EEG and Topographic Frequency Analysis in Migraine Attack Before and After Sumatriptan Infusion

Abstract

Electroencephalographic changes occurring in patients with migraine have received much attention. Although in migraineurs a number of studies have been done after nitroglycerin-induced attacks, there is no reported EEG study before and after nitroglycerin-induced sumatriptan-treated attacks. We, therefore, studied the EEG topographic frequency analysis in 19 symptom-free, otherwise healthy, unmedicated patients with common migraine and in 19 age- and sex-matched controls before nitroglycerin, at the time of maximum pain, and 30 minutes after sumatriptan. During headache attacks, an increase of slow rhythmic activity of the theta and delta range and a decrease of activity in the alpha and beta range were observed. These abnormalities disappeared 30 minutes after a sumatriptan injection. This suggests that common migraine is associated with disturbances of cortical electrogenesis and may provide insight into the causes of migraine and aid in the development of effective therapies.

Rapid absorption of sumatriptan powder and effects on glyceryl trinitrate model of headache following intranasal delivery using a novel bi-directional device

“…The percentage of activity in this frequency band was consistently decreased with the three treatments before GTN challenge and maintained for at least 15 min following the GTN challenge. These results are in accordance with previous findings reporting a decreased percentage of slow frequency activity with 6 mg subcutaneous sumatriptan and are opposite to the EEG changes induced by the GTN challenge (excess of theta activity by more than 15%, delta only a few percent) 30 . In our hands the drug in addition increased beta EEG activity.…”

“…Consequently, this study does not allow direct determination of the GTN challenge‐induced qEEG changes. However, the latter has been characterized in previous studies with increase in relative slow‐wave activity described as the main effects in migraine sufferers during GTN‐induced headache whereas decrease in alpha and beta activity was not significant 30,31 . A similar pattern of EEG slowing appears to characterize migraine sufferers compared with controls 32–34 …”

Does sumatriptan cross the blood–brain barrier in animals and man?

“…The abnormalities disappeared after a sumatriptan injection [57]. One cannot exclude, however, that the effect of sumatriptan in this study is due to an effect on migraine per se.…”

“…In another study on glyceryl trinitrate-induced migraine, during attacks there was an increase in slow rhythmic activity of the theta and delta range and a decrease of activity in the alpha and beta range [57]. The abnormalities disappeared after a sumatriptan injection [57].…”

Neurophysiologische Befunde bei Migräne - Spiegelbild der Pathophysiologie oder Epiphänomen?

“…[35] an Patienten mit MOA während der Kopfschmerzphase erbrachten ebenfalls lateralisierte Verlangsamungen der a-Grundtätigkeit in posterioren Kortexarealen. Diese iktualen Frequenzverlangsamungen zeigten sich in einer weiteren Untersuchung 30 Minuten nach Sumatriptaninfusion regredient [41]. Ferner fand sich während der Kopfschmerzphase eine drastische Absenkung der interiktual abnorm erhöhten Steady-State-VEP bei MOA [35].…”