Pathophysiological changes in incentive processing in episodic migraine: a preliminary event-related potential study

This study examined pathophysiological changes in incentive processing in migraineurs. Nineteen episodic migraine (EM) patients and 19 healthy controls (HCs) performed a monetary incentive delay task while their event-related potentials were recorded. During the incentive anticipation phase, both Cue-N2 and Cue-P3 amplitudes were responsive to incentive cues in both groups, indicating no between-group differences in the distinct anticipatory subprocesses that underly incentive cue evaluation. During the outcome phase, the feedback-related negativity amplitude, associated with performance evaluation, was larger for punishing feedback than rewarding feedback across both groups. However, the feedback-P3 amplitude, linked to attentional processing of motivational value of outcome feedback, was significantly larger for rewarding feedback than punishing feedback in HCs, but not in EM patients. Moreover, a significant negative correlation was observed between the feedback-P3 amplitude difference for rewarding minus punishing feedback and subjective pain intensity in EM patients. Finally, the feedback late-positive potential amplitude, related to affective processing of affective value of outcome feedback, was significantly larger for punishing feedback than rewarding feedback only in HCs, but not in EM patients. Our findings suggest that recurrent severe pain may relate to abnormal incentive-related brain activity during the outcome phase of incentive processing.