Cortical Mechanisms of Single-Pulse Transcranial Magnetic Stimulation in Migraine

Lloyd, Joseph; Chisholm, Kim I.; Oehle, Beatrice; Jones, Martyn G.; Okine, Bright N.; Al‐Kaisy, Adnan; Lambru, Giorgio; McMahon, Stephen B.; Andreou, Anna P.

doi:10.1007/s13311-020-00879-6

Cited by 17 publications

(7 citation statements)

References 40 publications

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“…The pooling of trials at multiple stimulation intensities shortens the stimulation protocol (Bauer et al 2019) and is supported by the relatively similar TEP waveforms in the small range of stimulation intensities, between 100 and by GABAergic neurons in the occipital cortex (Coppola et al 2013). Preclinically, single pulse TMS applied to the occipital cortex in rodents increased the threshold for inducing cortical spreading depolarization, the neurobiological correlate of the migraine aura, in the visual cortex (Lloyd et al 2020). GABA A/B antagonists reversed this effect, which indicates that TMS can suppress cortical neuronal activity by influencing GABAergic circuits (Lloyd et al 2020).…”

Section: Discussionmentioning

confidence: 95%

“…Preclinically, single pulse TMS applied to the occipital cortex in rodents increased the threshold for inducing cortical spreading depolarization, the neurobiological correlate of the migraine aura, in the visual cortex (Lloyd et al 2020). GABA A/B antagonists reversed this effect, which indicates that TMS can suppress cortical neuronal activity by influencing GABAergic circuits (Lloyd et al 2020). Paired pulse TMS to study short-interval intracortical inhibition (Cash et al 2017) could be used to further investigate the role of GABAergic networks in altered cortical responsivity in migraine.…”

Section: Discussionmentioning

confidence: 99%

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TMS-evoked EEG potentials demonstrate altered cortical excitability in migraine with aura

et al. 2023

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Migraine is associated with altered sensory processing, that may be evident as changes in cortical responsivity due to altered excitability, especially in migraine with aura. Cortical excitability can be directly assessed by combining transcranial magnetic stimulation with electroencephalography (TMS-EEG). We measured TMS evoked potential (TEP) amplitude and response consistency as these measures have been linked to cortical excitability but were not yet reported in migraine.We recorded 64-channel EEG during single-pulse TMS on the vertex interictally in 10 people with migraine with aura and 10 healthy controls matched for age, sex and resting motor threshold. On average 160 pulses around resting motor threshold were delivered through a circular coil in clockwise and counterclockwise direction. Trial-averaged TEP responses, frequency spectra and phase clustering (over the entire scalp as well as in frontal, central and occipital midline electrode clusters) were compared between groups, including comparison to sham-stimulation evoked responses.Migraine and control groups had a similar distribution of TEP waveforms over the scalp. In migraine with aura, TEP responses showed reduced amplitude around the frontal and occipital N100 peaks. For the migraine and control groups, responses over the scalp were affected by current direction for the primary motor cortex, somatosensory cortex and sensory association areas, but not for frontal, central or occipital midline clusters.This study provides evidence of altered TEP responses in-between attacks in migraine with aura. Decreased TEP responses around the N100 peak may be indicative of reduced cortical GABA-mediated inhibition and expand observations on enhanced cortical excitability from earlier migraine studies using more indirect measurements.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

TMS-evoked EEG potentials demonstrate altered cortical excitability in migraine with aura

et al. 2023

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“…The device consists of a coil electromagnet, and through electromagnetic induction this evokes an electrical current causing the neurons to depolarise. It is thought to disrupt CSD in animal models [110]. In the case of acute migraine treatment, a single or double pulse is administered on attack onset.…”

Section: Discussionmentioning

confidence: 99%

Transcranial Electrical Stimulation in Migraine – How Does It Work and What Can We Learn from It?

O’Hare¹,

Griffiths²

2022

OBM Neurobiol

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Although being one of the most common neurological disorders, migraine is commonly misunderstood and misdiagnosed. Current treatments rely on pharmacological approaches, which have been shown not to be effective for all, and so alternative, non-invasive treatments are being sought. Transcranial stimulation could be a possible treatment for migraine. Transcranial electrical stimulation generally involves applying a current to the cortex via the scalp. Whilst this has previously been mostly done in clinical settings, the advance of technology means that devices intended for use in the home are becoming more readily available. However, one of the major drawbacks is that we are not sure about the mode of action of transcranial electrical neurostimulation specifically in the case of migraine. The purpose of this review is to consolidate our current understanding of how these methods are thought to work in the case of migraine, considering not only their effectiveness in attempting to treat migraine, but also as a tool to understand migraine as a disorder.

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“…Anesthetized animals were fixed stereotaxically and rTMS stimulation was applied. After shaving the mouse's neck and making a minimal incision, a Tesla meter (FW Bell's model 8010) probe was inserted into the skull to measure the Tesla under the skull 18 . The mice were housed in four cages and maintained on a daily 12:12 h light–dark cycle in a temperature-controlled room.…”

Section: Methodsmentioning

confidence: 99%

Development and application of rTMS device to murine model

Choung

Bhattacharjee

Son

et al. 2023

Sci Rep

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Repetitive transcranial magnetic stimulation (rTMS) is attracting attention as a new treatment technique for brain lesions, and many animal studies showing its effects have been reported. However, the findings of animal application researches cannot directly represent the effects of rTMS in human, mainly due to size difference and mechanistic characteristics of rTMS. Therefore, the authors purposed to develop a mouse rTMS to simulate clinical application and to confirm. Firstly, a virtual head model was created according to magnetic resonance images of murine head. Then, simulations of rTMS stimulation with different coils were performed on the murine head phantom, and an rTMS device for mice was fabricated based on the optimal voltage conditions. Lastly, strengths of magnetic fields generated by the two rTMS devices, for human (conventional clinical use) and mouse (newly fabricated), were measured in air and on mouse head and compared. Resultantly, the magnetic field intensity generated by coil of mouse was lower than human’s (p < 0.01), and no differences were found between the predicted simulation values and the measured intensity in vivo (p > 0.05). Further in vivo researches using miniaturized rTMS devices for murine head should be followed to be more meaningful for human.

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Cortical Mechanisms of Single-Pulse Transcranial Magnetic Stimulation in Migraine

Cited by 17 publications

References 40 publications

TMS-evoked EEG potentials demonstrate altered cortical excitability in migraine with aura

TMS-evoked EEG potentials demonstrate altered cortical excitability in migraine with aura

Transcranial Electrical Stimulation in Migraine – How Does It Work and What Can We Learn from It?

Development and application of rTMS device to murine model

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