Altered processing of sensory stimuli in patients with migraine

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

Pattern reversal visual evoked potentials in migraine subjects without aura

Twenty seven patients with migraine without aura were investigated. The age was between 12 and 54 years; 5 were men and 22 women. The diagnosis of migraine was made according to the classification proposed by the International Headache Society. The method of visual evoked potential was performed with pattern reversal (VEP-PR), with monocular stimulation. The stimulation was performed with pattern reversal with 4x4 cm black and white and red and green squared screen placed 1 meter from the nasion at stimulus frequency 1/s; 128 individual trials were analysed. The VEP-PR with black/white and red/green study showed a significant increase of value of the P-100 latency in 10 migraine patients. In 8 cases the LP100 in VEP-PR black/white was normal but in VEP-PR red/green the LP100 showed increase. Specifically in 1 of our cases, LP100 were normal in VEP-PR black/white but in the red/green there were no reproductice waves. On basis of these observations we consider that the method of VEP-PR is an useful instrument for investigation of migraine patients without aura

Electrophysiological studies in migraine: a comprehensive review of their interest and limitations

Electrophysiological methods may help to unravel some of the pathophysiological mechanisms of migraine. Lack of habituation is the principal and most reproducible interictal abnormality in sensory processing in migraineurs. It is found in evoked potential (EP) studies for every stimulation modality including nociceptive stimuli, and it is likely to be responsible for the increased intensity dependence of EP. We have hypothesized that deficient EP habituation in migraine could be due to a reduced preactivation level of sensory cortices because of hypofunctioning subcortico-cortical aminergic pathways. This is not in keeping with simple hyperexcitability of the cortex, which has been suggested by some, but not all, studies of transcranial magnetic stimulation (TMS). A recent study of the effects of repetitive TMS on visual EP strongly supports the hypothesis that migraine is characterized by interictal cortical hypoexcitability. With regard to pain mechanisms in migraine, electrophysiological studies of trigeminal pathways using nociceptive blink and corneal reflexes have confirmed that sensitization of central trigeminal nociceptors occurs during migraine attacks