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Published on: December 18, 2016
The patent foramen ovale may alter migraine brain activity: A pilot study of electroencephalography spectrum and
Xiangyu Lei1, Meng Wei1, Yi Qi1
1Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Background:
A link has been shown between patent foramen ovale (PFO) and migraine, particularly migraine with aura. However, it is unknown if PFO might cause migraine by altering cortical excitability and neural network, which may lower the threshold of cortical spreading depression (CSD). This study aims to compare the spectrum power and functional connectivity of the alpha and beta bands of electroencephalography (EEG) across migraine patients with and without PFO.
Methods:
Thirty-five migraine patients with PFO (PFO +), 35 migraine patients without PFO (PFO -) and 20 PFO patients without migraine (control) were enrolled in this cross-sectional analysis. 19-channel EEG was recorded for all patients under resting state and intermittent photic stimulation. Power spectrum density (PSD) and phase lag index (PLI) of alpha and beta bands were then calculated and compared between the three groups.
Results:
During photic stimulation, the beta band PSD at the occipital area was substantially higher in PFO + migraine patients compared to PFO-migraine patients (p < 0.05, Bonferroni corrected). Subgroup analysis showed that both migraine with and without aura patients with PFO had increased PSD in the alpha and beta bands at the occipital region during photic stimulation (p < 0.05, Bonferroni corrected). Meanwhile, the beta band PLI during photic stimulation was significantly elevated (adjusted p = 0.008, utilizing the network-based statistic technique) in PFO + group compared to PFO-group. Furthermore, although failed to pass the correction, the beta band power in the occipital area during photic stimulation at 20 Hz on O1 (R = 0.392, p = 0.024) and O2 channel (R = 0.348, p = 0.047) was prone to positively correlated with MIDAS score, and during photic stimulation at 12 Hz on O2 channel (R = 0.396, p = 0.022) and 20 Hz (R = 0.365, p = 0.037) on O1 channel was prone to positively correlated to HIT-6 score in PFO+ migraineurs, whereas no similar correlation was found in the PFO-group patients.
Conclusion:
The outcomes of this investigation suggested that PFO may change the cortical excitability in the occipital lobe of both migraineurs with and without aura. Meanwhile, the beta band PSD on the occipital area during photic stimulation might be an objective measure of severity in migraineurs with PFO.
Insights
Patent foramen ovale (PFO) may alter cortical excitability in migraine patients, particularly in the occipital lobe. Increased beta band power during photic stimulation may indicate migraine severity in those with PFO.
Area of Science:
- Neuroscience
- Cardiology
- Neurology
Background:
- A link exists between patent foramen ovale (PFO) and migraine, especially migraine with aura.
- The mechanism by which PFO might influence migraine, such as altering cortical excitability and neural networks, remains unclear.
- This study investigates the role of PFO in migraine pathophysiology by examining electroencephalography (EEG) patterns.
Purpose of the Study:
- To compare alpha and beta band spectrum power and functional connectivity in migraine patients with and without PFO.
- To explore the relationship between PFO, cortical excitability, and migraine characteristics.
- To identify potential EEG markers for migraine severity in patients with PFO.
Main Methods:
- Cross-sectional analysis of 35 migraine patients with PFO (PFO+), 35 migraine patients without PFO (PFO-), and 20 controls with PFO but no migraine.
- 19-channel EEG recorded during resting state and intermittent photic stimulation.
- Calculation and comparison of power spectrum density (PSD) and phase lag index (PLI) for alpha and beta bands between groups.
Main Results:
- Beta band PSD in the occipital area was significantly higher in PFO+ migraine patients during photic stimulation compared to PFO- patients (p < 0.05).
- Both migraine with and without aura patients with PFO showed increased alpha and beta band PSD in the occipital region during photic stimulation (p < 0.05).
- Beta band PLI during photic stimulation was significantly elevated in the PFO+ group compared to the PFO- group (adjusted p = 0.008).
Conclusions:
- PFO may alter occipital lobe cortical excitability in migraineurs, irrespective of aura presence.
- Increased beta band PSD in the occipital area during photic stimulation could serve as an objective measure of migraine severity in patients with PFO.
