Functional MRI-BOLD of Visually Triggered Headache in Patients With Migraine

Abstract

We conclude that visually triggered headache and visual change in patients with migraine is accompanied by spreading suppression of initial neuronal activation and increased occipital cortex oxygenation. We postulate that this spreading suppression may be associated with initial activation of a migraine attack, independent of whether there are associated aura symptoms. We further postulate that there may be an association between vasodilation accompanying the initial stage of suppression and the induction of headache.

Mechanisms of migraine aura revealed by functional MRI in human visual cortex

“…Our data confirmed previous reports that CSD-like phenomena can be seen with neuroimaging techniques (7,10,12,15,19,20,28). Like those previous studies, our data indicated a slowly spreading area of abnormal blood flow in the occipital lobe during migraine aura.…”

“…Our findings build on the recent observations of Cao et al (19) in the following ways. First, we identified specific BOLD events in the visual cortex that appeared to be directly linked to the aura percept, in both space (retinotopy) and time.…”

Mechanisms of migraine aura revealed by functional MRI in human visual cortex

“…Our data confirmed previous reports that CSD-like phenomena can be seen with neuroimaging techniques (7,10,12,15,19,20,28). Like those previous studies, our data indicated a slowly spreading area of abnormal blood flow in the occipital lobe during migraine aura.…”

“…Our findings build on the recent observations of Cao et al (19) in the following ways. First, we identified specific BOLD events in the visual cortex that appeared to be directly linked to the aura percept, in both space (retinotopy) and time.…”

Evaluating migraine with typical aura with neuroimaging

“…This study for the first time used fMRI to visualize the aura itself, as well as the interictal phase in 3 subjects, and provided supportive imaging evidence for CSD mediating visual aura in the occipital cortex in this subject, and the propagation of this correlating with clinical symptoms. Similar findings had been previously observed using fMRI by Cao et al (1999) , with two captured auras ( Cao et al, 1999 ).…”

“…This study for the first time used fMRI to visualize the aura itself, as well as the interictal phase in 3 subjects, and provided supportive imaging evidence for CSD mediating visual aura in the occipital cortex in this subject, and the propagation of this correlating with clinical symptoms. Similar findings had been previously observed using fMRI by Cao et al (1999), with two captured auras (Cao et al, 1999). Arngrim et al (2017) were able to demonstrate differences in BOLD response over the visual cortex between positive and negative aura symptoms, suggesting a correlation between BOLD signal and clinical aura phenotype, and also suggested that occipital changes could occur bilaterally in bilateral aura.…”

Aura and Other Neurologic Dysfunction in or with Migraine

“…These changes in BOLD activation expanded into neighboring cortex at a rate of 3.5 mm per minute and were consistent with BOLD fMRI findings observed in animal models of CSD . In a later series of patients who experienced migraine attacks (both with and without aura) triggered by visual stimuli, both headache and visual symptoms were preceded by suppression of initial activation with slow propagation into the contiguous occipital cortex at a rate ranging from 3 to 6 mm/min and accompanied by increased occipital cortex oxygenation …”

Mechanisms of migraine aura revealed by functional MRI in human visual cortex

“…Our data confirmed previous reports that CSD-like phenomena can be seen with neuroimaging techniques (7,10,12,15,19,20,28). Like those previous studies, our data indicated a slowly spreading area of abnormal blood flow in the occipital lobe during migraine aura.…”

“…Our findings build on the recent observations of Cao et al (19) in the following ways. First, we identified specific BOLD events in the visual cortex that appeared to be directly linked to the aura percept, in both space (retinotopy) and time.…”

Evaluating migraine with typical aura with neuroimaging

“…This study for the first time used fMRI to visualize the aura itself, as well as the interictal phase in 3 subjects, and provided supportive imaging evidence for CSD mediating visual aura in the occipital cortex in this subject, and the propagation of this correlating with clinical symptoms. Similar findings had been previously observed using fMRI by Cao et al (1999) , with two captured auras ( Cao et al, 1999 ).…”

“…This study for the first time used fMRI to visualize the aura itself, as well as the interictal phase in 3 subjects, and provided supportive imaging evidence for CSD mediating visual aura in the occipital cortex in this subject, and the propagation of this correlating with clinical symptoms. Similar findings had been previously observed using fMRI by Cao et al (1999), with two captured auras (Cao et al, 1999). Arngrim et al (2017) were able to demonstrate differences in BOLD response over the visual cortex between positive and negative aura symptoms, suggesting a correlation between BOLD signal and clinical aura phenotype, and also suggested that occipital changes could occur bilaterally in bilateral aura.…”

Aura and Other Neurologic Dysfunction in or with Migraine

“…These changes in BOLD activation expanded into neighboring cortex at a rate of 3.5 mm per minute and were consistent with BOLD fMRI findings observed in animal models of CSD . In a later series of patients who experienced migraine attacks (both with and without aura) triggered by visual stimuli, both headache and visual symptoms were preceded by suppression of initial activation with slow propagation into the contiguous occipital cortex at a rate ranging from 3 to 6 mm/min and accompanied by increased occipital cortex oxygenation …”

Mechanisms of migraine aura revealed by functional MRI in human visual cortex

“…Our data confirmed previous reports that CSD-like phenomena can be seen with neuroimaging techniques (7,10,12,15,19,20,28). Like those previous studies, our data indicated a slowly spreading area of abnormal blood flow in the occipital lobe during migraine aura.…”

“…Our findings build on the recent observations of Cao et al (19) in the following ways. First, we identified specific BOLD events in the visual cortex that appeared to be directly linked to the aura percept, in both space (retinotopy) and time.…”

Evaluating migraine with typical aura with neuroimaging

“…This study for the first time used fMRI to visualize the aura itself, as well as the interictal phase in 3 subjects, and provided supportive imaging evidence for CSD mediating visual aura in the occipital cortex in this subject, and the propagation of this correlating with clinical symptoms. Similar findings had been previously observed using fMRI by Cao et al (1999) , with two captured auras ( Cao et al, 1999 ).…”

“…This study for the first time used fMRI to visualize the aura itself, as well as the interictal phase in 3 subjects, and provided supportive imaging evidence for CSD mediating visual aura in the occipital cortex in this subject, and the propagation of this correlating with clinical symptoms. Similar findings had been previously observed using fMRI by Cao et al (1999), with two captured auras (Cao et al, 1999). Arngrim et al (2017) were able to demonstrate differences in BOLD response over the visual cortex between positive and negative aura symptoms, suggesting a correlation between BOLD signal and clinical aura phenotype, and also suggested that occipital changes could occur bilaterally in bilateral aura.…”

Aura and Other Neurologic Dysfunction in or with Migraine

“…These changes in BOLD activation expanded into neighboring cortex at a rate of 3.5 mm per minute and were consistent with BOLD fMRI findings observed in animal models of CSD . In a later series of patients who experienced migraine attacks (both with and without aura) triggered by visual stimuli, both headache and visual symptoms were preceded by suppression of initial activation with slow propagation into the contiguous occipital cortex at a rate ranging from 3 to 6 mm/min and accompanied by increased occipital cortex oxygenation …”