Dynamic brainstem and somatosensory cortical excitability during migraine cycles

The Journal of Headache and Pain

Fu-Jung Hsiao¹  Li-Ling Hope Pan¹  Shih-Pin Chen²  Shuu-Jiun Wang²  Wei-Ta Chen³  Gianluca Coppola⁴  Hung-Yu Liu⁵  Yen-Feng Wang⁵  Kuan-Lin Lai⁵ 

[1] Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan;Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, 112, Taipei, Taiwan;Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, 112, Taipei, Taiwan;Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan;Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, 112, Taipei, Taiwan;

关键词: Brainstem;    Primary somatosensory cortex (S1);    Migraine cycle;    Excitability;    Inhibition;   

DOI  :  10.1186/s10194-022-01392-1

来源: Springer

【 摘 要 】

BackgroundMigraine has complex pathophysiological characteristics and episodic attacks. To decipher the cyclic neurophysiological features of migraine attacks, in this study, we compared neuronal excitability in the brainstem and primary somatosensory (S1) region between migraine phases for 30 consecutive days in two patients with episodic migraine.MethodsBoth patients underwent EEG recording of event-related potentials with the somatosensory and paired-pulse paradigms for 30 consecutive days. The migraine cycle was divided into the following phases: 24–48 h before headache onset (Pre2), within 24 h before headache onset (Pre1), during the migraine attack (Ictal), within 24 h after headache offset (Post1), and the interval of ˃48 h between the last and next headache phase (Interictal). The normalised current intensity in the brainstem and S1 and gating ratio in the S1 were recorded and examined.ResultsSix migraine cycles (three for each patient) were analysed. In both patients, the somatosensory excitability in the brainstem (peaking at 12–14 ms after stimulation) and S1 (peaking at 18–19 ms after stimulation) peaked in the Pre1 phase. The S1 inhibitory capability was higher in the Ictal phase than in the Pre1 phase.ConclusionThis study demonstrates that migraine is a cyclic excitatory disorder and that the neural substrates involved include the somatosensory system, starting in the brainstem and spanning subsequently to the S1 before the migraine occurs. Further investigations with larger sample sizes are warranted.

【 授权许可】

CC BY