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We evaluated motor and occipital cortex excitability in migraine patients using transcranial magnetic stimulation.
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.
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.
Our findings indicate that the occipital cortex, but not the motor cortex, is hyperexcitable in migraine patients.
Nous avons évalué par stimulation magnétique transcrânienne l'excitabilité du cortex moteur et du cortex occipital chez des patients migraineux.
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.
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.
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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