Electrophysiological correlates of episodic migraine chronification: evidence for thalamic involvementReportar como inadecuado

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The Journal of Headache and Pain

, 14:76

First Online: 09 September 2013Received: 01 August 2013Accepted: 05 September 2013


BackgroundEpisodic migraine is characterized by decreased high-frequency somatosensory oscillations HFOs, reflecting thalamo-cortical activity, and deficient habituation of low-frequency LF- somatosensory evoked potentials SSEPs to repetitive sensory stimulation between attacks. Here, we study conventional LF-SSEPs and HFOs in episodic migraineurs who developed chronic migraine CM.

MethodsThirty-four episodic 15 interictally MOii, 19 ictally MOi and 19 CM patients underwent right median nerve SSEPs. The patient groups were compared to a group of 20 healthy volunteers HV of comparable age and gender distribution. We measured the N20-P25 LF-SSEP 1st amplitude block and habituation, and, after applying a band-pass filter 450–750 Hz, maximal peak-to-peak latency and the amplitudes of the early and late HFOs.

ResultsReduced early HFOs, lower 1st block LF-SSEPs and deficient habituation characterize MOii. Initially higher SSEP amplitudes and late normal habituation characterize both CM and MOi patients. After the digital filtration, both patient groups showed shortened latency peaks and normalization of early HFO amplitudes with increased late HFOs. When data of MO and CM patients were combined, the monthly number of days with headache negatively correlated with the LF-SSEP slope r = −0.385, p = 0.006, which in turn negatively correlated with the 1st amplitude block r = 0.568, p < 0.001.

ConclusionsOur results show abnormalities in chronic migraine that are also reported during attacks in episodic migraineurs, namely early response sensitization and late habituation. The HFO analysis suggests that this sensory sensitization may be explained by an increase in the strength of the connections between the thalamus and cortex compared to episodic migraine between attacks. Whether this electro-functional behaviour is primary or secondary to daily headache, thus reflecting an electrophysiological fingerprint of the somatosensory system central sensitization process, remains to be determined.

KeywordsChronic migraine Thalamus Somatosensory evoked potentials Central sensitization Habituation AbbreviationsCMChronic Migraine

HFOsHigh-Frequency Oscillations

HVHealthy Volunteer


MOiiMigraineur without aura recorded interictally

MOiMigraineur without aura recorded ictally

SSEPSomatosensory Evoked Potential.

Electronic supplementary materialThe online version of this article doi:10.1186-1129-2377-14-76 contains supplementary material, which is available to authorized users.

Gianluca Coppola, Elisa Iacovelli contributed equally to this work.

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Autor: Gianluca Coppola - Elisa Iacovelli - Martina Bracaglia - Mariano Serrao - Cherubino Di Lorenzo - Francesco Pierelli

Fuente: https://link.springer.com/


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