Peri-ictal Normalization of Visual Cortex Excitability in Migraine: an MEG Study

Wt, Chen; Sj, Wang; Fuh, Jong Ling; Chen, Lin; Yc, Ko; Lin, Yaping

doi:10.1111/j.1468-2982.2009.01857.x

Cited by 55 publications

(61 citation statements)

References 51 publications

(71 reference statements)

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“…This interpretation is in line with numerous evoked potential studies that have applied similar protocols (e.g. Afra et al, 1998;Ambrosini et al, 2003;Brodsky et al, 2013;Chen et al, 2009;Coppola et al, 2013b;Ozkul and Uckardes, 2002;Sand et al, 2008;Schoenen et al, 1995;Siniatchkin et al, 2006;Valeriani et al, 2003). The present study did not aim to investigate if the amplitude decline during VEP stimulation is caused by habituation in the central nervous system.…”

Section: Progressive Amplitude Changes During Recoding Of Vepsupporting

confidence: 71%

Visual evoked potentials in migraine: Is the “neurophysiological hallmark” concept still valid?

Omland

Uglem

Hagen

et al. 2016

Clinical Neurophysiology

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Please cite this article as: Omland, P.M., Uglem, M., Hagen, K., Linde, M., Tronvik, E., Sand, T., Visual evoked potentials in migraine: Is the "neurophysiological hallmark" concept still valid ?, Clinical Neurophysiology (2015), doi: http://dx.doi.org/10. 1016/j.clinph.2014.12.035 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. • Lack of VEP habituation is not a reliable "neurophysiological hallmark" in interictal migraine• Strict focus on methodology, including blinding during the recording and assessment of VEP, is important to avoid overestimation of effect sizes in future studies.2 Abstract Objective Lack of habituation is considered a neurophysiological hallmark of migraine. However, the results of visual evoked potential (VEP) studies have been discrepant, possibly because of different stimulation parameters and lack of blinding. Hence, there is a need for independent confirmation of lack of VEP habituation in migraine. In this blinded study we applied 16' checks to supplement our previous findings with 8', 31', 62' and 65' checks. MethodsVEPs in 41 interictal migraineurs and 30 controls were compared. VEPs were recorded in six blocks of 100 single responses. Linear N70-P100 amplitude change over blocks (habituation slope) was compared with an independent samples Student's t-test. ResultsAmplitude decline over blocks was observed in both groups. Habituation slope was not significantly different between controls (-0.43 ± 0.54 μV/block) and migraineurs (-0.29 ± 0.35 μV/block) (p = 0.33). ConclusionVEP habituation with 16' checks did not differ in migraineurs and controls. This is in agreement with previous findings with other stimulation parameters. It is therefore unlikely that use of different stimulation parameters could explain the discrepant results of previous studies. No studies that applied blinding during recording of VEP have found lack of habituation in migraineurs. SignificanceLack of VEP habituation cannot be considered a reliable neurophysiological hallmark in migraine.

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Section: Progressive Amplitude Changes During Recoding Of Vepsupporting

confidence: 71%

Visual evoked potentials in migraine: Is the “neurophysiological hallmark” concept still valid?

Omland

Uglem

Hagen

et al. 2016

Clinical Neurophysiology

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“…[44][45][46][47] Subsequently, deficient habituation was demonstrated for another event related potential, P300, which is eli cited in the process of decision making after visual 48 or auditory 49,50 stimulation. Deficient habitu ation was also subsequently described for several other modality specific evoked potentials: pattern reversal visual evoked potentials (VEPs), [33][34][35][36][37][38][39][40][41][42] visual evoked magneto encephalographic (MEG) responses, 43 auditory evoked potentials (AEPs), 51,52 and somatosensory evoked poten tials (SSEPs). [53][54][55] Several other studies, however, were not able to reproduce these results and found no habitu ation deficit in individuals with migraine, possibly because of differences in the methods used or selection of patients.…”

Section: Impaired Habituationmentioning

confidence: 92%

“…It is accompanied by initially decreased or normal amplitude of response after a small number of stimuli, followed by a stable amplitude, or even a transient amplitude increase (potentiation). [34][35][36][37][38][39][40][41][42][43] The first evidence for altered interictal habituation in patients with migraine came from studies of contingent negative variation (CNV), a slow event related corti cal response representing higher mental functions. [44][45][46][47] Subsequently, deficient habituation was demonstrated for another event related potential, P300, which is eli cited in the process of decision making after visual 48 or auditory 49,50 stimulation.…”

Section: Impaired Habituationmentioning

confidence: 99%

“…Interestingly, the habituation deficit reappears when patients evolve from chronic to episodic migraine. 83 Since the response pattern in chronic migraine is indistinguishable from that observed during migraine attacks, 43,[51][52][53][54][55][56][57][58][59][60][61][62][70][71][72] our research group has suggested that patients with chronic migraine are locked in an ictal like state. 84 The most prevalent factor associated with the tran sition from episodic to chronic migraine is acute medication overuse.…”

Section: Chronic Migrainementioning

confidence: 99%

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Altered processing of sensory stimuli in patients with migraine

et al. 2014

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| Migraine is a cyclic disorder, in which functional and morphological brain changes fluctuate over time, culminating periodically in an attack. In the migrainous brain, temporal processing of external stimuli and sequential recruitment of neuronal networks are often dysfunctional. These changes reflect complex CNS dysfunction patterns. Assessment of multimodal evoked potentials and nociceptive reflex responses can reveal altered patterns of the brain's electrophysiological activity, thereby aiding our understanding of the pathophysiology of migraine. In this Review, we summarize the most important findings on temporal processing of evoked and reflex responses in migraine. Considering these data, we propose that thalamocortical dysrhythmia may be responsible for the altered synchronicity in migraine. To test this hypothesis in future research, electrophysiological recordings should be combined with neuroimaging studies so that the temporal patterns of sensory processing in patients with migraine can be correlated with the accompanying anatomical and functional changes.

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“…This could be related to the changes in visual cortex responsiveness over the migraine cycle [20,22] and between episodic and chronic migraine [23]. For instance, during stimulus repetition, EEG and magnetoencephalographic visual evoked responses lack habituation in episodic migraine between attacks, but habituate normally during attacks and in chronic migraine [24,25,26]. Since the response pattern in chronic migraine is indistinguishable from that found during attacks in episodic migraine, it was suggested that chronic migraine patients are locked in an "ictal-like state" [23,27].…”

Section: Discussionmentioning

confidence: 99%

Analysis and clinical correlates of 20 Hz photic driving on routine EEG in migraine

et al. 2014

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Abstract:Enhanced photic driving (PD) during high frequency flicker stimulation, the so-called H response, is a classical feature of migraine patients between attacks, but is thought to be of poor clinical utility. Visual inspection of the EEG for its detection may not be reliable, however, and data on its possible correlations with clinical features and migraine pathophysiology are scarce.We have compared visual inspection and EEG spectral analysis to detect abnormal PD in 280 consecutive migraine patients of our headache clinic (episodic migraine without aura, n=171; chronic migraine, n=48; migraine with aura, n=61) and in a group of 24 non-migrainous neurological controls. Spectral frequency analyses were performed blindly by one of us (YF). On visual inspection, 50.4% of migraineurs were thought to have increased 20Hz PD. After spectral analysis, only 62.4% of them had PD power superior to the mean+95%CI of the control group. Sensitivity of visually identified PD was 82.24%, specificity 69.36%. Increased PD on spectral analysis was more prevalent in episodic migraine than in chronic migraine, in patients with low attack frequency, in those with ictal autonomic symptoms in addition to nausea and in those with a strong family history of migraine. We confirm therefore that 20Hz photic driving is of little diagnostic utility and its prevalence in migraine overestimated on visual inspection. Its presence on spectral analysis of the EEG, however, might be of pathophysiological interest, as it identifies subgroups of migraineurs of whom the common denominator could be lack of habituation of cortical responses during repetitive stimulation. We have compared visual inspection and EEG spectral analysis to detect abnormal PD in 280 consecutive migraine patients of our headache clinic (episodic migraine without aura, n=171; chronic migraine, n=48; migraine with aura, n=61) and in a group of 24 non-migrainous neurological controls. Spectral frequency analyses were performed blindly by one of us (YF).On visual inspection, 50.4% of migraineurs were thought to have increased 20Hz PD. After spectral analysis, only 62.4% of them had PD power superior to the mean+95%CI of the control group. Sensitivity of visually identified PD was 82.24%, specificity 69.36%.Increased PD on spectral analysis was more prevalent in episodic migraine than in chronic migraine, in patients with low attack frequency, in those with ictal autonomic symptoms in addition to nausea and in those with a strong family history of migraine.We confirm therefore that 20Hz photic driving is of little diagnostic utility and its prevalence in migraine overestimated on visual inspection. Its presence on spectral analysis of the EEG, however, might be of pathophysiological interest, as it identifies subgroups of migraineurs of whom the common denominator could be lack of habituation of cortical responses during repetitive stimulation.

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Peri-ictal Normalization of Visual Cortex Excitability in Migraine: an MEG Study

Cited by 55 publications

References 51 publications

Visual evoked potentials in migraine: Is the “neurophysiological hallmark” concept still valid?

Visual evoked potentials in migraine: Is the “neurophysiological hallmark” concept still valid?

Altered processing of sensory stimuli in patients with migraine

Analysis and clinical correlates of 20 Hz photic driving on routine EEG in migraine

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