Somatosensory gating is altered and associated with migraine chronification: A magnetoencephalographic study

Cephalalgia ◽  
2017 ◽  
Vol 38 (4) ◽  
pp. 744-753 ◽  
Author(s):  
Fu-Jung Hsiao ◽  
Shuu-Jiun Wang ◽  
Yung-Yang Lin ◽  
Jong-Ling Fuh ◽  
Yu-Chieh Ko ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Migraine Without Aura ◽  
Headache Frequency ◽  
Sensory Modulation ◽  
Brain Excitability ◽  
Paired Stimuli ◽  
Somatosensory Cortices ◽  
First Response ◽  
Electrical Stimuli ◽  
Somatosensory Gating

Background Brain excitability is changed in migraine but not fully characterized yet. This study explored if somatosensory gating is altered in migraine and linked to migraine chronification. Methods Paired electrical stimuli were delivered to the left index fingers of 21 patients with migraine without aura (MO), 22 patients with chronic migraine (CM), and 36 controls. The first and second responses to the paired stimuli were obtained from the contralateral primary (cSI), contralateral secondary (cSII) and ipsilateral secondary (iSII) somatosensory cortices to compute the gating ratios (second vs. first response strengths). Results The first and second cSI responses and gating ratios differed in all groups ( p < 0.05); the responses were typically smaller in the MO and CM groups. The cSI gating ratio increased as a continuum across controls (0.73 ± 0.04, p < 0.001), MO (0.83 ± 0.04) to CM (0.97 ± 0.06) and was higher in CM vs. controls ( p < 0.001). When MO and CM were combined, cSI gating ratio was associated with headache frequency (r = 0.418, p = 0.005). Paired responses and gating ratios of cSII and iSII did not differ among the groups. Conclusions Somatosensory gating is altered in migraine and associated with headache chronification. Further studies must clarify if this abnormal sensory modulation is a true gating deficit independent of low preexcitation level.

Migraine

2020 ◽  
pp. 213-224
Author(s):  
Julio R Vieira ◽  
Richard B Lipton
Keyword(s):  
Chronic Migraine ◽  
Migraine With Aura ◽  
Cortical Spreading Depression ◽  
Migraine Without Aura ◽  
Spreading Depression ◽  
Headache Frequency ◽  
Motor Symptoms ◽  
Migraine Aura ◽  
Younger Age ◽  
Psychiatric Conditions

This chapter examines migraine. The incidence of migraine varies depending on multiple aspects, including age, sex, and the presence of aura. At an earlier age (younger than age ten), migraine initially affects more boys than girls, with migraine with aura (MA) occurring at a younger age than migraine without aura (MO). Later in life, when puberty starts, this relationship changes and it becomes more common in women than men. Migraine aura are focal neurological symptoms that typically occur prior to the onset of a headache due to a phenomenon called cortical spreading depression. The prevalence of migraine with aura vary between visual, sensory, or motor symptoms. It can also present as diplopia, slurred speech, aphasia, dizziness, vertigo, and hemiparesis. Moreover, the prevalence of migraine varies according to headache frequency. The chapter then looks at chronic migraine and menstrual migraine. It also explores several comorbidities associated with migraine, including many neurologic, medical, and psychiatric conditions.

scholarly journals Botulinum toxin in the management of chronic migraine: clinical evidence and experience

2016 ◽  
Vol 10 (2) ◽  
pp. 127-135 ◽  
Author(s):  
Claus M Escher ◽  
Lejla Paracka ◽  
Dirk Dressler ◽  
Katja Kollewe
Keyword(s):  
Chronic Migraine ◽  
Botulinum Neurotoxin ◽  
Prophylactic Treatment ◽  
Clinical Evidence ◽  
The United States ◽  
Headache Frequency ◽  
United States Food ◽  
History Of ◽  
States Food ◽  
Review Reports

Chronic migraine (CM) is a severely disabling neurological condition characterized by episodes of pulsating unilateral or bilateral headache. The United States Food and Drug Administration (FDA) approved onabotulinumtoxinA (Botox®) for the prophylactic treatment of CM in 2010. It has been shown that onabotulinumtoxinA is effective in the reduction of headache frequency and severity in patients with CM. Treatment is well tolerated by the patients. This review reports on the history of botulinum neurotoxin (BoNT) in CM and presents the current clinical evidence for the use of onabotulinumtoxinA in the treatment of CM.

Psychophysical testing in chronic migraine and chronic tension type headache: An observational study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110603
Author(s):  
Ignacio Elizagaray-García ◽  
Gabriela F Carvalho ◽  
Tibor M Szikszay ◽  
Waclaw M Adamczyk ◽  
Gonzalo Navarro-Fernández ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Tension Type Headache ◽  
Headache Frequency ◽  
Chronic Tension Type Headache ◽  
Psychophysical Testing ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Neck Disability ◽  
Painful Area

Background Clinical presentation is the key to the diagnosis of patients with migraine and tension-type headache, but features may overlap when both become chronic. Psychophysical parameters may distinguish both conditions. We aimed to compare psychophysical aspects of patients with chronic migraine, chronic tension-type headache and headache-free controls, and to determine whether these can predict headache frequency. Methods An examiner blinded to the diagnosis assessed 100 participants (chronic migraine (n = 38), chronic tension-type headache (n = 31) and controls (n = 31)). Assessed variables included painful area, pressure pain thresholds, temporal summation, cervical range of motion, neck posture, headache and neck impact, quality of life, and kinesiophobia. Comparison between groups was performed with one-way ANOVA and multiple linear regression was used to assess the headache frequency predictors. Results We found differences of both headache groups compared to controls ( p < 0.01), but not between headache groups. Neck disability was a significant predictor of headache frequency for chronic tension-type headache (adjusted R2 = 0.14; β = 0.43; p = 0.03) and chronic migraine (adjusted R2 = 0.18; β = 0.51; p < 0.01). Conclusions Chronic tension-type headache and chronic migraine showed similar psychophysical results, but were significantly worse when compared to controls. The psychophysical examination did not discriminate between headache types. The variable best explaining headache frequency for both headache types was neck disability.

scholarly journals Detection of possible factors favouring the evolution of migraine without aura into chronic migraine

2012 ◽  
Vol 33 (S1) ◽  
pp. 165-167 ◽  
Author(s):  
G. C. Manzoni ◽  
L. L. Lombardi ◽  
S. Lana ◽  
M. Maffezzoni ◽  
C. Camarda ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Migraine Without Aura

scholarly journals 1151 Is Timing Of Light Exposure Different In Women With Chronic Migraine?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A438-A439
Author(s):  
S C Dawson ◽  
M Kim ◽  
K Reid ◽  
H J Burgess ◽  
J K Wyatt ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Light Exposure ◽  
Pearson Correlation ◽  
Significant Trend ◽  
Headache Frequency ◽  
Healthy Controls ◽  
Start Time ◽  
Headache Severity ◽  
Wrist Actigraphy ◽  
Daily Headache

Abstract Introduction Light avoidance is a common coping behavior of individuals with migraine headaches. It is not known whether timing of light exposure is different in individuals with chronic migraine (CM) compared to those without migraine and how this may relate to headache frequency and severity. We tested this by examining timing of the brightest and darkest light and headaches in women with chronic migraines and healthy controls. Methods Sixteen women with CM (mean age = 33.07) and 18 female healthy controls (HC; mean age = 32.22) completed daily ratings of headache severity (0-10, severity &gt; 2 classified as headache) concurrent with light exposure measured by wrist actigraphy for approximately one month (M=28.00 days, range=21-36). Start time of each day’s 10-hour periods of maximum light (M10) and 5-hour periods of lowest light (L5) were calculated and averaged for each participant. T-tests and Cohen’s d effect sizes were used to compare groups. Pearson correlation coefficients were calculated to examine associations between M10/L5 timing and headache frequency and severity. Results M10 was earlier in the CM group compared to the HC group (07:42±00:47 vs. 08:50±00:58, t(32)=3.69, p=0.0008, d=1.08). The CM group exhibited non-significant trend towards earlier L5 compared to the HC group (12:26±00:48 vs. 01:07±01:03, t(32)=1.89, p=0.0723, d=0.62). Among individuals with CM, later M10 timing was associated with more severe average daily headache (r=0.60, p=0.0136) and more frequent headaches (r=0.55, p=0.0257). Later L5 timing was significantly associated with more severe average daily headache (r=0.66, p=0.0052) and showed a non-significant trend toward association with more frequent headaches (r=0.47, p=0.0686). Conclusion Timing of the greatest light exposure period was earlier in CM compared to HC. Within the CM group, those who had earlier light and dark periods reported lower headache severity and fewer days with headaches. These findings suggest the possibility of a role for the circadian system in chronic migraine. Support This study was supported by grant R21NS081088 from the National Institutes of Health.

Presence of vestibular symptoms and related disability in migraine with and without aura and chronic migraine

Cephalalgia ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Gabriela F Carvalho ◽  
Flávia Heck Vianna-Bell ◽  
Lidiane L Florencio ◽  
Carina F Pinheiro ◽  
Fabiola Dach ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Migraine With Aura ◽  
Migraine Without Aura ◽  
Cross Sectional Study ◽  
Control Group ◽  
Dizziness Handicap Inventory ◽  
Cross Sectional ◽  
Severe Handicap ◽  
Migraine Frequency ◽  
Vestibular Symptoms

Objective To assess the presence and handicap due to vestibular symptoms in three subgroups of patients with migraine and controls. Methods Women between 18–55 years old were diagnosed by headache specialists and stratified as migraine with aura (n = 60), migraine without aura (n = 60), chronic migraine (n = 60) and controls (n = 60). Information regarding demographics, headache and vestibular symptoms were collected in this cross-sectional study. The self-perceived handicap related to vestibular symptoms was assessed through the Dizziness Handicap Inventory questionnaire. Results A total of 85% of women with migraine with aura and chronic migraine had vestibular symptoms contrasted to 70% of the migraine without aura group ( p < 0.05), and 12% of the control group reported symptoms ( p < 0.0001). Patients with migraine exhibited greater Dizziness Handicap Inventory scores than controls ( p < 0.001); and migraine with aura and chronic migraine groups reached greater scores than migraine without aura ( p < 0.01). Presence of migraine is associated with a greater risk of vestibular symptoms (migraine without aura: 5.20, migraine with aura: 6.60, chronic migraine:6.20, p < 0.0003) and with a greater risk of moderate-to-severe handicap (migraine without aura: 20.0, migraine with aura: 40.0, chronic migraine: 40.0, p < 0.0003). The presence of aura and greater migraine frequency adds to the risk of any handicap (migraine with aura: 1.9, chronic migraine: 1.7, p < 0.04) and to the risk of moderate-to-severe handicap (migraine with aura: 2.0, chronic migraine: 2.0, p < 0.0003). Migraine aura, intensity and frequency predict 36% of the dizziness handicap. Conclusion The prevalence of vestibular symptoms is increased in migraine during and between headache attacks, particularly in migraine with aura and chronic migraine along with an increased handicap due to those symptoms. Vestibular symptoms among subgroups of migraine should be considered when evaluating the functional impact of migraine.

Improved Amplitude of Myogenic Motor Evoked Responses after Paired Transcranial Electrical Stimulation during Sufentanil/Nitrous Oxide Anesthesia

1995 ◽  
Vol 83 (2) ◽  
pp. 270-276. ◽  
Author(s):  
Cor J. Kalkman ◽  
Leon H. Ubags ◽  
Henk D. Been ◽  
Astrid Swaan ◽  
John C. Drummond
Keyword(s):  
Aortic Surgery ◽  
Maximum Amplitude ◽  
Single Pulse ◽  
Single Stimulus ◽  
Transcranial Electrical Stimulation ◽  
Anesthetic Techniques ◽  
Transcranial Stimulation ◽  
Evoked Responses ◽  
Paired Stimuli ◽  
Electrical Stimuli

Background Measurement of motor evoked responses to transcranial stimulation (tc-MER) is a technique for intraoperative monitoring of motor pathways in the brain and spinal cord. However, clinical application of tc-MER monitoring is hampered because most anesthetic techniques severely depress the amplitude of motor evoked responses. Because paired electrical stimuli increase tc-MER responses in awake subjects, we examined their effects in anesthetized patients undergoing surgery. METHODS. Eleven patients whose neurologic condition was normal and who were undergoing spinal or aortic surgery were anesthetized with sufentanil-N20-ketamine. Partial neuromuscular blockade (single-twitch height 25% of baseline) was maintained with vecuronium. Single and paired electrical stimuli were delivered to the scalp, and compound action potentials were recorded from the tibialis anterior muscle. The amplitude and latency of the tc-MERs were measured as the interval between paired stimuli was varied between 0 (single stimulus) and 10 ms. All recordings were completed before spinal manipulation or aortic clamping. Results Median amplitude of the tc-MER after a single stimulus was 106 microV (10th-90th percentiles: 23-1,042 microV), and the latency to onset was 33.2 +/- 1.4 ms (SD). With paired stimuli (interstimulus interval 2-3 ms), tc-MER amplitudes increased to 285 (79-1,605) microV, or 269% of the single-pulse response (P &lt; 0.01). Reproducibility of individual responses increased with paired stimulation. Onset latency decreased to 31.4 +/- 3.2 ms (P &lt; 0.05). Maximum amplitude augmentation was observed with interstimulus intervals between 2 and 5 ms and in patients with low-amplitude responses after single-pulse stimulation. Conclusions Application of paired transcranial electrical stimuli increases amplitudes and reproducibility of tc-MERs during anesthetic-induced depression of the motor system. The effect may represent temporal summation of stimulation at cortical or spinal sites. The results of this study warrant further clinical evaluation of paired transcranial stimulation.

Effects of The Remote C Fibres Stimulation Induced by Capsaicin on the Blink Reflex in Chronic Migraine

Cephalalgia ◽  
2007 ◽  
Vol 27 (8) ◽  
pp. 881-890 ◽  
Author(s):  
M de Tommaso ◽  
M Sardaro ◽  
C Pecoraro ◽  
O Di fruscolo ◽  
C Serpino ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Normal Subjects ◽  
Blink Reflex ◽  
Episodic Migraine ◽  
Capsaicin Application ◽  
Subjective Pain ◽  
The Right ◽  
Electrical Stimuli ◽  
Trigeminal Reflex ◽  
Central Level

The aim of this study was to test the function of the diffuse noxious inhibitory control system (DNIC) in chronic and episodic migraine, exploring the blink reflex (BR) modifications induced by topical application of capsaicin on the hand. We evaluated 11 migraine without aura (MA) and nine chronic migraine (CM) patients during the not symptomatic phase; they were compared with 14 non-headache subjects (N). The BR was elicited by weak electrical stimuli delivered to the right supraorbital nerve; it was obtained 10 min and 20 min after the application of 1 ml of 3% capsaicin in a cream base (Teofarma) on the skin of the dorsum of the right hand, and 60 min after capsaicin removal. The subjective pain sensation induced by capsaicin was significantly increased in CM with respect to both MA patients and normal subjects; the R2 area was increased in CM patients during capsaicin application, with respect to controls and MA patients, who did not exhibit any reflex alterations. These results may suggest a failure of DNIC and a disturbed control of the trigeminal reflex at the central level, linked with migraine frequency.

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