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Related Experiment Videos

Visual cortex excitability in migraine before and after valproate prophylaxis: a pilot study using TMS.

W M Mulleners1, E P Chronicle, J W Vredeveld

  • 1Department of Neurology, Atrium Medical Center, Heerlen, The Netherlands. w.mulleners@freeler.nl

European Journal of Neurology
|January 11, 2002
PubMed
Summary

Sodium valproate improved migraine symptoms and increased occipital cortical excitability thresholds in some patients. This suggests that gamma-aminobutyric acid (GABA)-ergic interventions may reduce cortical excitability for migraine prophylaxis.

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Area of Science:

  • Neuroscience
  • Neurology
  • Pharmacology

Background:

  • Migraine is a common neurological disorder characterized by recurrent headaches.
  • Cortical excitability changes are implicated in migraine pathophysiology.
  • Sodium valproate is a standard migraine prophylaxis treatment.

Purpose of the Study:

  • To investigate the effect of sodium valproate on occipital cortical excitability in migraine patients.
  • To determine if reduced clinical migraine parameters correlate with changes in cortical excitability.

Main Methods:

  • 31 migraine patients underwent transcranial magnetic stimulation (TMS) assessments before and after 1 month of sodium valproate prophylaxis.
  • Occipital cortical excitability was measured using phosphene threshold determination with circular and figure-of-eight coils.

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  • Headache parameters were recorded by patients throughout the study.

    • Main Results:

    • Sodium valproate significantly improved headache indexes.
    • Phosphene thresholds, indicating cortical excitability, were significantly higher post-treatment in migraine with aura (MA) patients assessed with a figure-of-eight coil.
    • No significant changes in phosphene thresholds were observed in migraine without aura (MO) patients or MA patients assessed with a circular coil.
    • A modest correlation was found between increased phosphene threshold and decreased headache index in MA patients.

    Conclusions:

    • Sodium valproate therapy is effective in improving migraine symptoms.
    • The findings suggest that sodium valproate may reduce cortical excitability, particularly in MA patients, supporting the role of gamma-aminobutyric acid (GABA)-ergic mechanisms in migraine prophylaxis.
    • Further research is warranted to explore the effects of sodium valproate and similar agents on cortical excitability in migraine.