Neuromagnetic Abnormality of Motor Cortical Activation and Phases of Headache Attacks in Childhood Migraine

Abstract

The cerebral cortex serves a primary role in the pathogenesis of migraine. This aberrant brain activation in migraine can be noninvasively detected with magnetoencephalography (MEG). The objective of this study was to investigate the differences in motor cortical activation between attacks (ictal) and pain free intervals (interictal) in children and adolescents with migraine using both low- and high-frequency neuromagnetic signals. Thirty subjects with an acute migraine and 30 subjects with a history of migraine, while pain free, were compared to age- and gender-matched controls using MEG. Motor cortical activation was elicited by a standardized, validated finger-tapping task. Low-frequency brain activation (1∼50 Hz) was analyzed with waveform measurements and high-frequency oscillations (65–150 Hz) were analyzed with wavelet-based beamforming. MEG waveforms showed that the ictal latency of low-frequency brain activation was significantly delayed as compared with controls, while the interictal latency of brain activation was similar to that of controls. The ictal amplitude of low-frequency brain activation was significantly increased as compared with controls, while the interictal amplitude of brain activation was similar to that of controls. The ictal source power of high-frequency oscillations was significantly stronger than that of the controls, while the interictal source power of high-frequency oscillations was significantly weaker than that of controls. The results suggest that aberrant low-frequency brain activation in migraine during a headache attack returned to normal interictally. However, high-frequency oscillations changed from ictal hyper-activation to interictal hypo-activation. Noninvasive assessment of cortical abnormality in migraine with MEG opens a new window for developing novel therapeutic strategies for childhood migraine by maintaining a balanced cortical excitability.

Multi-frequency analysis of brain connectivity networks in migraineurs: a magnetoencephalography study

“…Most previous studies have investigated migraine by using MEG while patients were performing a task, including visual stimuli task [ 34 ], auditory stimuli task [ 28 ] and motor stimuli task [ 35 ]. However, these methods can only explore the stimulus-activated brain regions and not the entire brain.…”

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

“…Similarly, neuromagnetic difference between treatment controlled and treatment uncontrolled requires more subjects in our follow-up assessments. The present study provides evidence supporting increased cortical excitability in migraine as compared with controls, but how these neural signatures of migraine differs from those of epilepsy remains unknown 36, 37 . As the present study focused on the auditory and motor systems, the spatial information leading to emphasis on heterogeneity is limited to the two functional modalities.…”

“…Recent reports have shown that cyclical changes of cortical excitability play a key role in migraine attacks 16, 36 . Magnetoencephalography (MEG), a relatively new clinical modality for noninvasive assessment of functional brain activation, has been used to find that there are significant neuromagnetic abnormalities in the motor cortex of childhood migraine sufferers 13,37 .…”

Migraine with Aura or Sports-Related Concussion: Case Report, Pathophysiology, and Multidisciplinary Approach to Management

“…Similarly, alterations of consciousness and confusion can occur during attacks of familial hemiplegic migraine. In children, acute confusional migraine has been reported (52), and slowed cortical activation during acute migraine in children and adolescents can contribute to cognitive dysfunction (63,64). However, there is some debate as to whether confusional migraine in children and adolescents is truly confusional or simply a language disorder (29).…”