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Motor and Occipital Cortex Excitability in Migraine Patients

  • Sefer Gunaydin (a1), Aysun Soysal (a1), Turan Atay (a1) and Baki Arpaci (a1)
Abstract:
Objective:

We evaluated motor and occipital cortex excitability in migraine patients using transcranial magnetic stimulation.

Methods:

In this study, we included 15 migraine patients with aura (MwA), 15 patients without aura (MwoA) between attacks, and 31 normal healthy controls. Motor thresholds at rest, amplitudes of motor evoked potentials, central motor conduction time and cortical silent period were measured by stimulation of the motor cortex by using 13.5 cm circular coil and recording from abductor digiti minimi muscle. Additionally, phosphene production and the threshold of phosphene production was determined by stimulation of the visual cortex with the same coil.

Results:

No significant differences were observed between the groups with respect to the motor thresholds, Motor evoked potential max/compound muscle action potential max (MEPmax/Mmax) amplitudes, central motor conduction times and duration of cortical silent period. Although not statistically significant, the proportion of the migraineurs with phosphene generation (90%) was found to be higher than that of normal controls (71%). Phosphene threshold levels in migraine patients, however, were significantly lower than those of the controls with MwA patients having the lowest levels.

Conclusion:

Our findings indicate that the occipital cortex, but not the motor cortex, is hyperexcitable in migraine patients.

RÉSUMÉ Objectif:

Nous avons évalué par stimulation magnétique transcrânienne l'excitabilité du cortex moteur et du cortex occipital chez des patients migraineux.

Méthodes:

Nous avons étudié entre les crises 15 patients ayant une migraine avec aura (MaA), 15 patients migraineux sans aura (MsA) et 31 témoins en bonne santé. Les seuils moteurs au repos, les amplitudes des potentiels évoqués moteurs (PÉM), le temps de conduction moteur central et la période de silence cortical ont été mesurés par stimulation du cortex moteur au moyen d'une spirale circulaire de 13,5 cm et enregistrement au niveau du muscle abducteur du petit doigt. De plus, la production de phosphènes et le seuil de production de phosphènes ont été déterminés par stimulation du cortex visuel avec la même spirale.

Résultats:

Nous n'avons observé aucune différence significative entre les groupes quant aux seuils moteurs, aux amplitudes PÉMmax/Mmax, aux temps de conduction motrice centrale et à la durée des périodes de silence cortical. Bien que ce ne soit pas significatif au point de vue statistique, la proportion de migraineux qui ont eu des phosphènes (90%) était plus élevée que celle des témoins normaux (71%). Le niveau seuil de phosphènes chez les migraineux était cependant significativement plus bas que celui des témoins et les MaA avaient le seuil le plus bas.

Conclusion:

Nos observations indiquent que le cortex occipital est hyperexcitable chez les migraineux, mais que le cortex moteur ne l'est pas.

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Atakoy 5. Kisim E1/1A Blok Daire: 8 34158 Bakirkoy/Istanbul, Turkey
References
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1. Betucci, D, Cantello, R, Gianelli, M, Naldi, P, Mutani, R. Menstrüelmigraine without aura: cortical excitability to magnetic stimulation. Headache. 1992; 32: 3457.
2. Maertens de Noordhout, A, Pepin, JL, Schoenen, J, Delwaide, PJ. Percutaneous magnetic stimulation of the motor cortex in migraine. Electroencephalogr Clin Neurophysiol. 1992; 85: 1105.
3. van der Kamp, W, Maassen VanDenBrink, A, Ferrari, MD, van Dijk, JG. Interictal cortical hyperexcitability in migraine patients demonstrated with transcranial magnetic stimulation. J Neurol Sci. 1996; 139: 10610.
4. van der Kamp, W, Maassen Van Den Brink, A, Ferrari, MD, van Dijk, JG. Interictal cortical excitability to magnetic stimulation in familial hemiplegic migraine. Neurology. 1997; 48: 14624.
5. Afra, J, Mascia, A, Gerard, P, de Noordhout, MA, Schoenen, J. Interictal cortical excitability in migraine: a study using transcranial magnetic stimulation of motor and visual cortices. Ann Neurol. 1998; 44: 20915.
6. Aurora, SK, Welch, KMA. Brain excitability in migraine: evidencefrom transcranial magnetic stimulation studies. Curr Opin Neurol. 1998; 11: 2059.
7. Aurora, SK, Ahmad, BK, Welch, KMA, Bhardwaj, P, Ramadan, NM. Transcranial magnetic stimulation confirms hyperexcitability of occipital cortex in migraine. Neurology. 1998; 50: 11114.
8. Aurora, SK, Al-Sayeed, F, Welch, KMA. The cortical silent period isshortened in migraine with aura. Cephalalgia. 1999; 19: 70812.
9. Aurora, SK, Cao, Y, Bowyer, SM, Welch, KMA. The occipital cortex ishyperexcitable in migraine: experimental evidence. Headache 1999; 39: 46976.
10. Werhahn, KJ, Wisenen, K, Herzog, J, et al. Motor cortex excitability inpatients with migraine with aura and hemiplegic migraine. Cephalalgia. 2000; 20: 4550.
11. Mulleners, WM, Chronicle, EP, Palmer, JE, Koehler, PJ, Vredeveld, JW. Visual cortex excitability in migraine with and without aura. Headache. 2001;41: 56572.
12. Mulleners, WM, Chronicle, EP, Palmer, JE, Koehler, PJ, Vredeveld, JW. Supression of perception in migraine: evidence for reduced inhibition in the visual cortex. Neurology. 2001; 56: 17883.
13. Battelli, L, Black, KR, Wray, SH. Transcranial magnetic stimulation ofvisual area V5 in migraine. Neurology. 2002; 58: 10669.
14. Brighina, F, Piazza, A, Daniele, O, Fierro, B. Modulation of visualcortical excitability in migraine with aura: effects of 1 Hz repetetive transcranial magnetic stimulation. Exp Brain Res. 2002; 145 : 17781.
15. Mulleners, WM, Chronicle, EP, Vredeveld, JW, Koehler, PJ. Visualcortex excitability in migraine before and after valproate prophylaxis: a pilot study using TMS. Eur J Neurol. 2002; 9: 3540.
16. Ozturk, V, Cakmur, R, Donmez, B, et al. Comparison of corticalexcitability in chronic migraine (transformed migraine) and migraine without aura. J Neurol. 2002; 249: 126871.
17. Ambrosini, A, de Noordhout, AM, Sandor, PS,Schoenen, J. Electrophysiological studies in migraine: a comprehensive review of their interest and limitations. Cephalalgia. 2003; 23 Suppl 1: 1331.
18. Aurora, SK, Welch, KMA, Al-Sayeed, F. The threshold for phosphenesis lower in migraine. Cephalalgia. 2003; 23: 25863.
19. Fierro, B, Ricci, R, Piazza, A, et al. 1 Hz rTMS enhances extrastriatecortex activity in migraine: evidence of a reduced inhibition? Neurology. 2003; 61: 14468.
20. Fumal, A, Bohotin, V, Vandenheede, M, Schoenen, J. Transcranialmagnetic stimulation in migraine: a review of facts and controversies. Acta Neurol Belg. 2003; 103: 14454.
21. Rossini, PM. The anatomic and physiologic bases of motor evokedpotentials. In: Gilmore, R, editor. Neurologic clinics: evoked potentials. Philadelphia: W.B. Saunders Company; 1988. p. 75169.
22. Kimura, J. Somatosensory and motor evoked potentials. In: Kimura, J ,editor. Electrodiagnosis in diseases of nerve and muscle: principles and practice. Philadelphia: F.A. Davis Company; 1989.p. 375426.
23. Murray, NMF. Motor evoked potentials. In: Aminoff, MJ, editor. Electrodiagnosis in clinical neurology. New York: ChurchillLivingstone; 1992. p. 60526.
24. Cros, D, Chiappa, KH. Motor evoked potentials. In: Chiappa, KH, editor. Evoked potentials in clinical medicine. Philadelphia:Lippincott-Raven Publishers; 1997. p. 477507.
25. Robinson, LR. Magnetic stimulation of the central and peripheralnervous systems. In: Dumitri, D, Amato, AA, Zwarts, MJ, editors. Electrodiagnostic medicine. Philadelphia: Hanley & Belfus, inc;2002. p. 41527.
26. Headache Classification Committee of the International HeadacheSociety. Classification and diagnostic criteria for headache disorders, cranial neuralgies and facial pain. Cephalalgia. 1988; 8 Suppl 7: 196.
27. Ramadan, NM, Halvarson, H, Vande-Linde, A, et al. Low brainmagnesium in migraine. Headache. 1989; 29: 5903.
28. Gallai, V, Sarchielli, P, Coata, G, et al. Serum and salivary magnesiumlevels in migraine. Results in a group of juvenile patients. Headache. 1992; 32: 1325.
29. Mauskop, A, Altura, BT, Cracco, RQ, Altura, BM. Deficiency in serumionized magnesium but not total magnesium in patients with migraines. Possible role of ICa2+/IMg2+ ratio. Headache. 1993;33: 1358.
30. Aloisi, P, Marrelli, A, Porto, C, Tozzi, E, Cerone, G. Visual evokedpotentials and serum magnesium levels in juvenile migraine patients. Headache. 1997; 37: 3835.
31. Silberstein, SD, Lipton, RB, Dalessio, DJ. The pathophysiology ofprimary headache. In: Silberstein, SD, Lipton, RB, Dalessio, DJ, editors. Headache in clinical practice. Oxford: ISIS Medical Media; 1998. p. 4158.
32. Swanson, JW, Dodick, DW, Capobianco, DJ. Headache and othercraniofacial pain. In: Bradley, WG, Daroff, RB, Fenichel, GM, Marsden, CD, editors. Neurology in clinical practice. Vol 2. Boston: Butterworth-Heinemann; 2000. p. 182978.
33. Ferrari, MD, Haan, J. Genetics of headache. In: Silberstein, SD, Lipton, RB, Dalessio, DJ, editors. Wolff's headeache and other head pain. Oxford: Oxford University Press; 2001. p. 7384.
34. Boroojerdi, B, Prager, A, Muellbacher, W, Cohen, L.G. Reduction ofhuman visual cortex excitability using 1 Hz. transcranial magnetic stimulation. Neurology. 2000; 54: 152931.
35. Bohotin, V, Fumal, A, Vandenheede, M, Bohotin, C, Schoenen, J. Excitability of visual V1-V2 and motor cortices to single transcranial magnetic stimuli in migraine: a reappraisal using afigure-of-eight coil. Cephalalgia. 2003; 23: 26470.
36. Aurora, SK, Welch, KMA. Phosphene generation in migraine (letter).Ann Neurol. 1999; 45: 4167.
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