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Persistent ictal-like visual cortical excitability in chronic migraine
Wei-Ta Chen1, Shuu-Jiun Wang, Jong-Ling Fuh
1Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan.
Chronic migraine (CM) patients exhibit persistent visual cortex overexcitability between attacks, unlike episodic migraine (EM) patients. This suggests central inhibitory dysfunction may drive CM progression from EM.
Area of Science:
- Neuroscience
- Neurology
- Migraine Pathophysiology
Background:
- Episodic migraine (EM) can progress to chronic migraine (CM) through unknown mechanisms.
- Understanding the pathophysiology of CM is crucial for developing targeted treatments.
Purpose of the Study:
- To investigate the differences in visual cortical responses between EM and CM patients.
- To elucidate the underlying mechanisms of migraine transformation.
Main Methods:
- Neuromagnetic visual-evoked responses (P100m) were recorded in EM (interictal and ictal), CM (interictal), and control groups.
- Habituation of P100m amplitude was assessed by comparing responses across blocks of visual stimulation.
- Analysis focused on changes in P100m amplitude from initial to final stimulation blocks.
Main Results:
- Controls showed P100m habituation, while EM patients in the interictal state exhibited potentiation.
- CM patients displayed P100m habituation but with higher initial amplitudes compared to interictal EM.
- The P100m pattern in CM mirrored that of EM patients during ictal states, suggesting persistent hyperexcitability.
Conclusions:
- Chronic migraine is associated with a persistent ictal-like visual cortex excitability pattern between attacks.
- This pattern suggests a potential central inhibitory dysfunction contributing to CM development and persistence.
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