TY - JOUR
T1 - Electrophysiological findings in migraine may reflect abnormal synaptic plasticity mechanisms
T2 - A narrative review
AU - Puledda, Francesca
AU - Viganò, Alessandro
AU - Sebastianelli, Gabriele
AU - Parisi, Vincenzo
AU - Hsiao, Fu Jung
AU - Wang, Shuu Jiun
AU - Chen, Wei Ta
AU - Massimini, Marcello
AU - Coppola, Gianluca
N1 - Publisher Copyright:
© International Headache Society 2023.
PY - 2023/8
Y1 - 2023/8
N2 - Background: The cyclical brain disorder of sensory processing accompanying migraine phases lacks an explanatory unified theory. Methods: We searched Pubmed for non-invasive neurophysiological studies on migraine and related conditions using transcranial magnetic stimulation, electroencephalography, visual and somatosensory evoked potentials. We summarized the literature, reviewed methods, and proposed a unified theory for the pathophysiology of electrophysiological abnormalities underlying migraine recurrence. Results: All electrophysiological modalities have determined specific changes in brain dynamics across the different phases of the migraine cycle. Transcranial magnetic stimulation studies show unbalanced recruitment of inhibitory and excitatory circuits, more consistently in aura, which ultimately results in a substantially distorted response to neuromodulation protocols. Electroencephalography investigations highlight a steady pattern of reduced alpha and increased slow rhythms, largely located in posterior brain regions, which tends to normalize closer to the attacks. Finally, non-painful evoked potentials suggest dysfunctions in habituation mechanisms of sensory cortices that revert during ictal phases. Conclusion: Electrophysiology shows dynamic and recurrent functional alterations within the brainstem-thalamus-cortex loop varies continuously and recurrently in migraineurs. Given the central role of these structures in the selection, elaboration, and learning of sensory information, these functional alterations suggest chronic, probably genetically determined dysfunctions of the synaptic short- and long-term learning mechanisms.
AB - Background: The cyclical brain disorder of sensory processing accompanying migraine phases lacks an explanatory unified theory. Methods: We searched Pubmed for non-invasive neurophysiological studies on migraine and related conditions using transcranial magnetic stimulation, electroencephalography, visual and somatosensory evoked potentials. We summarized the literature, reviewed methods, and proposed a unified theory for the pathophysiology of electrophysiological abnormalities underlying migraine recurrence. Results: All electrophysiological modalities have determined specific changes in brain dynamics across the different phases of the migraine cycle. Transcranial magnetic stimulation studies show unbalanced recruitment of inhibitory and excitatory circuits, more consistently in aura, which ultimately results in a substantially distorted response to neuromodulation protocols. Electroencephalography investigations highlight a steady pattern of reduced alpha and increased slow rhythms, largely located in posterior brain regions, which tends to normalize closer to the attacks. Finally, non-painful evoked potentials suggest dysfunctions in habituation mechanisms of sensory cortices that revert during ictal phases. Conclusion: Electrophysiology shows dynamic and recurrent functional alterations within the brainstem-thalamus-cortex loop varies continuously and recurrently in migraineurs. Given the central role of these structures in the selection, elaboration, and learning of sensory information, these functional alterations suggest chronic, probably genetically determined dysfunctions of the synaptic short- and long-term learning mechanisms.
KW - Aura
KW - cortical excitability
KW - electrophysiology
KW - neurophysiology
KW - synaptic plasticity
KW - transcranial magnetic stimulation
UR - http://www.scopus.com/inward/record.url?scp=85168753803&partnerID=8YFLogxK
U2 - 10.1177/03331024231195780
DO - 10.1177/03331024231195780
M3 - Review article
C2 - 37622421
AN - SCOPUS:85168753803
SN - 0333-1024
VL - 43
JO - Cephalalgia
JF - Cephalalgia
IS - 8
ER -