) produced by single-pulse transcranial magnetic stimulation (TMS) of the motor cortex can be an objective measure of cortical excitability. Previously, MEP thresholds were found to be normal, increased, or even reduced in patients with migraine. In the present study, we determined whether the level of cortical excitability changes with the time interval from the last migraine attack, thereby accounting for the inconsistencies in previous reports. Methods Twenty-six patients with untreated migraine without aura (MO) underwent a MEP study between attacks. Their data were then compared to the MEP data collected from a group of 24 healthy volunteers (HVs). During the experiment, the TMS figure-of-eight coil was positioned over the left motor area. After identifying the resting motor threshold (RMT), we delivered 10 single TMS pulses (rate: 0.1 Hz, intensity: 120% of the RMT) and averaged the resulting MEP amplitudes. Results The mean RMTs and MEP amplitudes were not significantly different between the MO and HV groups. In patients with MO, the RMTs were negatively correlated with the number of days elapsed since the last migraine attack (rho = -0.404, p = 0.04). Conclusion Our results suggest that the threshold for evoking MEPs is influenced by the proximity of an attack; specifically, the threshold is lower when a long time interval has passed after an attack, and is higher (within the range of normative values) when measured close to an attack. These dynamic RMT variations resemble those we reported previously for visual and somatosensory evoked potentials and may represent time-dependent plastic changes in brain excitability in relation to the migraine cycle.
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Affiliation(s)
- Francesca Cortese
- Department of Medico-Surgical Sciences and Biotechnologies, 'Sapienza' University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.
| | - Gianluca Coppola
- G. B. Bietti Foundation IRCCS, Research Unit of Neurophysiology of Vision and Neuro-Ophthalmology, Rome, Italy
| | - Davide Di Lenola
- Department of Medico-Surgical Sciences and Biotechnologies, 'Sapienza' University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, 'Sapienza' University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | | | - Vincenzo Parisi
- G. B. Bietti Foundation IRCCS, Research Unit of Neurophysiology of Vision and Neuro-Ophthalmology, Rome, Italy
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, 'Sapienza' University of Rome Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.,INM Neuromed IRCCS, Pozzilli, (IS), Italy
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Coppola G, Di Renzo A, Tinelli E, Lepre C, Di Lorenzo C, Di Lorenzo G, Scapeccia M, Parisi V, Serrao M, Colonnese C, Schoenen J, Pierelli F. Thalamo-cortical network activity between migraine attacks: Insights from MRI-based microstructural and functional resting-state network correlation analysis. J Headache Pain 2016; 17:100. [PMID: 27778244 PMCID: PMC5078119 DOI: 10.1186/s10194-016-0693-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 10/18/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Resting state magnetic resonance imaging allows studying functionally interconnected brain networks. Here we were aimed to verify functional connectivity between brain networks at rest and its relationship with thalamic microstructure in migraine without aura (MO) patients between attacks. METHODS Eighteen patients with untreated MO underwent 3 T MRI scans and were compared to a group of 19 healthy volunteers (HV). We used MRI to collect resting state data among two selected resting state networks, identified using group independent component (IC) analysis. Fractional anisotropy (FA) and mean diffusivity (MD) values of bilateral thalami were retrieved from a previous diffusion tensor imaging study on the same subjects and correlated with resting state ICs Z-scores. RESULTS In comparison to HV, in MO we found significant reduced functional connectivity between the default mode network and the visuo-spatial system. Both HV and migraine patients selected ICs Z-scores correlated negatively with FA values of the thalamus bilaterally. CONCLUSIONS The present results are the first evidence supporting the hypothesis that an abnormal resting within networks connectivity associated with significant differences in baseline thalamic microstructure could contribute to interictal migraine pathophysiology.
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Affiliation(s)
- Gianluca Coppola
- Research Unit of Neurophysiology of Vision and Neurophthalmology, G.B. Bietti Foundation-IRCCS, Via Livenza 3, 00198, Rome, Italy.
| | - Antonio Di Renzo
- Research Unit of Neurophysiology of Vision and Neurophthalmology, G.B. Bietti Foundation-IRCCS, Via Livenza 3, 00198, Rome, Italy
| | - Emanuele Tinelli
- Department of Neurology and Psychiatry, Neuroradiology Section, "Sapienza" University of Rome, Rome, Italy
| | - Chiara Lepre
- Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, "Sapienza" University of Rome, Rome, Italy
| | | | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology, Psychiatric Clinic, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Scapeccia
- Department of Neurology and Psychiatry, Neuroradiology Section, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Parisi
- Research Unit of Neurophysiology of Vision and Neurophthalmology, G.B. Bietti Foundation-IRCCS, Via Livenza 3, 00198, Rome, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Latina, Italy
| | - Claudio Colonnese
- Department of Neurology and Psychiatry, Neuroradiology Section, "Sapienza" University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, (IS), Italy
| | - Jean Schoenen
- Headache Research Unit, Department of Neurology-CHR Citadelle, University of Liège, Liège, Belgium
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Latina, Italy
- IRCCS Neuromed, Pozzilli, (IS), Italy
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Porcaro C, Di Lorenzo G, Seri S, Pierelli F, Tecchio F, Coppola G. Impaired brainstem and thalamic high-frequency oscillatory EEG activity in migraine between attacks. Cephalalgia 2016; 37:915-926. [DOI: 10.1177/0333102416657146] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction We investigated whether interictal thalamic dysfunction in migraine without aura (MO) patients is a primary determinant or the expression of its functional disconnection from proximal or distal areas along the somatosensory pathway. Methods Twenty MO patients and twenty healthy volunteers (HVs) underwent an electroencephalographic (EEG) recording during electrical stimulation of the median nerve at the wrist. We used the functional source separation algorithm to extract four functionally constrained nodes (brainstem, thalamus, primary sensory radial, and primary sensory motor tangential parietal sources) along the somatosensory pathway. Two digital filters (1–400 Hz and 450–750 Hz) were applied in order to extract low- (LFO) and high- frequency (HFO) oscillatory activity from the broadband signal. Results Compared to HVs, patients presented significantly lower brainstem (BS) and thalamic (Th) HFO activation bilaterally. No difference between the two cortical HFO as well as in LFO peak activations between the two groups was seen. The age of onset of the headache was positively correlated with HFO power in the right brainstem and thalamus. Conclusions This study provides evidence for complex dysfunction of brainstem and thalamocortical networks under the control of genetic factors that might act by modulating the severity of migraine phenotype.
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Affiliation(s)
- Camillo Porcaro
- LET’S-ISTC-CNR, Ospedale Fatebenefratelli, Isola Tiberina, Rome, Italy
- Movement Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology, Psychiatric Chair, Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
- Psychiatry and Clinical Psychology Unit, Department of Neurosciences, Fondazione Policlinico ‘Tor Vergata’, Rome, Italy
| | - Stefano Seri
- The Wellcome Trust Laboratory for MEG Studies, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Francesco Pierelli
- Sapienza University of Rome Polo Pontino, Latina and IRCCS Neuromed, Pozzilli (IS), Italy
| | - Franca Tecchio
- LET’S-ISTC-CNR, Ospedale Fatebenefratelli, Isola Tiberina, Rome, Italy
| | - Gianluca Coppola
- G.B. Bietti Foundation IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome, Italy
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Di Lorenzo C, Coppola G, Bracaglia M, Di Lenola D, Evangelista M, Sirianni G, Rossi P, Di Lorenzo G, Serrao M, Parisi V, Pierelli F. Cortical functional correlates of responsiveness to short-lasting preventive intervention with ketogenic diet in migraine: a multimodal evoked potentials study. J Headache Pain 2016; 17:58. [PMID: 27245682 PMCID: PMC4887398 DOI: 10.1186/s10194-016-0650-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/27/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Here, we aim to identify cortical electrofunctional correlates of responsiveness to short-lasting preventiveintervention with ketogenic diet (KD) in migraine. METHODS Eighteen interictal migraineurs underwent visual (VEPs) and median nerve somatosensory (SSEPs) evokedpotentials before and after 1 month of KD during ketogenesis. We measured VEPs N1-P1 and SSEPs N20-P25 amplitudes respectively in six and in two sequential blocks of 100 sweeps as well as habituation as theslope of the linear regression between block 1 to 6 for VEPs or between 1 to 2 for SSEPs. RESULTS After 1-month of KD, a significant reduction in the mean attack frequency and duration was observed (all P< 0.001). The KD did not change the 1st SSEP and VEP block of responses, but significantly inducednormalization of the interictally reduced VEPs and SSEPs (all p < 0.01) habituation during the subsequentblocks. CONCLUSIONS KD could restore normal EPs habituation curves during stimulus repetition without significantly changing theearly amplitude responses. Thus, we hypothesize that KD acts on habituation regulating the balancebetween excitation and inhibition at the cortical level.
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Affiliation(s)
| | - Gianluca Coppola
- Department of Neurophysiology of Vision and Neurophthalmology, G. B. Bietti Foundation-IRCCS, Rome, Italy
| | - Martina Bracaglia
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Latina, Italy
| | - Davide Di Lenola
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Latina, Italy
| | - Maurizio Evangelista
- Istituto di Anestesiologia, Rianimazione e Terapia del Dolore, Università Cattolica del Sacro Cuore/CIC, Rome, Italy
| | - Giulio Sirianni
- Delle Medical Center, Wellness and Dietary Medicine, Rome, Italy
| | - Paolo Rossi
- INI, Headache Clinic, Grottaferrata, (RM), Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome "Tor Vergata", Laboratory of Psychophysiology, Rome, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Latina, Italy
| | - Vincenzo Parisi
- Department of Neurophysiology of Vision and Neurophthalmology, G. B. Bietti Foundation-IRCCS, Rome, Italy
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome Polo Pontino, Latina, Italy.,INM Neuromed IRCCS, Pozzilli, (IS), Italy
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48
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Antal A. On the way to understanding migraine. Cephalalgia 2015; 36:725-6. [PMID: 26460337 DOI: 10.1177/0333102415610877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Andrea Antal
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Germany
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