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The Journal of Headache and Pain

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Open Access 01-12-2019 | Migraine | Review article

Clinical neurophysiology of migraine with aura

Authors: Gianluca Coppola, Cherubino Di Lorenzo, Vincenzo Parisi, Marco Lisicki, Mariano Serrao, Francesco Pierelli

Published in: The Journal of Headache and Pain | Issue 1/2019

Abstract

Background

The purpose of this review is to provide a comprehensive overview of the findings of clinical electrophysiology studies aimed to investigate changes in information processing of migraine with aura patients.

Main body

Abnormalities in alpha rhythm power and symmetry, the presence of slowing, and increased information flow in a wide range of frequency bands often characterize the spontaneous EEG activity of MA. Higher grand-average cortical response amplitudes, an increased interhemispheric response asymmetry, and lack of amplitude habituation were less consistently demonstrated in response to any kind of sensory stimulation in MA patients. Studies with single-pulse and repetitive transcranial magnetic stimulation (TMS) have reported abnormal cortical responsivity manifesting as greater motor evoked potential (MEP) amplitude, lower threshold for phosphenes production, and paradoxical effects in response to both depressing or enhancing repetitive TMS methodologies. Studies of the trigeminal system in MA are sparse and the few available showed lack of blink reflex habituation and abnormal findings on SFEMG reflecting subclinical, probably inherited, dysfunctions of neuromuscular transmission. The limited studies that were able to investigate patients during the aura revealed suppression of evoked potentials, desynchronization in extrastriate areas and in the temporal lobe, and large variations in direct current potentials with magnetoelectroencephalography. Contrary to what has been observed in the most common forms of migraine, patients with familial hemiplegic migraine show greater habituation in response to visual and trigeminal stimuli, as well as a higher motor threshold and a lower MEP amplitude than healthy subjects.

Conclusion

Since most of the electrophysiological abnormalities mentioned above were more frequently present and had a greater amplitude in migraine with aura than in migraine without aura, neurophysiological techniques have been shown to be of great help in the search for the pathophysiological basis of migraine aura.

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Title: Clinical neurophysiology of migraine with aura
Authors: Gianluca Coppola
Cherubino Di Lorenzo
Vincenzo Parisi
Marco Lisicki
Mariano Serrao
Francesco Pierelli
Publication date: 01-12-2019
Publisher: Springer Milan
Keywords: Migraine
Motor Evoked Potential
Magnetoencephalography
Transcranial Magnetic Stimulation
Repetitive Transcranial Magnetic Stimulation
Evoked Potential
Electroencephalography
Motor Evoked Potential
Nerve Stimulation
Aura
Evoked Potential
Transcranial Magnetic Stimulation
Published in: The Journal of Headache and Pain / Issue 1/2019
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-019-0997-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical neurophysiology of migraine with aura

Abstract

Background

Main body

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Main body

Conclusion

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