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Deodato M, Granato A, Buoite Stella A, Martini M, Marchetti E, Lise I, Galmonte A, Murena L, Manganotti P. Efficacy of a dual task protocol on neurophysiological and clinical outcomes in migraine: a randomized control trial. Neurol Sci 2024; 45:4015-4026. [PMID: 38806882 PMCID: PMC11255006 DOI: 10.1007/s10072-024-07611-8] [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: 04/02/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024]
Abstract
The main aim of this study was to investigate the efficacy of a dual task protocol in people with episodic migraine with respect to both active exercises only and cognitive task only treatments, concerning some neurophysiological and clinical outcomes. A randomized control trial was adopted in people with episodic migraine without aura. Some neurophysiological and clinical outcomes were collected (t0): resting motor threshold (rMT), short intracortical inhibition (SICI) and facilitation (ICF), pressure pain threshold (PPT), trail making test (TMT), frontal assessment battery (FAB), headache-related disability (MIDAS) and headache parameters. Then, participants were randomized into three groups: active exercise only (n = 10), cognitive task only (n = 10) and dual task protocol (n = 10). After 3 months of each treatment and after 1-month follow-up the same neurophysiological and clinical outcomes were revaluated. A significant time x group effect was only found for the trapezius muscle (p = 0.012, pη2 = 0.210), suggesting that PPT increased significantly only in active exercise and dual task protocol groups. A significant time effect was found for rMT (p < 0.001, pη2 = 0.473), MIDAS (p < 0.001, pη2 = 0.426), TMT (p < 0.001, pη2 = 0.338) and FAB (p < 0.001, pη2 = 0.462). A repeated measures ANOVA for SICI at 3 ms highlighted a statistically significant time effect for the dual task group (p < 0.001, pη2 = 0.629), but not for the active exercises group (p = 0.565, pη2 = 0.061), and for the cognitive training (p = 0.357, pη2 = 0.108). The dual task protocol seems to have a more evident effect on both habituation and sensitization outcomes than the two monotherapies taken alone in people with migraine.
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Affiliation(s)
- Manuela Deodato
- Department of Life Sciences, University of Trieste, Trieste, Italy.
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
- Azienda Sanitaria Universitaria Giuliano Isontina, Via Pascoli 31, 34100, Trieste, Italy.
| | - Antonio Granato
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Azienda Sanitaria Universitaria Giuliano Isontina, Via Pascoli 31, 34100, Trieste, Italy
| | - Alex Buoite Stella
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Azienda Sanitaria Universitaria Giuliano Isontina, Strada Di Fiume 447, 34149, Trieste, Italy
| | - Miriam Martini
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Azienda Sanitaria Universitaria Giuliano Isontina, Via Pascoli 31, 34100, Trieste, Italy
| | - Enrico Marchetti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Ilaria Lise
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Alessandra Galmonte
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Luigi Murena
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Azienda Sanitaria Universitaria Giuliano Isontina, Via Pascoli 31, 34100, Trieste, Italy
| | - Paolo Manganotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Azienda Sanitaria Universitaria Giuliano Isontina, Via Pascoli 31, 34100, Trieste, Italy
- Azienda Sanitaria Universitaria Giuliano Isontina, Strada Di Fiume 447, 34149, Trieste, Italy
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Manganotti P, Deodato M, D’Acunto L, Biaduzzini F, Garascia G, Granato A. Effects of Anti-CGRP Monoclonal Antibodies on Neurophysiological and Clinical Outcomes: A Combined Transcranial Magnetic Stimulation and Algometer Study. Neurol Int 2024; 16:673-688. [PMID: 39051212 PMCID: PMC11270432 DOI: 10.3390/neurolint16040051] [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: 05/17/2024] [Revised: 06/16/2024] [Accepted: 06/19/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND the aim of this study was to investigate the neurophysiological effect of anti-CGRP monoclonal antibodies on central and peripheral levels in migraine patients. METHODS An observational cohort study in patients with migraine was performed. All subjects underwent Single-Pulse and Paired-Pulse Transcranial Magnetic Stimulation, as well as a Pressure Pain Threshold assessment. The same protocol was repeated three and four months after the first injection of anti-CGRP monoclonal antibodies. RESULTS A total of 11 patients with a diagnosis of migraine and 11 healthy controls were enrolled. The main findings of this study are the significant effects of anti-CGRP mAb treatment on the TMS parameters of intracortical inhibition and the rise in the resting motor threshold in our group of patients affected by resistant migraine. The clinical effect of therapy on migraine is associated with the increase in short-interval intracortical inhibition (SICI), resting motor threshold (RMT), and Pressure Pain Threshold (PPT). In all patients, all clinical headache parameters improved significantly 3 months after the first injection of mAbs and the improvement was maintained at the 1-month follow-up. At baseline, migraineurs and HCs had significant differences in all TMS parameters and in PPT, while at follow-up assessment, no differences were observed on RMT, SICI, and PPT between the two groups. After anti-CGRP monoclonal antibody injection, a significant increase in the intracortical inhibition, in the motor threshold, and in the Pressure Pain Threshold in critical head areas was observed in patients with migraine, which was related to significant clinical benefits. CONCLUSIONS Anti-CGRP monoclonal antibodies improved clinical and neurophysiological outcomes, reflecting a normalization of cortical excitability and peripheral and central sensitization. By directly acting on the thalamus or hypothalamus and indirectly on the trigeminocervical complex, treatment with anti-CGRP monoclonal antibodies may modulate central sensorimotor excitability and peripheral sensitization pain.
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Affiliation(s)
- Paolo Manganotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy; (P.M.); (L.D.); (F.B.); (G.G.); (A.G.)
- Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), 34128 Trieste, Italy
| | - Manuela Deodato
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy; (P.M.); (L.D.); (F.B.); (G.G.); (A.G.)
- Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), 34128 Trieste, Italy
| | - Laura D’Acunto
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy; (P.M.); (L.D.); (F.B.); (G.G.); (A.G.)
- Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), 34128 Trieste, Italy
| | - Francesco Biaduzzini
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy; (P.M.); (L.D.); (F.B.); (G.G.); (A.G.)
- Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), 34128 Trieste, Italy
| | - Gabriele Garascia
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy; (P.M.); (L.D.); (F.B.); (G.G.); (A.G.)
- Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), 34128 Trieste, Italy
| | - Antonio Granato
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy; (P.M.); (L.D.); (F.B.); (G.G.); (A.G.)
- Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), 34128 Trieste, Italy
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Di Marco S, Pilati L, Torrente A, Maccora S, Santangelo A, Cosentino G, Correnti E, Raieli V, Fierro B, Brighina F. Pediatric Migraine and Visual Cortical Excitability: A Prospective Observational Study with Sound-Induced Flash Illusions. CHILDREN (BASEL, SWITZERLAND) 2024; 11:394. [PMID: 38671611 PMCID: PMC11049238 DOI: 10.3390/children11040394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
The pathophysiological mechanisms underlying migraine are more difficult to investigate in children than in the adult population. Abnormal cortical excitability turns out to be one of the most peculiar aspects of migraine, accounting for the manifestations of migraine attacks. Recently, visual cortical excitability has been explored effectively in adult migraineurs with a technique based on cross-modal audio-visual illusions (with sound-induced flash illusions (SIFIs) being reduced in migraineurs compared to non-migraineur subjects). On such a basis, in this study, we investigated visual cortical excitability in children with migraine using SIFIs using combinations of visual and sound stimuli presented randomly. We evaluated 26 children with migraine without aura and 16 healthy children. Migraineurs did not differ from the age-matched healthy subjects regarding fission or fusion illusions but perceived more flashes in trials of multiple flashes with or without beeps. The higher number of SIFIs in migraineur children compared to adults may be due to a greater propensity of visual stimulation to be driven by auditory stimuli (i.e., acoustic dominance). The increased ability to perceive flashes reveals a hyperfunctional visual cortex, demonstrating that the use of SIFIs is a valid tool for assessing visual cortical responsiveness even in pediatric migraine.
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Affiliation(s)
- Salvatore Di Marco
- Department of Biomedicine, Neuroscience and advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (S.D.M.); (L.P.); (A.T.); (S.M.); (B.F.); (F.B.)
- Neurology and Stroke Unit, P.O. “S. Antonio Abate”, 91016 Trapani, Italy
| | - Laura Pilati
- Department of Biomedicine, Neuroscience and advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (S.D.M.); (L.P.); (A.T.); (S.M.); (B.F.); (F.B.)
- Neurology and Stroke Unit, P.O. “S. Antonio Abate”, 91016 Trapani, Italy
| | - Angelo Torrente
- Department of Biomedicine, Neuroscience and advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (S.D.M.); (L.P.); (A.T.); (S.M.); (B.F.); (F.B.)
| | - Simona Maccora
- Department of Biomedicine, Neuroscience and advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (S.D.M.); (L.P.); (A.T.); (S.M.); (B.F.); (F.B.)
- Neurology Unit, ARNAS Civico di Cristina and Benfratelli Hospitals, 90127 Palermo, Italy
| | - Andrea Santangelo
- Pediatrics Department, AOUP Santa Chiara Hospital, 56126 Pisa, Italy;
| | - Giuseppe Cosentino
- Translational Neurophysiology Research Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy;
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Edvige Correnti
- Child Neurology and Psychiatry Unit—ISMEP, “G. Di Cristina” Children’s Hospital—ARNAS Civico, 90127 Palermo, Italy;
| | - Vincenzo Raieli
- Child Neurology and Psychiatry Unit—ISMEP, “G. Di Cristina” Children’s Hospital—ARNAS Civico, 90127 Palermo, Italy;
| | - Brigida Fierro
- Department of Biomedicine, Neuroscience and advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (S.D.M.); (L.P.); (A.T.); (S.M.); (B.F.); (F.B.)
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy; (S.D.M.); (L.P.); (A.T.); (S.M.); (B.F.); (F.B.)
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Zhang T, Guo B, Zuo Z, Long X, Hu S, Li S, Su X, Wang Y, Liu C. Excitatory-inhibitory modulation of transcranial focus ultrasound stimulation on human motor cortex. CNS Neurosci Ther 2023; 29:3829-3841. [PMID: 37309308 PMCID: PMC10651987 DOI: 10.1111/cns.14303] [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: 02/17/2023] [Revised: 04/10/2023] [Accepted: 05/27/2023] [Indexed: 06/14/2023] Open
Abstract
AIMS Transcranial focus ultrasound stimulation (tFUS) is a promising non-invasive neuromodulation technology. This study aimed to evaluate the modulatory effects of tFUS on human motor cortex (M1) excitability and explore the mechanism of neurotransmitter-related intracortical circuitry and plasticity. METHODS Single pulse transcranial magnetic stimulation (TMS)-eliciting motor-evoked potentials (MEPs) were used to assessed M1 excitability in 10 subjects. Paired-pulse TMS was used to measure the effects of tFUS on GABA- and glutamate-related intracortical excitability and 1 H-MRS was used to assess the effects of repetitive tFUS on GABA and Glx (glutamine + glutamate) neurometabolic concentrations in the targeting region in nine subjects. RESULTS The etFUS significantly increased M1 excitability, decreased short interval intracortical inhibition (SICI) and long interval intracortical inhibition (LICI). The itFUS significantly suppressed M1 excitability, increased SICI, LICI, and decreased intracortical facilitation (ICF). Seven times of etFUS decreased the GABA concentration (6.32%), increased the Glx concentration (12.40%), and decreased the GABA/Glx ratio measured by MRS, while itFUS increased the GABA concentration (18.59%), decreased Glx concentration (0.35%), and significantly increased GABA/Glx ratio. CONCLUSION The findings support that tFUS with different parameters can exert excitatory and inhibitory neuromodulatory effects on the human motor cortex. We provide novel insights that tFUS change cortical excitability and plasticity by regulating excitatory-inhibition balance related to the GABAergic and glutamatergic receptor function and neurotransmitter metabolic level.
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Affiliation(s)
- Tingting Zhang
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeuromodulationBeijingChina
| | - Bingqi Guo
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeuromodulationBeijingChina
| | - Zhentao Zuo
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of BiophysicsChinese Academy of SciencesBeijingChina
- Hefei Comprehensive National Science CenterInstitute of Artificial IntelligenceHefeiChina
- Sino‐Danish CollegeUniversity of Chinese Academy of SciencesBeijingChina
| | - Xiaojing Long
- Shenzhen Institutes of Advanced TechnologyChinese Academy of SciencesShenzhenChina
| | - Shimin Hu
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeuromodulationBeijingChina
| | - Siran Li
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Xin Su
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Yuping Wang
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeuromodulationBeijingChina
- Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing Institute for Brain DisordersCapital Medical UniversityBeijingChina
- Hebei Hospital of Xuanwu HospitalCapital Medical UniversityShijiazhuangChina
- Neuromedical Technology Innovation Center of Hebei ProvinceShijiazhuangChina
| | - Chunyan Liu
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeuromodulationBeijingChina
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Shen M, Li C, Wei X, Zhang L, Li Y, Wu H, Zhang X, Dong Z, Gao S, Ma Y, Ma Y. Transcranial Magnetic Stimulation as a Therapy for Migraine: An Overview of Systematic Reviews. J Pain Res 2023; 16:3133-3144. [PMID: 37724171 PMCID: PMC10505396 DOI: 10.2147/jpr.s416993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/05/2023] [Indexed: 09/20/2023] Open
Abstract
Introduction This overview of systematic reviews (SRs) systematically collected, evaluated, and combined the evidence for migraine treatment with transcranial magnetic stimulation (TMS). Methods We conducted a systematic literature search in various databases, such as PubMed, The Cochrane Library, Web of Science, Embase, the China National Knowledge Infrastructure, Wanfang, VIP, and China Biomedical Literature. Two reviewers independently assessed the methodological quality, risk of bias, reporting quality, and strength of evidence of the included studies using AMSTAR-2, ROBIS, the PRISMA checklist, and the GRADE system. Results We performed an overview of 7 relevant SRs, of which 4 were of moderate quality and 3 were of low quality according to AMSTAR 2. All SRs had low risk of bias in Phase 1 (Assessing relevance), Domain 1 (Study eligibility criteria), and Domain 4 (Synthesis and findings) as evaluated by ROBIS. In Domain 2 (Identification and selection of studies), 4 SRs (57.1%) had low risk of bias, while in Domain 3 (data collection and study appraisal) and Risk of Bias in the Review Phase 3, 4 SRs (57.1%) had low risk of bias. The PRISMA reporting standards were generally comprehensive, but some limitations were observed in the assessments, pooled results, evidence reliability, registration and protocols, and funding sources. The GRADE levels ranged from moderate to low, with 10 outcomes of moderate quality and 6 outcomes of low quality. The main reason for the low quality of evidence was the small sample size and high heterogeneity of the available studies. Conclusion TMS may improve migraine severity and frequency, but the evidence is limited due to methodological flaws and heterogeneity. Future studies should standardize use, assess side effects, and compare with other treatments.
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Affiliation(s)
- Min Shen
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Chunjing Li
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Xiaocen Wei
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Linlin Zhang
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Yang Li
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Hongxue Wu
- Department of Rehabilitation, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Xiaobin Zhang
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Zhibin Dong
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Shuzhong Gao
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Yuning Ma
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
| | - Yuxia Ma
- Department of Acupuncture and Massage College, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
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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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Uzair M, Abualait T, Arshad M, Yoo WK, Mir A, Bunyan RF, Bashir S. Transcranial magnetic stimulation in animal models of neurodegeneration. Neural Regen Res 2022; 17:251-265. [PMID: 34269184 PMCID: PMC8464007 DOI: 10.4103/1673-5374.317962] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/08/2020] [Accepted: 12/24/2020] [Indexed: 11/13/2022] Open
Abstract
Brain stimulation techniques offer powerful means of modulating the physiology of specific neural structures. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation, have emerged as therapeutic tools for neurology and neuroscience. However, the possible repercussions of these techniques remain unclear, and there are few reports on the incisive recovery mechanisms through brain stimulation. Although several studies have recommended the use of non-invasive brain stimulation in clinical neuroscience, with a special emphasis on TMS, the suggested mechanisms of action have not been confirmed directly at the neural level. Insights into the neural mechanisms of non-invasive brain stimulation would unveil the strategies necessary to enhance the safety and efficacy of this progressive approach. Therefore, animal studies investigating the mechanisms of TMS-induced recovery at the neural level are crucial for the elaboration of non-invasive brain stimulation. Translational research done using animal models has several advantages and is able to investigate knowledge gaps by directly targeting neuronal levels. In this review, we have discussed the role of TMS in different animal models, the impact of animal studies on various disease states, and the findings regarding brain function of animal models after TMS in pharmacology research.
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Affiliation(s)
- Mohammad Uzair
- Department of Biological Sciences, Faculty of Basic & Applied Sciences, International Islamic University Islamabad, Pakistan
| | - Turki Abualait
- College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Arshad
- Department of Biological Sciences, Faculty of Basic & Applied Sciences, International Islamic University Islamabad, Pakistan
| | - Woo-Kyoung Yoo
- Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Anyang, South Korea
- Hallym Institute for Translational Genomics & Bioinformatics, Hallym University College of Medicine, Anyang, South Korea
| | - Ali Mir
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Reem Fahd Bunyan
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
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Leahu P, Bange M, Ciolac D, Scheiter S, Matei A, Gonzalez-Escamilla G, Chirumamilla VC, Groppa SA, Muthuraman M, Groppa S. Increased migraine-free intervals with multifocal repetitive transcranial magnetic stimulation. Brain Stimul 2021; 14:1544-1552. [PMID: 34673259 DOI: 10.1016/j.brs.2021.10.383] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/13/2021] [Accepted: 10/16/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Episodic migraine is a debilitating condition associated with vast impairments of health, daily living, and life quality. Several prophylactic treatments exist, having a moderate ratio of action related to side effects and therapy costs. Repetitive transcranial magnetic stimulation (rTMS) is an evidence based therapy in several neuropsychiatric conditions, showing robust efficacy in alleviating specific symptoms. However, its efficacy in migraine disorders is unequivocal and might be tightly linked to the applied rTMS protocol. We hypothesized that multifocal rTMS paradigm could improve clinical outcomes in patients with episodic migraine by reducing the number of migraine days, frequency and intensity of migraine attacks, and improve the quality of life. METHODS We conducted an experimental, double-blind, randomized controlled study by applying a multifocal rTMS paradigm. Patients with episodic migraine with or without aura were enrolled in two centers from August 2018, to December 2019, and randomized to receive either real (n = 37) or sham (sham coil stimulation, n = 28) multifocal rTMS for six sessions over two weeks. Patients, physicians, and raters were blinded to the applied protocol. The experimental multifocal rTMS protocol included two components; first, swipe stimulation of 13 trains of 140 pulses/train, 67 Hz, 60% of RMT, and 2s intertrain interval and second, spot burst stimulation of 33 trains of 15 pulses/train, 67 Hz, 85% of RMT, and 8s intertrain interval. Reduction >50% from the baseline in migraine days (as primary outcome) and frequency and intensity of migraine attacks (as key secondary outcomes) over a 12-week period were assessed. To balance the baseline variables between the treatment arms, we applied the propensity score matching through the logistic regression. RESULTS Among 65 randomized patients, sixty (age 39.7 ± 11.6; 52 females; real rTMS n = 33 and sham rTMS n = 27) completed the trial and five patients dropped out. Over 12 weeks, the responder's rate in the number of migraine days was significantly higher in the real rTMS compared to the sham group (42% vs. 26%, p < 0.05). The mean migraine days per month decreased from 7.6 to 4.3 days in the real rTMS group and from 6.2 to 4.3 days in the sham rTMS group, resulting in a difference with real vs. sham rTMS of -3.2 days (p < 0.05). Similarly, over the 12-week period, the responder's rate in the reduction of migraine attacks frequency was higher in the real rTMS compared to the sham group (42% vs 33%, p < 0.05). No serious adverse events were observed. CONCLUSION Our pilot study shows compelling evidence in a double placebo-controlled trial that multifocal rTMS is an effective and well-tolerated preventive treatment in patients with episodic migraine.
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Affiliation(s)
- Pavel Leahu
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn(2)), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Neurology, Institute of Emergency Medicine, Chisinau, Republic of Moldova; Laboratory of Neurobiology and Medical Genetics, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Manuel Bange
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn(2)), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Dumitru Ciolac
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn(2)), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Neurology, Institute of Emergency Medicine, Chisinau, Republic of Moldova; Laboratory of Neurobiology and Medical Genetics, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Stefanie Scheiter
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn(2)), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexandru Matei
- Department of Neurology, Institute of Emergency Medicine, Chisinau, Republic of Moldova
| | - Gabriel Gonzalez-Escamilla
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn(2)), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Venkata C Chirumamilla
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn(2)), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stanislav A Groppa
- Department of Neurology, Institute of Emergency Medicine, Chisinau, Republic of Moldova; Laboratory of Neurobiology and Medical Genetics, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Muthuraman Muthuraman
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn(2)), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn(2)), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
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Corp DT, Bereznicki HGK, Clark GM, Youssef GJ, Fried PJ, Jannati A, Davies CB, Gomes-Osman J, Kirkovski M, Albein-Urios N, Fitzgerald PB, Koch G, Di Lazzaro V, Pascual-Leone A, Enticott PG. Large-scale analysis of interindividual variability in single and paired-pulse TMS data. Clin Neurophysiol 2021; 132:2639-2653. [PMID: 34344609 DOI: 10.1016/j.clinph.2021.06.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study brought together over 60 transcranial magnetic stimulation (TMS) researchers to create the largest known sample of individual participant single and paired-pulse TMS data to date, enabling a more comprehensive evaluation of factors driving response variability. METHODS Authors of previously published studies were contacted and asked to share deidentified individual TMS data. Mixed-effects regression investigated a range of individual and study level variables for their contribution to variability in response to single and paired-pulse TMS data. RESULTS 687 healthy participant's data were pooled across 35 studies. Target muscle, pulse waveform, neuronavigation use, and TMS machine significantly predicted an individual's single-pulse TMS amplitude. Baseline motor evoked potential amplitude, motor cortex hemisphere, and motor threshold (MT) significantly predicted short-interval intracortical inhibition response. Baseline motor evoked potential amplitude, test stimulus intensity, interstimulus interval, and MT significantly predicted intracortical facilitation response. Age, hemisphere, and TMS machine significantly predicted MT. CONCLUSIONS This large-scale analysis has identified a number of factors influencing participants' responses to single and paired-pulse TMS. We provide specific recommendations to minimise interindividual variability in single and paired-pulse TMS data. SIGNIFICANCE This study has used large-scale analyses to give clarity to factors driving variance in TMS data. We hope that this ongoing collaborative approach will increase standardisation of methods and thus the utility of single and paired-pulse TMS.
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Affiliation(s)
- Daniel T Corp
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Hannah G K Bereznicki
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Gillian M Clark
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - George J Youssef
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
| | - Peter J Fried
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ali Jannati
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Charlotte B Davies
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Joyce Gomes-Osman
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Melissa Kirkovski
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Natalia Albein-Urios
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia; Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Central Clinical School, Melbourne, Australia
| | - Giacomo Koch
- Non-invasive Brain Stimulation Unit, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Biomedical and Specialty Surgical Sciences, Section of Human Physiology, University of Ferrara, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology and Neurobiology, Università Campus Bio-Medico, Rome, Italy
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institute, Institut Guttmann de Neurorehabilitació, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
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Yuksel H, Topalkara KK. Increased Cortical Excitability in Female Migraineurs: A Transcranial Magnetic Stimulation Study Conducted in the Preovulatory Phase. J Clin Neurol 2021; 17:236-241. [PMID: 33835744 PMCID: PMC8053541 DOI: 10.3988/jcn.2021.17.2.236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 01/01/2023] Open
Abstract
Background and Purpose The cerebral cortex has been the focus of investigations of the pathogenesis of migraine for a long time. Transcranial magnetic stimulation (TMS) is a safe and effective technique for evaluating cortex excitability. Previous studies of the duration of the cortical silent period (CSP)—a measure of intracortical inhibition—in migraine patients have yielded conflicting results. We aimed to characterize cortical excitability by applying TMS to female migraineurs during the preovulatory phase of the menstrual cycle, in order to eliminate the effects of variations in sex hormones. Methods We enrolled 70 female subjects: 20 migraine with aura (MA) patients, 20 migraine without aura (MO) patients, and 30 healthy controls. We measured the CSP, resting motor threshold (rMT), and motor evoked potential (MEP) induced by TMS to evaluate cortical excitability during the preovulatory phase of the menstrual cycle. Results The CSP was shorter in MA patients (88.93±3.82 ms, mean±SEM) and MO patients (86.98±2.72 ms) than in the control group (109.06±2.85 ms) (both p=0.001), and did not differ significantly between the MA and MO groups (p=0.925). The rMT did not differ significantly among the groups (p=0.088). MEPmax was higher in MA patients than in healthy controls (p=0.014), while that in MO patients did not differ from those in MA patients and healthy controls (p=0.079 and p=0.068). Conclusions We detected a shorter CSP in both MA and MO patients. This finding may indicate the presence of motor cortex hyperexcitability, which is probably due to reduced GABAergic neuronal inhibition in migraine.
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Affiliation(s)
- Hatice Yuksel
- Department of Neurology, Ankara City Hospital, Ankara, Turkey.
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11
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Fatih P, Kucuker MU, Vande Voort JL, Doruk Camsari D, Farzan F, Croarkin PE. A Systematic Review of Long-Interval Intracortical Inhibition as a Biomarker in Neuropsychiatric Disorders. Front Psychiatry 2021; 12:678088. [PMID: 34149483 PMCID: PMC8206493 DOI: 10.3389/fpsyt.2021.678088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/06/2021] [Indexed: 12/23/2022] Open
Abstract
Long-interval intracortical inhibition (LICI) is a paired-pulse transcranial magnetic stimulation (TMS) paradigm mediated in part by gamma-aminobutyric acid receptor B (GABAB) inhibition. Prior work has examined LICI as a putative biomarker in an array of neuropsychiatric disorders. This review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) sought to examine existing literature focused on LICI as a biomarker in neuropsychiatric disorders. There were 113 articles that met the inclusion criteria. Existing literature suggests that LICI may have utility as a biomarker of GABAB functioning but more research with increased methodologic rigor is needed. The extant LICI literature has heterogenous methodology and inconsistencies in findings. Existing findings to date are also non-specific to disease. Future research should carefully consider existing methodological weaknesses and implement high-quality test-retest reliability studies.
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Affiliation(s)
- Parmis Fatih
- Mayo Clinic Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - M Utku Kucuker
- Mayo Clinic Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Jennifer L Vande Voort
- Mayo Clinic Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Deniz Doruk Camsari
- Mayo Clinic Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Faranak Farzan
- School of Mechatronic Systems Engineering, Centre for Engineering-Led Brain Research, Simon Fraser University, Surrey, BC, Canada
| | - Paul E Croarkin
- Mayo Clinic Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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12
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Nikolov P, Zimmermann JV, Hassan SS, Albrecht P, Schnitzler A, Groiss SJ. Impact of the number of conditioning pulses on motor cortex excitability: a transcranial magnetic stimulation study. Exp Brain Res 2020; 239:583-589. [PMID: 33373012 PMCID: PMC7936961 DOI: 10.1007/s00221-020-06010-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/07/2020] [Indexed: 12/03/2022]
Abstract
Conditioning transcranial magnetic stimulation (TMS) with subthreshold conditioning stimulus followed by supra-threshold test stimulus at inter-stimulus intervals (ISI) of 1–5 ms results in inhibition (SICI), while ISI at 10–15 ms results in facilitation (ICF). One concerning issue, applying ICF/SICI protocols on patients is the substantial protocol variability. Here, we hypothesized that increasing the number of CS could result in more robust ICF/SICI protocols. Twenty healthy subjects participated in the study. Motor-evoked potentials (MEP) were obtained from conditioning TMS with a varying number of conditioning stimuli in 3, 4, 10, and 15 ms ISI over the primary motor cortex. MEP amplitudes were then compared to examine excitability. TMS with 3, 5, and 7 conditioning stimuli but not with one conditioning stimulus induced ICF. Moreover, 10 ms ISI produced stronger ICF than 15 ms ISI. Significant SICI was only induced with one conditioning stimulus. Besides, 3 ms ISI resulted in stronger SICI than 4 ms ISI. Only a train of conditioning stimuli induced stable ICF and may be more advantageous than the classical paired pulse ICF paradigm.
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Affiliation(s)
- Petyo Nikolov
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Johanna V Zimmermann
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Shady S Hassan
- Department of Neurology, Medical Faculty, Assiut University Hospital, Assiut, Egypt
| | - Philipp Albrecht
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Stefan J Groiss
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
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13
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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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14
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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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15
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Kaur S, Ali A, Siahbalaei Y, Ahmad U, Pandey AK, Singh B. Could rs4379368 be a genetic marker for North Indian migraine patients with aura?: Preliminary evidence by a replication study. Neurosci Lett 2019; 712:134482. [PMID: 31505242 DOI: 10.1016/j.neulet.2019.134482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/29/2019] [Accepted: 09/04/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Genome wide association studies (GWAS) have already found different migraine single nucleotide polymorphisms (SNPs). To further check if these variants differ by ethnicity, three single nucleotide polymorphisms (SNPs) (rs4379368, rs10504861and rs11172113) were genotyped here to find association with migraine susceptibility from North Indian population. METHODS AND RESULTS A case control study in 200 subjects was done by polymerase chain reaction and restriction-fragment-length polymorphism (PCR-RFLP) analysis. Univariate analysis was performed to check the association of different genotypic and allelic frequencies of these variants with migraine and its subtypes. We could not find any statistically relevant differences among frequencies at various levels of these selected SNPs between patients and healthy controls in this study (p > 0.05). However on subgroup analysis for rs4379368 SNP, the CT genotype was higher in migraine with aura (MA) (69.6%) than migraine without aura (MO) (51.9%) or control (42%) (p < 0.05). But this relation was not significant at allelic level. For other two SNPs, statistically significant differences were not observed in any of the two migraine subgroups. CONCLUSIONS This study was able to associate the role of rs4379368 SNP with migraine susceptibility and suggested that genotype CT in rs4379368 SNP could be a possible genetic marker for MA. More studies with larger sample size are needed to strengthen our results.
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Affiliation(s)
- Sukhvinder Kaur
- UGC-PDF, Gene Expression Lab., Department of Biosciences, Jamia Millia Islamia, New Delhi, India.
| | - Arif Ali
- UGC-BSR-FF, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Yaser Siahbalaei
- Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Uzair Ahmad
- Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - A K Pandey
- Department of Physiology, ESIC Medical College & Hospital, Faridabad, India
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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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