Monitoring Migraine Cycle Dynamics with an Easy-to-Use Electrophysiological Marker—A Pilot Study

Abstract

Migraine attacks can cause significant discomfort and reduced functioning for days at a time, including the pre-ictal and post-ictal periods. During the inter-ictsal period, however, migraineurs seem to function normally. It is puzzling, therefore, that event-related potentials of migraine patients often differ in the asymptomatic and inter-ictal period. Part of the electrophysiological dynamics demonstrated in the migraine cycle are attention related. In this pilot study we evaluated an easy-to-use new marker, the Brain Engagement Index (BEI), for attention monitoring during the migraine cycle. We sampled 12 migraine patients for 20 days within one calendar month. Each session consisted of subjects’ reports of stress level and migraine-related symptoms, and a 5 min EEG recording, with a 2-electrode EEG device, during an auditory oddball task. The first minute of the EEG sample was analyzed. Repetitive samples were also obtained from 10 healthy controls. The brain engagement index increased significantly during the pre-ictal (p ≈ 0.001) and the ictal (p ≈ 0.020) periods compared with the inter-ictal period. No difference was observed between the pre-ictal and ictal periods. Control subjects demonstrated intermediate Brain Engagement Index values, that is, higher than inter-ictal, yet lower than pre-ictal. Our preliminary results demonstrate the potential advantage of the use of a simple EEG system for improved prediction of migraine attacks. Further study is required to evaluate the efficacy of the Brain Engagement Index in monitoring the migraine cycle and the possible effects of interventions.

Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the Disease

“…This aspect of the migraine cycle shows a surprising symmetry with the fMRI, where the Broadman areas 17–19 of the visual cortex demonstrated a peculiar pattern of activation related to the distance from the migraine attack [ 16 ]. The same cyclic pattern has been shown in sensorimotor and visual cortices by both electrophysiological and neuroimaging studies [ 2 , 3 , 11 , 36 , 38 , 39 ]. Functional neuroimaging or combined electrophysiological techniques could help to discriminate morpho-functional elements.…”

Tracking the Migraine Cycle Using Visual Tasks

“…There are also now a number of reports that have tried to track migraine periodicity directly by testing patients sufficiently regularly that they catch changes before, during and after each episode [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]; these are reviewed in [ 44 ]. There are comparable reports of cyclic fluctuations in imaging studies in migraine, notably in the hypothalamus and brainstem [ 45 , 46 , 47 , 48 ].…”

The Effects of Anesthetics on the Cortex—Lessons From Event-Related Potentials

“…In further studies, we showed that it is possible to specify effective markers, for the attention-related process in the delta band activity from stimulus onset to about 600 ms after stimulus and for the perception-related process in the alpha band activity in the first 200 ms after stimulus onset (Shahaf et al, 2015). Specifically, with regard to the attention-related marker, we showed its efficacy in various clinical populations, such as patients with depression Isserles et al, 2018), attention deficit hyperactivity disorder (ADHD) patients (Shahaf et al, 2018b), migraine patients (Shahaf et al, 2018a), and patients in rehabilitation after stroke (Bartur et al, 2017(Bartur et al, , 2019.…”