Analysis of cerebral responses to flicker in patients complaining of episodic headache

Golla, F. L.; Winter, Audrey

doi:10.1016/0013-4694(59)90052-5

Cited by 126 publications

(79 citation statements)

References 7 publications

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“…8 SSVEPs to flash stimuli in the medium frequency range confirmed increased photic driving in individuals with migraine, without any relation to migraine severity or duration. 9,10 This observation was interpreted as hyper responsivity of the brain to visual stimuli.…”

Section: Eeg Changes Induced By Visual Stimulimentioning

confidence: 77%

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Altered processing of sensory stimuli in patients with migraine

et al. 2014

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| Migraine is a cyclic disorder, in which functional and morphological brain changes fluctuate over time, culminating periodically in an attack. In the migrainous brain, temporal processing of external stimuli and sequential recruitment of neuronal networks are often dysfunctional. These changes reflect complex CNS dysfunction patterns. Assessment of multimodal evoked potentials and nociceptive reflex responses can reveal altered patterns of the brain's electrophysiological activity, thereby aiding our understanding of the pathophysiology of migraine. In this Review, we summarize the most important findings on temporal processing of evoked and reflex responses in migraine. Considering these data, we propose that thalamocortical dysrhythmia may be responsible for the altered synchronicity in migraine. To test this hypothesis in future research, electrophysiological recordings should be combined with neuroimaging studies so that the temporal patterns of sensory processing in patients with migraine can be correlated with the accompanying anatomical and functional changes.

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Section: Eeg Changes Induced By Visual Stimulimentioning

confidence: 77%

“…The migraine attack is associated with sensitization of central nociceptive pathways (7). Abnormalities of responses evoked by noxious stimuli amplify and persist in chronic migraine (8). Dashed lines indicate hypothetical connections, for which there is currently little or no experimental evidence.…”

Section: Prospects For Clinical Researchmentioning

confidence: 99%

Altered processing of sensory stimuli in patients with migraine

et al. 2014

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“…Reactivity of the cerebral cortex, as explored by evoked potentials, was shown to vary with the migraine cycle [20]. However, there seems to be no significant variation of steady state visual EEG evoked-responses (SSVEPs) in the medium frequencies range (15-30 Hz) over the migraine cycle [7,12,21].…”

Section: Discussionmentioning

confidence: 98%

“…The tendency of EEG rhythms to synchronize to external repetitive stimuli varies with stimulation frequency in the low (approximately 10 Hz), medium (approximately 20 Hz) or high frequency range (approximately 40 Hz) [6]. An increased photic driving was described in the medium range in migraine patients, and called the H response [7]. That PD is abnormal in migraine irrespective of age and migraine subtype has been confirmed in other studies [8,9], although the same authors also reported greater abnormalities of SSVEPs in migraine with aura, and in patients with autonomic symptoms or a family history of migraine [10].…”

Section: Introductionmentioning

confidence: 99%

Analysis and clinical correlates of 20 Hz photic driving on routine EEG in migraine

et al. 2014

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Abstract:Enhanced photic driving (PD) during high frequency flicker stimulation, the so-called H response, is a classical feature of migraine patients between attacks, but is thought to be of poor clinical utility. Visual inspection of the EEG for its detection may not be reliable, however, and data on its possible correlations with clinical features and migraine pathophysiology are scarce.We have compared visual inspection and EEG spectral analysis to detect abnormal PD in 280 consecutive migraine patients of our headache clinic (episodic migraine without aura, n=171; chronic migraine, n=48; migraine with aura, n=61) and in a group of 24 non-migrainous neurological controls. Spectral frequency analyses were performed blindly by one of us (YF). On visual inspection, 50.4% of migraineurs were thought to have increased 20Hz PD. After spectral analysis, only 62.4% of them had PD power superior to the mean+95%CI of the control group. Sensitivity of visually identified PD was 82.24%, specificity 69.36%. Increased PD on spectral analysis was more prevalent in episodic migraine than in chronic migraine, in patients with low attack frequency, in those with ictal autonomic symptoms in addition to nausea and in those with a strong family history of migraine. We confirm therefore that 20Hz photic driving is of little diagnostic utility and its prevalence in migraine overestimated on visual inspection. Its presence on spectral analysis of the EEG, however, might be of pathophysiological interest, as it identifies subgroups of migraineurs of whom the common denominator could be lack of habituation of cortical responses during repetitive stimulation. We have compared visual inspection and EEG spectral analysis to detect abnormal PD in 280 consecutive migraine patients of our headache clinic (episodic migraine without aura, n=171; chronic migraine, n=48; migraine with aura, n=61) and in a group of 24 non-migrainous neurological controls. Spectral frequency analyses were performed blindly by one of us (YF).On visual inspection, 50.4% of migraineurs were thought to have increased 20Hz PD. After spectral analysis, only 62.4% of them had PD power superior to the mean+95%CI of the control group. Sensitivity of visually identified PD was 82.24%, specificity 69.36%.Increased PD on spectral analysis was more prevalent in episodic migraine than in chronic migraine, in patients with low attack frequency, in those with ictal autonomic symptoms in addition to nausea and in those with a strong family history of migraine.We confirm therefore that 20Hz photic driving is of little diagnostic utility and its prevalence in migraine overestimated on visual inspection. Its presence on spectral analysis of the EEG, however, might be of pathophysiological interest, as it identifies subgroups of migraineurs of whom the common denominator could be lack of habituation of cortical responses during repetitive stimulation.

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“…A recent review suggests that EEG is not valuable as a diagnostic tool for primary headache disorders [21]. The enhanced photic drive response on the EEG Hresponse, which was thought to be characteristic of migraine [22], has recently been confirmed by spectral analysis [23,24]. The specificity of the H-response, however, has been questioned since it may occur with other primary headache disorders [21].…”

Section: Evidence Of Interictal Disturbancesmentioning

confidence: 99%

Exciting excitable brains: an update on migraine pathophysiology

Aurora¹

2003

J Headache Pain

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Analysis of cerebral responses to flicker in patients complaining of episodic headache

Cited by 126 publications

References 7 publications

Altered processing of sensory stimuli in patients with migraine

Altered processing of sensory stimuli in patients with migraine

Analysis and clinical correlates of 20 Hz photic driving on routine EEG in migraine

Exciting excitable brains: an update on migraine pathophysiology

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