Does the menstrual cycle influence the motor and phosphene thresholds in migraine?

Boros, Klára; Poreisz, Csaba; Paulus, Walter; Antal, Andrea

doi:10.1111/j.1468-1331.2008.02500.x

Cited by 10 publications

(6 citation statements)

References 32 publications

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“…The exact generation of phosphene perception is still under discussion, results suggest that PTs are not functionally analogous to motor-evoked potentials following TMS over M1 but more to conscious perception of visual stimuli, nevertheless occurring within an earlier time window [52]. Unfortunately, it was not possible to measure the cortical excitability in the different phases of the menstrual cycle of the patients, therefore we could not evaluate if the fluctuation of PTs [3,14] was eventually reduced by the stimulation.…”

Section: Discussionmentioning

confidence: 75%

Prophylactic treatment in menstrual migraine: A proof-of-concept study

Wickmann

Stephani

Czesnik

et al. 2015

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 75%

Prophylactic treatment in menstrual migraine: A proof-of-concept study

Wickmann

Stephani

Czesnik

et al. 2015

Journal of the Neurological Sciences

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“…All experiments were performed at the same phase of the menstrual cycle, or in active dosage and withdrawal phases in each subject taking low dosage oral contraceptives, because previous studies showed that, even though MT are unchanged by hormonal levels in both MP and CS, there are differences in SICI measured in the follicular phase compared to the luteal phase in CS [24, 25]. …”

Section: Methodsmentioning

confidence: 99%

Increased variability of motor cortical excitability to transcranial magnetic stimulation in migraine: a new clue to an old enigma

et al. 2011

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Increased, decreased or normal excitability to transcranial magnetic stimulation (TMS) has been reported in the motor (M1) and visual cortices of patients with migraine. Light deprivation (LD) has been reported to modulate M1 excitability in control subjects (CS). Still, effects of LD on M1 excitability compared to exposure to environmental light exposure (EL) had not been previously described in patients with migraine (MP). To further our knowledge about differences between CS and MP, regarding M1 excitability and effects of LD on M1 excitability, we opted for a novel approach by extending measurement conditions. We measured motor thresholds (MTs) to TMS, short-interval intracortical inhibition, and ratios between motor-evoked potential amplitudes and supramaximal M responses in MP and CS on two different days, before and after LD or EL. Motor thresholds significantly increased in MP in LD and EL sessions, and remained stable in CS. There were no significant between-group differences in other measures of TMS. Short-term variation of MTs was greater in MP compared to CS. Fluctuation in excitability over hours or days in MP is an issue that, until now, has been relatively neglected. The results presented here will help to reconcile conflicting observations.Electronic supplementary materialThe online version of this article (doi:10.1007/s10194-011-0379-4) contains supplementary material, which is available to authorized users.

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“…Furthermore, the ovarian cycle may represent another factor influencing cortical excitability [45, 46]; only four studies explicitly assessed such a variable [32, 33, 35, 38], whose effect on cortical excitability is nevertheless still matter of debate [47, 48]. …”

Section: Exploration Of Heterogeneitymentioning

confidence: 99%

Transcranial magnetic stimulation of visual cortex in migraine patients: a systematic review with meta-analysis

et al. 2012

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We systematically reviewed the literature to evaluate the prevalence of phosphenes and the phosphene threshold (PT) values obtained during single-pulse transcranial magnetic stimulation (TMS) in adults with migraine. Controlled studies measuring PT by single-pulse TMS in adults with migraine with or without aura (MA, MwA) were systematically searched. Prevalence of phosphenes and PT values were assessed calculating mean difference (MD) and odds ratio (OR) with 95 % confidence intervals (CI). Ten trials (277 migraine patients and 193 controls) were included. Patients with MA had statistically significant lower PT compared with controls when a circular coil was used (MD −28.33; 95 % CI −36.09 to −20.58); a similar result was found in MwA patients (MD −17.12; 95 % CI −23.81 to −10.43); using a figure-of-eight coil the difference was not statistically significant. There was a significantly higher phosphene prevalence in MA patients compared with control subjects (OR 4.21; 95 % CI 1.18–15.01). No significant differences were found either in phosphene reporting between patients with MwA and controls, or in PT values obtained with a figure-of-eight coil in MA and MwA patients versus controls. Overall considered, these results support the hypothesis of a primary visual cortex hyper-excitability in MA, providing not enough evidence for MwA. A significant statistical heterogeneity reflects clinical and methodological differences across studies, and higher temporal variabilities among PT measurements over time, related to unstable excitability levels. Patients should therefore be evaluated in the true interictal period with an adequate headache-free interval. Furthermore, skull thickness and ovarian cycle should be assessed as possible confounding variables, and sham stimulation should be performed to reduce the rate of false positives. Phosphene prevalence alone cannot be considered a measure of cortical excitability, but should be integrated with PT evaluation.

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Does the menstrual cycle influence the motor and phosphene thresholds in migraine?

Abstract: The results imply that PTs and RMTs can be reliably measured independently from the menstrual hormone status in female migraineurs.

Cited by 10 publications

References 32 publications

Prophylactic treatment in menstrual migraine: A proof-of-concept study

Prophylactic treatment in menstrual migraine: A proof-of-concept study

Increased variability of motor cortical excitability to transcranial magnetic stimulation in migraine: a new clue to an old enigma

Transcranial magnetic stimulation of visual cortex in migraine patients: a systematic review with meta-analysis

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