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Reduced neurovascular coupling of the visual network in migraine patients with aura as revealed with arterial spin labeling MRI: is there a demand-supply mismatch behind the scenes?
J Headache Pain
October 2024
Headache Centre, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
Article Synopsis
- Research indicates that patients with migraine with aura exhibit increased activity in visual cortices but struggle with adequate vascular supply during triggers, which may lead to aura symptoms.
- A study involving MRI assessed cerebral blood flow and connectivity in patients with migraine with and without aura, along with healthy controls.
- Results showed heightened blood flow in the visual cortex of migraine with aura patients, along with decreased neurovascular coupling, suggesting a misalignment between energy demand and supply in the brain.
What has neurophysiology revealed about migraine and chronic migraine?
Handb Clin Neurol
December 2023
IRCCS-Neuromed, Headache Clinic, Pozzilli (IS), Italy. Electronic address:
Article Synopsis
- Since the first electroencephalographic recordings in 1959, various neurophysiological methods have been employed to understand the mechanisms behind recurrent migraine attacks.
- Research indicates that during the interictal phase (the time between attacks), the brain shows hyperresponsiveness to sensory inputs and malfunctions in brain circuits, especially involving the thalamus.
- Both episodic and chronic migraine sufferers exhibit increased cortical response to sensory stimuli, signifying a central sensitization process; future studies should focus on genetic and molecular dysfunctions rather than solely seeking a single site of dysfunction in the brain.
Central sensitization mechanisms in chronic migraine with medication overuse headache: a study of thalamocortical activation and lateral cortical inhibition.
Cephalalgia
October 2023
Sapienza University of Rome Polo Pontino ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy.
Background: It is unclear whether cortical hyperexcitability in chronic migraine with medication overuse headache (CM-MOH) is due to increased thalamocortical drive or aberrant cortical inhibitory mechanisms.
Methods: Somatosensory evoked potentials (SSEP) were performed by electrical stimulation of the median nerve (M), ulnar nerve (U) and simultaneous stimulation of both nerves (MU) in 27 patients with CM-MOH and, for comparison, in 23 healthy volunteers (HVs) of a comparable age distribution. We calculated the degree of cortical lateral inhibition using the formula: 100 - [MU/(M + U) × 100] and the level of thalamocortical activation by analyzing the high frequency oscillations (HFOs) embedded in parietal N20 median SSEPs.
The effects of estradiol levels on crossmodal perception: a study on the sound induced flash illusion in healthy and menstrually related migraine individuals.
Neurol Sci
August 2023
Section of Neurology, Department of Biomedicine, Neuroscience, and Advanced Diagnostic (BiND), University of Palermo, Via del Vespro 124, 90127, Palermo, Italy.
Article Synopsis
- The study investigates how the sound-induced flash illusion (SIFI) relates to multisensory perception and examines the effects of estrogen on this phenomenon during different phases of the menstrual cycle.
- It involved 27 women (16 healthy and 11 with menstrually related migraines) who were tested for SIFI on high and low estradiol days, revealing that non-migraineurs report fewer flashes during ovulation compared to days of low estradiol.
- Results indicate that high estrogen levels increase visual cortex sensitivity in non-migraineurs, while migraine sufferers show consistent reduced perception of flashes regardless of estrogen fluctuations.
Applying a biopsychosocial model to migraine: rationale and clinical implications.
J Headache Pain
August 2022
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Migraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability.
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