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

Conforto, Adriana Bastos; Moraes, Mariana Salim de; Amaro, Edson; Young, William B.; Lois, L. A.; Gonçalves, André Leite; Peres, Mario F. P.

doi:10.1007/s10194-011-0379-4

Cited by 17 publications

(15 citation statements)

References 52 publications

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“…Finally, we acknowledge as a possible limitation of the present study that some researchers observed that the RMT was not stable over days, which may have complicated the interpretation of values measured at one point in time [38]. However, this is not completely detrimental because it may further support our findings that cortex excitability is not stable between attacks but rather undergoes daily fluctuations during the so-called migraine cycle.…”

Section: Discussionmentioning

confidence: 60%

Excitability of the motor cortex in patients with migraine changes with the time elapsed from the last attack

et al. 2017

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BackgroundMotor-evoked potentials (MEPs) produced by single-pulse transcranial magnetic stimulation (TMS) of the motor cortex can be an objective measure of cortical excitability. Previously, MEP thresholds were found to be normal, increased, or even reduced in patients with migraine. In the present study, we determined whether the level of cortical excitability changes with the time interval from the last migraine attack, thereby accounting for the inconsistencies in previous reports.MethodsTwenty-six patients with untreated migraine without aura (MO) underwent a MEP study between attacks. Their data were then compared to the MEP data collected from a group of 24 healthy volunteers (HVs). During the experiment, the TMS figure-of-eight coil was positioned over the left motor area. After identifying the resting motor threshold (RMT), we delivered 10 single TMS pulses (rate: 0.1 Hz, intensity: 120% of the RMT) and averaged the resulting MEP amplitudes.ResultsThe mean RMTs and MEP amplitudes were not significantly different between the MO and HV groups. In patients with MO, the RMTs were negatively correlated with the number of days elapsed since the last migraine attack (rho = -0.404, p = 0.04).ConclusionOur results suggest that the threshold for evoking MEPs is influenced by the proximity of an attack; specifically, the threshold is lower when a long time interval has passed after an attack, and is higher (within the range of normative values) when measured close to an attack. These dynamic RMT variations resemble those we reported previously for visual and somatosensory evoked potentials and may represent time-dependent plastic changes in brain excitability in relation to the migraine cycle.

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Section: Discussionmentioning

confidence: 60%

Excitability of the motor cortex in patients with migraine changes with the time elapsed from the last attack

et al. 2017

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“…36,38 This finding may be very important in developing spatially targeted therapeutic interventions for migraine in the future. 7,26 …”

Section: Discussionmentioning

confidence: 99%

“…These findings support the notion that migraine is a neurologic disorder caused by cortical dysfunction. 7,26 …”

Section: Discussionmentioning

confidence: 99%

Altered Cortical Activation in Adolescents With Acute Migraine: A Magnetoencephalography Study

Xiang

deGrauw

Korostenskaja

et al. 2013

The Journal of Pain

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To quantitatively assess cortical dysfunction in pediatric migraine, 31 adolescents with acute migraine and age- and gender-matched controls were studied using a magnetoencephalography (MEG) system at a sampling rate of 6,000 Hz. Neuromagnetic brain activation was elicited by a finger-tapping task. The spectral and spatial signatures of magnetoencephalography data in 5 to 2,884 Hz were analyzed using Morlet wavelet and beamformers. Compared with controls, 31 migraine subjects during their headache attack phases (ictal) showed significantly prolonged latencies of neuromagnetic activation in 5 to 30 Hz, increased spectral power in 100 to 200 Hz, and a higher likelihood of neuromagnetic activation in the supplementary motor area, the occipital and ipsilateral sensorimotor cortices, in 2,200 to 2,800 Hz. Of the 31 migraine subjects, 16 migraine subjects during their headache-free phases (interictal) showed that there were no significant differences between interictal and control MEG data except that interictal spectral power in 100 to 200 Hz was significantly decreased. The results demonstrated that migraine subjects had significantly aberrant ictal brain activation, which can normalize interictally. The spread of abnormal ictal brain activation in both low- and high-frequency ranges triggered by movements may play a key role in the cascade of migraine attacks. Perspective This is the first study focusing on the spectral and spatial signatures of cortical dysfunction in adolescents with migraine using MEG signals in a frequency range of 5 to 2,884 Hz. This analyzing aberrant brain activation may be important for developing new therapeutic interventions for migraine in the future.

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“…Consequently, clinical treatment, such as TMS, may selectively target the affected region or functional neural network, which may lead to better clinical outcomes 16 . In other words, this finding may be very important in developing spatially targeted therapeutic interventions for migraine in the future 8, 30 . Third, the measurements of auditory and motor functions in the pediatric populations imply that the evaluation of a single functional modality (e.g.…”

Section: Discussionmentioning

confidence: 80%

“…This finding is important because it may explain some conflicting results in previous reports 10 . Specifically, many previous reports based on TMS 6, 8 and transcranial direct current stimulation (tDCS) 1, 33 have revealed alteration of cortical excitability in migraine. However, it remains unclear if migraine is associated with hyper- or hypo-excitability in the cortex 10 .…”

Section: Discussionmentioning

confidence: 99%

Spatial Heterogeneity of Cortical Excitability in Migraine Revealed by Multifrequency Neuromagnetic Signals

Xiang

Leiken

deGrauw

et al. 2016

The Journal of Pain

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To investigate the spatial heterogeneity of cortical excitability in adolescents with migraine, magnetoencephalography (MEG) recordings at a sampling rate of 6000 Hz were obtained from 35 adolescents with an acute migraine and 35 age- and gender-matched healthy controls during an auditory-motor task. Neuromagnetic activation from low- to high-frequency ranges (5–1,000 Hz) was measured at both sensor and source levels. The heterogeneity of cortical excitability was quantified within each functional modality (auditory vs. motor) and hemispherical lateralization. MEG data showed that high-frequency, not low-frequency neuromagnetic signals, revealed heterogeneous cortical activation in migraine subjects as compared with controls (p < 0.001). The alteration of the heterogeneity of cortical excitability in migraine was independent of age and gender. The degree of the neuromagnetic heterogeneity of cortical activation was significantly correlated with headache frequency (r=0.71, p < 0.005). The alteration of cortical excitability in migraine is spatially heterogeneous and frequency dependent, which has not previously been reported. The finding may be critical for developing spatially targeted therapeutic strategies for normalizing cortical excitability with the purpose of reducing headache attacks. Perspective This article presents a new approach to quantitatively measuring the spatial heterogeneity of cortical excitability in adolescents with migraine using MEG signals in a frequency range of 5–1000 Hz. The characteristics of the location and degree of cortical excitability may be critical for spatially targeted treatment for migraine.

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

Cited by 17 publications

References 52 publications

Excitability of the motor cortex in patients with migraine changes with the time elapsed from the last attack

Excitability of the motor cortex in patients with migraine changes with the time elapsed from the last attack

Altered Cortical Activation in Adolescents With Acute Migraine: A Magnetoencephalography Study

Spatial Heterogeneity of Cortical Excitability in Migraine Revealed by Multifrequency Neuromagnetic Signals

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