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Castro Zamparella T, Carpinella M, Peres M, Cuello FP, Maza P, Van Gansen M, Filipchuk M, Balaszczuk V, Maldonado C, Scarnato P, Conci Magris D, Lisicki M. Specific cognitive and psychological alterations are more strongly linked to increased migraine disability than chronic migraine diagnosis. J Headache Pain 2024; 25:37. [PMID: 38486142 PMCID: PMC10941545 DOI: 10.1186/s10194-024-01734-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION The efficiency of The International Classification of Headache Disorders (ICHD-3) in reflecting patients' disability has recently been questioned. This prompts consideration that clinical features beyond pain may more accurately indicate the extent of underlying brain impairment than the mere frequency of headache days. Important cognitive dysfunctions and psychological impairment have been reported in burdensome cases of migraine, and the presence of these alterations has been associated with biological changes in the nervous system. This study aimed to compare migraine-related disability within a specific patient group, classified using ICHD-3 criteria or classified based on findings from a neuropsychological evaluation using machine learning. Additionally, a complementary voxel-based morphometry (VBM) comparison was conducted to explore potential neuroanatomical differences between the resulting groups. PATIENTS AND METHODS The study included episodic and chronic migraine patients seeking consultation at a specialized headache department. A neuropsychological evaluation protocol, encompassing validated standardized tests for cognition, anxiety, depression, perceived stress, and headache-related impact (HIT-6) and disability (MIDAS), was administered. Results from this evaluation were input into an automated K-means clustering algorithm, with a predefined K=2 for comparative purposes. A supplementary Voxel-based Morphometry (VBM) evaluation was conducted to investigate neuroanatomical contrasts between the two distinct grouping configurations. RESULTS The study involved 111 participants, with 49 having chronic migraine and 62 having episodic migraine. Seventy-four patients were assigned to cluster one, and 37 patients were assigned to cluster two. Cluster two exhibited significantly higher levels of depression, anxiety, and perceived stress, and performed worse in alternating and focalized attention tests. Differences in HIT-6 and MIDAS scores between episodic and chronic migraine patients did not reach statistical significance (HIT-6: 64.39 (±7,31) vs 62.92 (±11,61); p= 0. 42 / MIDAS: 73.63 (±68,61) vs 84.33 (±63,62); p=0.40). In contrast, patients in cluster two exhibited significantly higher HIT-6 (62.32 (±10,11) vs 66.57 (±7,21); p=0.03) and MIDAS (68.69 (±62,58) vs 97.68 (±70,31); p=0.03) scores than patients in cluster one. Furthermore, significant differences in grey matter volume between the two clusters were noted, particularly involving the precuneus, while differences between chronic and episodic migraine patients did not withstand correction for multiple comparisons. CONCLUSIONS The classification of migraine patients based on neuropsychological characteristics demonstrates a more effective separation of groups in terms of disability compared to categorizing them based on the chronic or episodic diagnosis of ICHD-3. These findings could reveal biological changes that might explain differences in treatment responses among apparently similar patients.
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Affiliation(s)
- Tatiana Castro Zamparella
- Neuroscience Unit, Conci-Carpinella Institute, 358 (5000), Córdoba, Urquiza, Argentina
- Psychological Research Institute, Faculty of Psychology, National University of Córdoba (UNC - CONICET), Córdoba, Argentina
- National Council for Scientific and Technical Research (CONICET), Córdoba, Argentina
- Faculty of Psychology, National University of Córdoba (UNC), Córdoba, Argentina
| | - Mariela Carpinella
- Neuroscience Unit, Conci-Carpinella Institute, 358 (5000), Córdoba, Urquiza, Argentina
- Faculty of Psychology, National University of Córdoba (UNC), Córdoba, Argentina
- Faculty of Medicine, Catholic University of Cuyo, San Luis, Argentina
| | - Mario Peres
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da USP, Sao Paulo, SP, Brazil
| | - Florencia Patricia Cuello
- Neuroscience Unit, Conci-Carpinella Institute, 358 (5000), Córdoba, Urquiza, Argentina
- Faculty of Psychology, National University of Córdoba (UNC), Córdoba, Argentina
| | - Pilar Maza
- Neuroscience Unit, Conci-Carpinella Institute, 358 (5000), Córdoba, Urquiza, Argentina
- Faculty of Psychology, National University of Córdoba (UNC), Córdoba, Argentina
| | - Melanie Van Gansen
- Neuroscience Unit, Conci-Carpinella Institute, 358 (5000), Córdoba, Urquiza, Argentina
- Faculty of Psychology, National University of Córdoba (UNC), Córdoba, Argentina
| | - Marcelo Filipchuk
- Neuroscience Unit, Conci-Carpinella Institute, 358 (5000), Córdoba, Urquiza, Argentina
| | - Verónica Balaszczuk
- Psychological Research Institute, Faculty of Psychology, National University of Córdoba (UNC - CONICET), Córdoba, Argentina
- National Council for Scientific and Technical Research (CONICET), Córdoba, Argentina
- Faculty of Psychology, National University of Córdoba (UNC), Córdoba, Argentina
| | - Carolina Maldonado
- National Council for Scientific and Technical Research (CONICET), Córdoba, Argentina
- Faculty of Exact, Physical and Natural Sciences, National University of Córdoba (UNC), Córdoba, Argentina
| | - Pablo Scarnato
- Neuroscience Unit, Conci-Carpinella Institute, 358 (5000), Córdoba, Urquiza, Argentina
| | - Diego Conci Magris
- Neuroscience Unit, Conci-Carpinella Institute, 358 (5000), Córdoba, Urquiza, Argentina
| | - Marco Lisicki
- Neuroscience Unit, Conci-Carpinella Institute, 358 (5000), Córdoba, Urquiza, Argentina.
- Biomedical Physics Department, School of Medicine, National University of Córdoba (UNC), Córdoba, Argentina.
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Sezai T, Murphy MJ, Riddell N, Nguyen V, Crewther SG. Visual Processing During the Interictal Period Between Migraines: A Meta-Analysis. Neuropsychol Rev 2023; 33:765-782. [PMID: 36115887 PMCID: PMC10770263 DOI: 10.1007/s11065-022-09562-3] [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: 10/20/2021] [Accepted: 07/20/2022] [Indexed: 10/14/2022]
Abstract
Migraine is a poorly understood neurological disorder and a leading cause of disability in young adults, particularly women. Migraines are characterized by recurring episodes of severe pulsating unilateral headache and usually visual symptoms. Currently there is some disagreement in the electrophysiological literature regarding the universality of all migraineurs exhibiting physiological visual impairments also during interictal periods (i.e., the symptom free period between migraines). Thus, this meta-analysis investigated the evidence for altered visual function as measured electrophysiologically via pattern-reversal visual evoked potential (VEP) amplitudes and habituation in adult migraineurs with or without visual aura and controls in the interictal period. Twenty-three studies were selected for random effects meta-analysis which demonstrated slightly diminished VEP amplitudes in the early fast conducting P100 component but not in N135, and substantially reduced habituation in the P100 and the N135 in migraineurs with and without visual aura symptoms compared to controls. No statistical differences were found between migraineurs with and without aura, possibly due to inadequate studies. Overall, insufficient published data and substantial heterogeneity between studies was observed for all latency components of pattern-reversal VEP, highlighting the need for further electrophysiological experimentation and more targeted temporal analysis of visual function, in episodic migraineurs.
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Affiliation(s)
- Timucin Sezai
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Melanie J Murphy
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Nina Riddell
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Vinh Nguyen
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Sheila G Crewther
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia.
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Individual differences in visual evoked potential latency are associated with variance in brain tissue volume in people with multiple sclerosis: An analysis of brain function-structure correlates. Mult Scler Relat Disord 2022; 68:104116. [PMID: 36041331 DOI: 10.1016/j.msard.2022.104116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/16/2022] [Accepted: 08/13/2022] [Indexed: 12/15/2022]
Abstract
Visual evoked potentials (VEP) index visual pathway functioning, and are often used for clinical assessment and as outcome measures in people with multiple sclerosis (PwMS). VEPs may also reflect broader neural disturbances that extend beyond the visual system, but this possibility requires further investigation. In the present study, we examined the hypothesis that delayed latency of the P100 component of the VEP would be associated with broader structural changes in the brain in PwMS. We obtained VEP latency for a standard pattern-reversal checkerboard stimulus paradigm, in addition to Magnetic Resonance Imaging (MRI) measures of whole brain volume (WBV), gray matter volume (GMV), white matter volume (WMV), and T2-weighted fluid attenuated inversion recovery (FLAIR) white matter lesion volume (FLV). Correlation analyses indicated that prolonged VEP latency was significantly associated with lower WBV, GMV, and WMV, and greater FLV. VEP latency remained significantly associated with WBV, GMV, and WMV even after controlling for the variance associated with inter-ocular latency, age, time between VEP and MRI assessments, and other MRI variables. VEP latency delays were most pronounced in PwMS that exhibited low volume in both white and gray matter simultaneously. Furthermore, PwMS that had delayed VEP latency based on a clinically relevant cutoff (VEP latency ≥ 113 ms) in both eyes had lower WBV, GMV, and WMV and greater FLV in comparison to PwMS that had normal VEP latency in one or both eyes. The findings suggest that PwMS that have delayed latency in both eyes may be particularly at risk for exhibiting greater brain atrophy and lesion volume. These analyses also indicate that VEP latency may index combined gray matter and white matter disturbances, and therefore broader network connectivity and efficiency. VEP latency may therefore provide a surrogate marker of broader structural disturbances in the brain in MS.
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Porcaro C, Di Renzo A, Tinelli E, Parisi V, Di Lorenzo C, Caramia F, Fiorelli M, Giuliani G, Cioffi E, Seri S, Di Piero V, Pierelli F, Di Lorenzo G, Coppola G. A Hypothalamic Mechanism Regulates the Duration of a Migraine Attack: Insights from Microstructural and Temporal Complexity of Cortical Functional Networks Analysis. Int J Mol Sci 2022; 23:13238. [PMID: 36362026 PMCID: PMC9658908 DOI: 10.3390/ijms232113238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 07/23/2023] Open
Abstract
The role of the hypothalamus and the limbic system at the onset of a migraine attack has recently received significant interest. We analyzed diffusion tensor imaging (DTI) parameters of the entire hypothalamus and its subregions in 15 patients during a spontaneous migraine attack and in 20 control subjects. We also estimated the non-linear measure resting-state functional MRI BOLD signal's complexity using Higuchi fractal dimension (FD) and correlated DTI/fMRI findings with patients' clinical characteristics. In comparison with healthy controls, patients had significantly altered diffusivity metrics within the hypothalamus, mainly in posterior ROIs, and higher FD values in the salience network (SN). We observed a positive correlation of the hypothalamic axial diffusivity with migraine severity and FD of SN. DTI metrics of bilateral anterior hypothalamus positively correlated with the mean attack duration. Our results show plastic structural changes in the hypothalamus related to the attacks severity and the functional connectivity of the SN involved in the multidimensional neurocognitive processing of pain. Plastic changes to the hypothalamus may play a role in modulating the duration of the attack.
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Affiliation(s)
- Camillo Porcaro
- Department of Neuroscience and Padova Neuroscience Center (PNC), University of Padova, 35128 Padova, Italy
- Institute of Cognitive Sciences and Technologies (ISTC)—National Research Council (CNR), 00185 Rome, Italy
- Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
| | | | - Emanuele Tinelli
- Unit of Neuroradiology, Department of Medical and Surgical Sciences, Magna Græcia University, 88100 Catanzaro, Italy
| | | | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino—I.C.O.T., 04100 Latina, Italy
| | - Francesca Caramia
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Marco Fiorelli
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Giada Giuliani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Ettore Cioffi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino—I.C.O.T., 04100 Latina, Italy
| | - Stefano Seri
- Aston Institute of Health and Neurodevelopment, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
- Department of Clinical Neurophysiology, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham B4 6NH, UK
| | - Vittorio Di Piero
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino—I.C.O.T., 04100 Latina, Italy
| | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- IRCCS—Fondazione Santa Lucia, 00179 Rome, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino—I.C.O.T., 04100 Latina, Italy
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Bilen N, Hamurcu M. Evaluation of electrophysiological changes in migraine with visual aura. Taiwan J Ophthalmol 2022; 12:295-300. [PMID: 36248085 PMCID: PMC9558466 DOI: 10.4103/2211-5056.354281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/02/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE: The purpose of this study was to evaluate the electrical responses in the retina and cortex of migraine patients with electrophysiological tests and compare with healthy controls. MATERIALS AND METHODS: This prospective study included 18 migraine patients with visual aura and 28 healthy controls. Pattern-reversal visual evoked potentials (VEP) and flash electroretinography (fERG) of migraine patients during the headache-free period were compared with healthy controls. RESULTS: There were statistically significant differences in VEP results: P100 and N75 amplitudes increased significantly (P = 0.025 and P = 0.007 respectively) and P100 latency decreased significantly in migraine patients (P = 0.022). Furthermore, fERG scotopic combined cone and rod amplitude increased significantly in migraine patients (P = 0.01). CONCLUSION: Migraine brain displays abnormal visual evoked responses in between migraine attacks. In migraine eye, scotopic cone and rod response increased. The results of this study support the hyperexcitability of the retina and cortex in patients with migraine.
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Fila M, Chojnacki C, Chojnacki J, Blasiak J. Nutrients to Improve Mitochondrial Function to Reduce Brain Energy Deficit and Oxidative Stress in Migraine. Nutrients 2021; 13:nu13124433. [PMID: 34959985 PMCID: PMC8707228 DOI: 10.3390/nu13124433] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 12/11/2022] Open
Abstract
The mechanisms of migraine pathogenesis are not completely clear, but 31P-nuclear magnetic resonance studies revealed brain energy deficit in migraineurs. As glycolysis is the main process of energy production in the brain, mitochondria may play an important role in migraine pathogenesis. Nutrition is an important aspect of migraine pathogenesis, as many migraineurs report food-related products as migraine triggers. Apart from approved anti-migraine drugs, many vitamins and supplements are considered in migraine prevention and therapy, but without strong supportive evidence. In this review, we summarize and update information about nutrients that may be important for mitochondrial functions, energy production, oxidative stress, and that are related to migraine. Additionally, we present a brief overview of caffeine and alcohol, as they are often reported to have ambiguous effects in migraineurs. The nutrients that can be considered to supplement the diet to prevent and/or ameliorate migraine are riboflavin, thiamine, magnesium ions, niacin, carnitine, coenzyme Q10, melatonin, lipoic acid, pyridoxine, folate, and cobalamin. They can supplement a normal, healthy diet, which should be adjusted to individual needs determined mainly by the physiological constitution of an organism. The intake of caffeine and alcohol should be fine-tuned to the history of their use, as withdrawal of these agents in regular users may become a migraine trigger.
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Affiliation(s)
- Michal Fila
- Department of Developmental Neurology and Epileptology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Poland;
| | - Cezary Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (C.C.), (J.C.)
| | - Jan Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (C.C.), (J.C.)
| | - Janusz Blasiak
- Department of Molecular Genetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-236 Lodz, Poland
- Correspondence:
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Covey TJ, Golan D, Doniger GM, Sergott R, Zarif M, Srinivasan J, Bumstead B, Wilken J, Buhse M, Mebrahtu S, Gudesblatt M. Visual evoked potential latency predicts cognitive function in people with multiple sclerosis. J Neurol 2021; 268:4311-4320. [PMID: 33870445 DOI: 10.1007/s00415-021-10561-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Prior studies have reported an association between visual evoked potentials (VEPs) and cognitive performance in people with multiple sclerosis (PwMS), but the specific mechanisms that account for this relationship remain unclear. We examined the relationship between VEP latency and cognitive performance in a large sample of PwMS, hypothesizing that VEP latency indexes not only visual system functioning but also general neural efficiency. Standardized performance index scores were obtained for the domains of memory, executive function, visual-spatial processing, verbal function, attention, information processing speed, and motor skills, as well as global cognitive performance (NeuroTrax battery). VEP P100 component latency was obtained using a standard checkerboard pattern-reversal paradigm. Prolonged VEP latency was significantly associated with poorer performance in multiple cognitive domains, and with the number of cognitive domains in which performance was ≥ 1 SD below the normative mean. Relationships between VEP latency and cognitive performance were significant for information processing speed, executive function, attention, motor skills, and global cognitive performance after controlling for disease duration, visual acuity, and inter-ocular latency differences. This study provides evidence that VEP latency delays index general neural inefficiency that is associated with cognitive disturbances in PwMS.
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Affiliation(s)
- Thomas J Covey
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University At Buffalo, Sherman Hall Annex Room 114, Buffalo, NY, 14214, USA. .,Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University At Buffalo, Buffalo, NY, USA.
| | - Daniel Golan
- Department of Neurology and Multiple Sclerosis Center, Lady Davis Carmel Medical Center, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Glen M Doniger
- Department of Clinical Research, NeuroTrax Corporation, Modiin, Israel
| | | | - Myassar Zarif
- South Shore Neurologic Associates, 712 Main Street, Islip, Patchogue, NY, USA
| | - Jared Srinivasan
- South Shore Neurologic Associates, 712 Main Street, Islip, Patchogue, NY, USA
| | - Barbara Bumstead
- South Shore Neurologic Associates, 712 Main Street, Islip, Patchogue, NY, USA
| | - Jeffrey Wilken
- Washington Neuropsychology Research Group, Fairfax, VA, USA.,Department of Neurology, Georgetown University, Washington, DC, USA
| | - Marijean Buhse
- South Shore Neurologic Associates, 712 Main Street, Islip, Patchogue, NY, USA
| | - Samson Mebrahtu
- South Shore Neurologic Associates, 712 Main Street, Islip, Patchogue, NY, USA
| | - Mark Gudesblatt
- South Shore Neurologic Associates, 712 Main Street, Islip, Patchogue, NY, USA.
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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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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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11
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Wang HZ, Wang WH, Shi HC, Yuan CH. Is there a reliable brain morphological signature for migraine? J Headache Pain 2020; 21:89. [PMID: 32652927 PMCID: PMC7353790 DOI: 10.1186/s10194-020-01158-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022] Open
Abstract
Voxel-based morphometry (VBM) is a popular non-invasive magnetic resonance imaging technique to investigate brain gray matter (GM) differences between groups. Recently, two VBM studies in migraine have been published in The Journal of Headache and Pain. Reviewing the two and those previous published VBM studies, we found considerable variations of the results. Spatially diverse brain regions with decreased and increased GM alterations and null findings have been reported. It is interesting to know whether there is a reliable brain morphological signature for migraine. Coordinate-based meta-analysis (CBMA) is increasingly used to quantitatively pool individual neuroimaging studies to identify consistent and reliable findings. Several CBMA have been conducted, however, their results were inconsistent. The algorithms for CBMA have evolved and more eligible VBM studies in migraine have been published. We therefore conducted an updated CBMA using the latest algorithms for CBMA, seed-based d mapping with permutation of subject images (SDM-PSI). The present CBMA of 32 VBM studies (41 datasets comprising 1252 patients and 1025 healthy controls) found no evidence of consistent GM alterations in migraine. Sensitivity analysis, subgroup meta-analyses, and meta-regression analyses revealed that the result was robust. This negative result indicates that there is no reliable brain morphological signature for migraine. VBM investigations in migraine remain a heterogeneous field. Many potential confounding factors, such as underpowered sample sizes, variations in demographic and clinical characteristics, and differences in MRI scanners, head coils, scanning parameters, preprocessing procedures, and statistical strategies may cause the inconsistences of the results. Future VBM studies are warranted to enroll well-characterized and homogeneous subtype samples with appropriate sample sizes, comprehensively assess comorbidities and medication status, and use well-validated and standardized imaging protocols and processing and analysis pipelines to produce robust and replicable results in migraine.
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Affiliation(s)
- Hong Zhou Wang
- Department of Neurology, Kunshan Hospital, Affiliated to Jiangsu University, Kunshan, People's Republic of China
| | - Wan Hua Wang
- Department of Neurology, Kunshan Hospital, Affiliated to Jiangsu University, Kunshan, People's Republic of China
| | - Hai Cun Shi
- Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, People's Republic of China
| | - Cong Hu Yuan
- Department of Anesthesia and Pain Management, Affiliated Yancheng Hospital, School of Medicine, Southeast University, West Xindu Road 2#, Yancheng, Jiangsu Province, 224001, People's Republic of China.
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12
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Masson R, Lévêque Y, Demarquay G, ElShafei H, Fornoni L, Lecaignard F, Morlet D, Bidet-Caulet A, Caclin A. Auditory attention alterations in migraine: A behavioral and MEG/EEG study. Clin Neurophysiol 2020; 131:1933-1946. [PMID: 32619799 DOI: 10.1016/j.clinph.2020.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 04/14/2020] [Accepted: 05/05/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To evaluate alterations of top-down and/or bottom-up attention in migraine and their cortical underpinnings. METHODS 19 migraineurs between attacks and 19 matched control participants performed a task evaluating jointly top-down and bottom-up attention, using visually-cued target sounds and unexpected task-irrelevant distracting sounds. Behavioral responses and magneto- and electro-encephalography signals were recorded. Event-related potentials and fields were processed and source reconstruction was applied to event-related fields. RESULTS At the behavioral level, neither top-down nor bottom-up attentional processes appeared to be altered in migraine. However, migraineurs presented heightened evoked responses following distracting sounds (orienting component of the N1 and Re-Orienting Negativity, RON) and following target sounds (orienting component of the N1), concomitant to an increased recruitment of the right temporo-parietal junction. They also displayed an increased effect of the cue informational value on target processing resulting in the elicitation of a negative difference (Nd). CONCLUSIONS Migraineurs appear to display increased bottom-up orienting response to all incoming sounds, and an enhanced recruitment of top-down attention. SIGNIFICANCE The interictal state in migraine is characterized by an exacerbation of the orienting response to attended and unattended sounds. These attentional alterations might participate to the peculiar vulnerability of the migraine brain to all incoming stimuli.
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Affiliation(s)
- Rémy Masson
- Lyon Neuroscience Research Center (CRNL), INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
| | - Yohana Lévêque
- Lyon Neuroscience Research Center (CRNL), INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Geneviève Demarquay
- Lyon Neuroscience Research Center (CRNL), INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France; Neurological Hospital Pierre Wertheimer, Functional Neurology and Epilepsy Department, Hospices Civils de Lyon and Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Hesham ElShafei
- Lyon Neuroscience Research Center (CRNL), INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Lesly Fornoni
- Lyon Neuroscience Research Center (CRNL), INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Françoise Lecaignard
- Lyon Neuroscience Research Center (CRNL), INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Dominique Morlet
- Lyon Neuroscience Research Center (CRNL), INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Aurélie Bidet-Caulet
- Lyon Neuroscience Research Center (CRNL), INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Anne Caclin
- Lyon Neuroscience Research Center (CRNL), INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
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13
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Sheng L, Zhao P, Ma H, Yuan C, Zhong J, Dai Z, Pan P. A lack of consistent brain grey matter alterations in migraine. Brain 2020; 143:e45. [PMID: 32363400 DOI: 10.1093/brain/awaa123] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- LiQin Sheng
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China
| | - PanWen Zhao
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - HaiRong Ma
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China
| | - CongHu Yuan
- Department of Anesthesia and Pain Management, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - ZhenYu Dai
- Department of Radiology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - PingLei Pan
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
- Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
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14
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Lisicki M, D'Ostilio K, Coppola G, Nonis R, Maertens de Noordhout A, Parisi V, Magis D, Schoenen J. Headache Related Alterations of Visual Processing in Migraine Patients. THE JOURNAL OF PAIN 2020; 21:593-602. [DOI: 10.1016/j.jpain.2019.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 07/12/2019] [Accepted: 08/07/2019] [Indexed: 01/12/2023]
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15
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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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16
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Puledda F, Ffytche D, O'Daly O, Goadsby PJ. Imaging the Visual Network in the Migraine Spectrum. Front Neurol 2019; 10:1325. [PMID: 31920945 PMCID: PMC6923266 DOI: 10.3389/fneur.2019.01325] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/29/2019] [Indexed: 01/13/2023] Open
Abstract
The involvement of the visual network in migraine pathophysiology has been well-known for more than a century. Not only is the aura phenomenon linked to cortical alterations primarily localized in the visual cortex; but also migraine without aura has shown distinct dysfunction of visual processing in several studies in the past. Further, the study of photophobia, a hallmark migraine symptom, has allowed unraveling of distinct connections that link retinal pathways to the trigeminovascular system. Finally, visual snow, a recently recognized neurological disorder characterized by a continuous visual disturbance, is highly comorbid with migraine and possibly shares with it some common pathophysiological mechanisms. Here, we review the most relevant neuroimaging literature to date, considering studies that have either attempted to investigate the visual network or have indirectly shown visual processing dysfunctions in migraine. We do this by taking into account the broader spectrum of migrainous biology, thus analyzing migraine both with and without aura, focusing on light sensitivity as the most relevant visual symptom in migraine, and finally analyzing the visual snow syndrome. We also present possible hypotheses on the underlying pathophysiology of visual snow, for which very little is currently known.
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Affiliation(s)
- Francesca Puledda
- Headache Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NIHR-Wellcome Trust King's Clinical Research Facility, SLaM NIHR Biomedical Research Centre, King's College Hospital, London, United Kingdom
| | - Dominic Ffytche
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Owen O'Daly
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Peter J. Goadsby
- Headache Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NIHR-Wellcome Trust King's Clinical Research Facility, SLaM NIHR Biomedical Research Centre, King's College Hospital, London, United Kingdom
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17
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Enhanced Thalamocortical Synaptic Transmission and Dysregulation of the Excitatory-Inhibitory Balance at the Thalamocortical Feedforward Inhibitory Microcircuit in a Genetic Mouse Model of Migraine. J Neurosci 2019; 39:9841-9851. [PMID: 31645463 DOI: 10.1523/jneurosci.1840-19.2019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/05/2019] [Accepted: 09/22/2019] [Indexed: 12/22/2022] Open
Abstract
Migraine is a complex brain disorder, characterized by attacks of unilateral headache and global dysfunction in multisensory information processing, whose underlying cellular and circuit mechanisms remain unknown. The finding of enhanced excitatory, but unaltered inhibitory, neurotransmission at intracortical synapses in mouse models of familial hemiplegic migraine (FHM) suggested the hypothesis that dysregulation of the excitatory-inhibitory balance in specific circuits is a key pathogenic mechanism. Here, we investigated the thalamocortical (TC) feedforward inhibitory microcircuit in FHM1 mice of both sexes carrying a gain-of-function mutation in CaV2.1. We show that TC synaptic transmission in somatosensory cortex is enhanced in FHM1 mice. Due to similar gain of function of TC excitation of layer 4 excitatory and fast-spiking inhibitory neurons elicited by single thalamic stimulations, neither the excitatory-inhibitory balance nor the integration time window set by the TC feedforward inhibitory microcircuit was altered in FHM1 mice. However, during repetitive thalamic stimulation, the typical shift of the excitatory-inhibitory balance toward excitation and the widening of the integration time window were both smaller in FHM1 compared with WT mice, revealing a dysregulation of the excitatory-inhibitory balance, whereby the balance is relatively skewed toward inhibition. This is due to an unexpected differential effect of the FHM1 mutation on short-term synaptic plasticity at TC synapses on cortical excitatory and fast-spiking inhibitory neurons. Our findings point to enhanced transmission of sensory, including trigeminovascular nociceptive, signals from thalamic nuclei to cortex and TC excitatory-inhibitory imbalance as mechanisms that may contribute to headache, increased sensory gain, and sensory processing dysfunctions in migraine.SIGNIFICANCE STATEMENT Migraine is a complex brain disorder, characterized by attacks of unilateral headache and by global dysfunction in multisensory information processing, whose underlying cellular and circuit mechanisms remain unknown. Here we provide insights into these mechanisms by investigating thalamocortical (TC) synaptic transmission and the function of the TC feedforward inhibitory microcircuit in a mouse model of a rare monogenic migraine. This microcircuit is critical for gating information flow to cortex and for sensory processing. We reveal increased TC transmission and dysregulation of the cortical excitatory-inhibitory balance set by the TC feedforward inhibitory microcircuit, whereby the balance is relatively skewed toward inhibition during repetitive thalamic activity. These alterations may contribute to headache, increased sensory gain, and sensory processing dysfunctions in migraine.
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18
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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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19
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Lisicki M, D'Ostilio K, Coppola G, Parisi V, de Noordhout AM, Magis D, Schoenen J, Scholtes F, Versijpt J. Age related metabolic modifications in the migraine brain. Cephalalgia 2019; 39:978-987. [DOI: 10.1177/0333102419828984] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose The aim of this study was to evaluate the possibility that migraine patients exhibit specific age-related metabolic changes in the brain, which occur regardless of disease duration or the frequency of attacks. Methods We analysed the relation between brain glucose (18F-fluorodeoxyglucose) uptake and age in healthy volunteers (n = 20) and episodic migraine patients (n = 19). In the latter, we additionally compared the correlation between 18F-fluorodeoxyglucose uptake and disease duration and monthly migraine days. Results In contrast to controls, in migraine patients advancing age was positively correlated to increased metabolism in the brainstem (especially the posterior pons), hippocampus, fusiform gyrus and parahippocampus. Conversely, no significant correlations between cerebral metabolism and disease duration or migraine days were observed. Conclusions Findings of this cross-sectional study show that episodic migraine patients exhibit specific metabolic brain modifications while ageing. As such, age is correlated with metabolic changes in key regions of the brain previously associated with migraine's pathophysiology to a better extent than disease duration or the number of monthly migraine days. More than the repeated headache attacks, the continuous interaction with the environment seemingly models the brain of migraine sufferers in an adaptive manner. A positive control (e.g. chronic pain) is missing in this study and therefore findings cannot be proven to be migraine-specific.
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Affiliation(s)
- Marco Lisicki
- Headache Research Unit, University Department of Neurology CHR, Citadelle Hospital, University of Liège, Liège, Belgium
| | - Kevin D'Ostilio
- Headache Research Unit, University Department of Neurology CHR, Citadelle Hospital, University of Liège, Liège, Belgium
| | - Gianluca Coppola
- IRCCS – Fondazione Bietti, Research Unit of Neurophysiology of Vision and Neurophthalmology, Rome, Italy
| | - Vincenzo Parisi
- IRCCS – Fondazione Bietti, Research Unit of Neurophysiology of Vision and Neurophthalmology, Rome, Italy
| | - Alain Maertens de Noordhout
- Headache Research Unit, University Department of Neurology CHR, Citadelle Hospital, University of Liège, Liège, Belgium
| | - Delphine Magis
- Headache Research Unit, University Department of Neurology CHR, Citadelle Hospital, University of Liège, Liège, Belgium
| | - Jean Schoenen
- Headache Research Unit, University Department of Neurology CHR, Citadelle Hospital, University of Liège, Liège, Belgium
| | - Felix Scholtes
- Department of Neurosurgery, University of Liège, Liège, Belgium
- Department of Neuroanatomy, University of Liège, Liège, Belgium
| | - Jan Versijpt
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Neurology, Brussels, Belgium
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20
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Hyperresponsivity in migraine: a network dysfunction or an analytic cognitive style-connected feature? Neurol Sci 2019; 40:415-416. [DOI: 10.1007/s10072-018-3593-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 09/27/2018] [Indexed: 10/28/2022]
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21
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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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