Cortical modulation of thalamic function during cortical spreading depression- Unraveling a new central mechanism involved in migraine aura"

Andreou, Anna P.; Sprenger, Till; Goadsby, PJ

doi:10.1186/1129-2377-14-s1-i6

Cited by 13 publications

(7 citation statements)

References 4 publications

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“…Contradicting preclinical data to these previous findings also exists [113, 114]. An alternative hypothesis suggests that CSD activates cortico-thalamic fibres that in turn sensitize third order neurons of the ascending trigemino-thalamic pathway [115].…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of migraine as a chronic evolutive condition

2019

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Understanding the mechanisms of migraine remains challenging as migraine is not a static disorder, and even in its episodic form migraine remains an “evolutive” chronic condition. Considerable progress has been made in elucidating the pathophysiological mechanisms of migraine, associated genetic factors that may influence susceptibility to the disease, and functional and anatomical changes during the progression of a migraine attack or the transformation of episodic to chronic migraine. Migraine is a life span neurological disorder that follows an evolutive age-dependent change in its prevalence and even clinical presentations. As a disorder, migraine involves recurrent intense head pain and associated unpleasant symptoms. Migraine attacks evolve over different phases with specific neural mechanisms and symptoms being involved during each phase. In some patients, migraine can be transformed into a chronic form with daily or almost daily headaches. The mechanisms behind this evolutive process remain unknown, but genetic and epigenetic factors, inflammatory processes and central sensitization may play an important role.

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Section: Introductionmentioning

confidence: 99%

Mechanisms of migraine as a chronic evolutive condition

2019

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“…sTMS inhibits CSD in rat and cat [ 15 ]. It has no effect on nociceptive trigeminocervical neurons [ 17 ], while it certainly inhibits nociceptive trigeminothalamic neurons [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Single-pulse transcranial magnetic stimulation (sTMS) for the acute treatment of migraine: evaluation of outcome data for the UK post market pilot program

et al. 2015

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BackgroundSingle pulse transcranial magnetic stimulation (sTMS) is a novel treatment for acute migraine. Previous randomised controlled data demonstrated that sTMS is effective and well tolerated in the treatment of migraine with aura. The aim of the programme reported here was to evaluate patient responses in the setting of routine clinical practice.MethodsMigraine patients with and without aura treating with sTMS had an initial review (n = 426) and training call, and then participated in telephone surveys at week six (n = 331) and week 12 during a 3-month treatment period (n = 190).ResultsOf patients surveyed with 3 month data (n = 190; episodic, n = 59; chronic, n = 131), 62 % reported pain relief, finding the device effective at reducing or alleviating migraine pain; in addition there was relief reported of associated features: nausea- 52 %; photophobia- 55 %; and phonophobia- 53 %. At 3 months there was a reduction in monthly headache days for episodic migraine, from 12 (median, 8–13 IQ range) to 9 (4–12) and for chronic migraine, a reduction from 24 (median, 16–30 IQ range) to 16 (10–30). There were no serious or unanticipated adverse events.ConclusionsTMS may be a valuable addition to options for the treatment of both episodic and chronic migraine.

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“…Migraine with aura is a condition with various subtypes that likely differ in pathophysiological mechanisms. Cortical spreading depression (CSD) is thought to be the substrate of the migraine aura (23–31). The distance to which CSD spreads rests on the steadiness between factors that predispose or inhibit the brain to CSD, and the recovery from CSD depends largely on intact neurovascular coupling to match the increased energy demand and to restore ion gradients.…”

Section: Discussionmentioning

confidence: 99%

“…It is also known that the thalamus is a key structure in migraine pathogenesis, and its direct connection to the visual pathway and the cerebral cortex provides a vital interaction between these structures (32). Investigators have demonstrated that CSD markedly alters neuronal firing of ipsilateral third order thalamic neurons, independent of peripheral trigeminal inputs (31). It is well recognised that the thalamus processes signals from the retina to create images and plays a key role in coordinating complex sensory and motor input to and from the cortex.…”

Section: Discussionmentioning

confidence: 99%