TY - JOUR
T1 - Persistent ictal-like visual cortical excitability in chronic migraine
AU - Chen, Wei Ta
AU - Wang, Shuu Jiun
AU - Fuh, Jong Ling
AU - Lin, Ching Po
AU - Ko, Yu Chieh
AU - Lin, Yung Yang
N1 - Funding Information:
This study was supported by National Science Council (Taiwan) [NSC 94-2314-B-038-014 and NSC-96-2314-B-075-073-MY3 to W.T., NSC-96-2628-B-010-030-MY3 and NSC98-2321-B-010-007 to Y.Y., NSC-95-2314-B-010-031-MY3 to S.J.]; Taipei Veterans General Hospital [V98B2-004 to W.T., V99C1-063 to S.J., V97ER3-006, VGHUST97-P6-24, V97C1-034, VGH ER3-98-002, VGH-S4-98-018, VGH-C1-99-156, and VGH-ER3-99-006 to Y.Y.]; and a grant from the Ministry of Education, Aim for the Top University Plan.
PY - 2011/2
Y1 - 2011/2
N2 - Episodic migraine (EM) may evolve into the more disabling chronic migraine (CM, monthly migraine days ≥ 8 and headache days ≥ 15) with unknown mechanism. Aiming to elucidate the pathophysiology of CM and its relationship with EM, this study characterized the visual cortical responses in CM and EM. Neuromagnetic visual-evoked responses to left-hemifield checkerboard reversals were obtained in patients with EM (interictal or ictal states), CM (interictal) and age-matched controls. For each subject, the 1500 evoked responses were sequentially divided into 30 blocks and percentage changes of P100m amplitude in blocks 2, 9, 16, 23, and 30 compared to the first block were computed to assess habituation. At the end of visual stimulation (block 30), P100m amplitude was decreased (habituated) in the controls (n = 32) (35.2 ± 2.6 nAm vs. 41.9 ± 2.7, p = 0.005) but increased (potentiated) in the interictal state of EM (n = 29) (39.7 ± 3.8 vs. 33.5 ± 3.0, p = 0.007). In CM (n = 25), P100m was habituated (46.5 ± 2.9 vs. 51.6 ± 3.7, p = 0.013) but higher at the initial block than in those of the interictal state of EM (p = 0.001). These CM features also characterized the P100m in the ictal state of EM (n = 9). There was no difference of P100m between CM and ictal state of EM. In conclusion, patients with CM demonstrate a persistent ictal-like excitability pattern of the visual cortex between migraine attacks which may implicate central inhibitory dysfunction.
AB - Episodic migraine (EM) may evolve into the more disabling chronic migraine (CM, monthly migraine days ≥ 8 and headache days ≥ 15) with unknown mechanism. Aiming to elucidate the pathophysiology of CM and its relationship with EM, this study characterized the visual cortical responses in CM and EM. Neuromagnetic visual-evoked responses to left-hemifield checkerboard reversals were obtained in patients with EM (interictal or ictal states), CM (interictal) and age-matched controls. For each subject, the 1500 evoked responses were sequentially divided into 30 blocks and percentage changes of P100m amplitude in blocks 2, 9, 16, 23, and 30 compared to the first block were computed to assess habituation. At the end of visual stimulation (block 30), P100m amplitude was decreased (habituated) in the controls (n = 32) (35.2 ± 2.6 nAm vs. 41.9 ± 2.7, p = 0.005) but increased (potentiated) in the interictal state of EM (n = 29) (39.7 ± 3.8 vs. 33.5 ± 3.0, p = 0.007). In CM (n = 25), P100m was habituated (46.5 ± 2.9 vs. 51.6 ± 3.7, p = 0.013) but higher at the initial block than in those of the interictal state of EM (p = 0.001). These CM features also characterized the P100m in the ictal state of EM (n = 9). There was no difference of P100m between CM and ictal state of EM. In conclusion, patients with CM demonstrate a persistent ictal-like excitability pattern of the visual cortex between migraine attacks which may implicate central inhibitory dysfunction.
KW - Chronic migraine
KW - Human
KW - Magnetoencephalography
KW - Migraine
KW - Visual cortical excitability
KW - Visual-evoked magnetic field
UR - http://www.scopus.com/inward/record.url?scp=78651479106&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2010.08.047
DO - 10.1016/j.pain.2010.08.047
M3 - Article
C2 - 21145169
AN - SCOPUS:78651479106
SN - 0304-3959
VL - 152
SP - 254
EP - 258
JO - Pain
JF - Pain
IS - 2
ER -