Related Experiment Video
Updated: May 15, 2026
10:39
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Primary visual cortex excitability in migraine: a systematic review with meta-analysis
Francesco Brigo1, Monica Storti, Frediano Tezzon
1Section of Clinical Neurology, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy. dr.francescobrigo@gmail.com
Summary
Migraine patients with aura (MA) show lower phosphene thresholds and higher phosphene prevalence during transcranial magnetic stimulation (TMS), suggesting visual cortex hyper-excitability. Migraine without aura (MwA) showed no significant differences.
Area of Science:
- Neuroscience
- Clinical Neurology
- Ophthalmology
Background:
- Migraine is a common neurological disorder.
- Cortical excitability changes are hypothesized in migraine pathophysiology.
- Phosphenes, visual sensations, can be elicited by transcranial magnetic stimulation (TMS).
Purpose of the Study:
- To systematically review and meta-analyze the prevalence of phosphenes and phosphene threshold (PT) values in adults with migraine using single-pulse TMS.
- To compare PT and phosphene prevalence between migraine patients (with and without aura) and healthy controls.
Main Methods:
- Systematic literature review and meta-analysis of controlled studies measuring PT with single-pulse TMS.
- Inclusion of published and unpublished studies.
- Calculation of mean difference (MD) and odds ratio (OR) with 95% confidence intervals (CI).
Main Results:
- Fifteen trials (369 migraine patients, 269 controls) were included.
- Migraine with aura (MA) patients had a significantly lower PT with circular coils (MD: -22.27) and higher phosphene prevalence (OR: 3.57) compared to controls.
- No significant differences in PT or phosphene prevalence were found for migraine without aura (MwA) or with figure-of-eight coils.
Conclusions:
- Results provide slight support for primary visual cortex hyper-excitability in MA.
- Evidence for altered cortical excitability in MwA is insufficient.
- Significant heterogeneity across studies suggests clinical and methodological variability.
