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The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2013

Open Access 01-12-2013 | Research article

Electrophysiological correlates of episodic migraine chronification: evidence for thalamic involvement

Authors: Gianluca Coppola, Elisa Iacovelli, Martina Bracaglia, Mariano Serrao, Cherubino Di Lorenzo, Francesco Pierelli

Published in: The Journal of Headache and Pain | Issue 1/2013

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Abstract

Background

Episodic migraine is characterized by decreased high-frequency somatosensory oscillations (HFOs), reflecting thalamo-cortical activity, and deficient habituation of low-frequency (LF-) somatosensory evoked potentials (SSEPs) to repetitive sensory stimulation between attacks. Here, we study conventional LF-SSEPs and HFOs in episodic migraineurs who developed chronic migraine (CM).

Methods

Thirty-four episodic (15 interictally [MOii], 19 ictally [MOi]) and 19 CM patients underwent right median nerve SSEPs. The patient groups were compared to a group of 20 healthy volunteers (HV) of comparable age and gender distribution. We measured the N20-P25 LF-SSEP 1st amplitude block and habituation, and, after applying a band-pass filter (450–750 Hz), maximal peak-to-peak latency and the amplitudes of the early and late HFOs.

Results

Reduced early HFOs, lower 1st block LF-SSEPs and deficient habituation characterize MOii. Initially higher SSEP amplitudes and late normal habituation characterize both CM and MOi patients. After the digital filtration, both patient groups showed shortened latency peaks and normalization of early HFO amplitudes with increased late HFOs. When data of MO and CM patients were combined, the monthly number of days with headache negatively correlated with the LF-SSEP slope (r = −0.385, p = 0.006), which in turn negatively correlated with the 1st amplitude block (r = 0.568, p < 0.001).

Conclusions

Our results show abnormalities in chronic migraine that are also reported during attacks in episodic migraineurs, namely early response sensitization and late habituation. The HFO analysis suggests that this sensory sensitization may be explained by an increase in the strength of the connections between the thalamus and cortex compared to episodic migraine between attacks. Whether this electro-functional behaviour is primary or secondary to daily headache, thus reflecting an electrophysiological fingerprint of the somatosensory system central sensitization process, remains to be determined.
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Metadata
Title
Electrophysiological correlates of episodic migraine chronification: evidence for thalamic involvement
Authors
Gianluca Coppola
Elisa Iacovelli
Martina Bracaglia
Mariano Serrao
Cherubino Di Lorenzo
Francesco Pierelli
Publication date
01-12-2013
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2013
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/1129-2377-14-76

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