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Is the cerebral cortex hyperexcitable or hyperresponsive in migraine?

G Coppola1, F Pierelli, J Schoenen

  • 1G.B. Bietti Eye Foundation-IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome, Italy.

Cephalalgia : an International Journal of Headache
|November 24, 2007
PubMed
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Migraineurs exhibit a hyperresponsive brain, reacting excessively to repetitive stimuli. This hypersensitivity, not hyper- or hypo-excitability, may stem from thalamo-cortical dysrhythmia, requiring further research.

Area of Science:

  • Neuroscience
  • Neurology
  • Migraine Research

Background:

  • Migraineurs often report hypersensitivity to stimuli, fatigue, and sleepiness.
  • Neurophysiological studies reveal a lack of habituation in the migrainous brain across various sensory modalities.
  • Existing research on cortical excitability in migraine, particularly using transcranial magnetic stimulation, presents conflicting findings.

Purpose of the Study:

  • To review and synthesize available data on cortical excitability in migraine patients throughout the migraine cycle.
  • To clarify the nature of cortical responsivity in migraineurs, addressing the hyper- versus hypo-excitability debate.
  • To propose a unifying concept of 'hyperresponsivity' for the migrainous brain.

Main Methods:

  • Review of neurophysiological studies examining cortical excitability in migraine patients.

Related Experiment Videos

  • Analysis of data obtained using diverse methodological approaches, including transcranial magnetic stimulation.
  • Examination of patient responses to both single and repetitive stimuli across the migraine cycle.

    • Main Results:

    • Data consistently indicate that sensory cortices in migraineurs react excessively to repetitive stimuli, but not single stimuli.
    • The controversy surrounding hyper- versus hypo-excitability is resolved by understanding this specific pattern of response.
    • The term 'hyperresponsive' accurately describes the observed cortical activity in migraineurs.

    Conclusions:

    • The migrainous brain is best characterized as hyperresponsive, particularly to repetitive sensory input.
    • Thalamo-cortical dysrhythmia is proposed as a potential underlying mechanism for this hyperresponsivity.
    • Further research is needed to elucidate the cellular and molecular basis of migraine-associated hyperresponsivity.