Does the migraine aura reflect cortical organization?

Dahlem, Markus; Engelmann, Ralf; Löwel, Siegrid; Müller, Stefan

doi:10.1046/j.1460-9568.2000.00995.x

Cited by 35 publications

(27 citation statements)

References 32 publications

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“…[9][10][11] This low velocity matches the pace of cortical spreading depression (CSD), a slowly propagating wave of neuronal and glial depolarization followed by a period of depressed electrophysiological activity. Although the exact role of CSD in migraine has yet to be conclusively established, it has been long considered the most likely electrophysiologic substrate for migraine aura, and a migraine trigger via trigeminal sensory afferents activation.…”

Section: This Review Was Initiated With a Pubmed Search Of The Us Natmentioning

confidence: 94%

Structural and Functional Neuroimaging in Migraine: Insights From 3 Decades of Research

Lakhan

Avramut

Tepper³

2012

Headache

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Modern imaging methods provide unprecedented insights into brain structure, perfusion, metabolism, and neurochemistry, both during and between migraine attacks. Neuroimaging investigations conducted in recent decades bring us closer to uncovering migraine as a multifaceted, primarily central nervous system disorder. Three main categories of structural and functional brain changes are described in this review, corresponding to the migrainous aura, ictal headache, and interictal states. (Headache 2013;53:46-66)

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Section: This Review Was Initiated With a Pubmed Search Of The Us Natmentioning

confidence: 94%

Structural and Functional Neuroimaging in Migraine: Insights From 3 Decades of Research

Lakhan

Avramut

Tepper³

2012

Headache

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“…The cortical tissue SD traverses is functionally impaired causing the neurological migraine aura symptoms, like visual hallucinations [11]. Whether SD is also a key to the subsequent headache phase is an open question, in particular, in cases of migraine without aura (MO).…”

Section: Motivation Of a Macroscopic Model For Migraine Auramentioning

confidence: 99%

Transient Localized Wave Patterns and Their Application to Migraine

Dahlem

Isele

2013

The Journal of Mathematical Neuroscience

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Transient dynamics is pervasive in the human brain and poses challenging problems both in mathematical tractability and clinical observability. We investigate statistical properties of transient cortical wave patterns with characteristic forms (shape, size, duration) in a canonical reaction-diffusion model with mean field inhibition. The patterns are formed by ghost behavior near a saddle-node bifurcation in which a stable traveling wave (node) collides with its critical nucleation mass (saddle). Similar patterns have been observed with fMRI in migraine. Our results support the controversial idea that waves of cortical spreading depression (SD) have a causal relationship with the headache phase in migraine and, therefore, occur not only in migraine with aura (MA), but also in migraine without aura (MO), i.e., in the two major migraine subtypes. We suggest a congruence between the prevalence of MO and MA with the statistical properties of the traveling waves’ forms according to which two predictions follow: (i) the activation of nociceptive mechanisms relevant for headache is dependent upon a sufficiently large instantaneous affected cortical area; and (ii) the incidence of MA is reflected in the distance to the saddle-node bifurcation. We also observed that the maximal instantaneous affected cortical area is anticorrelated to both SD duration and total affected cortical area, which can explain why the headache is less severe in MA than in MO. Furthermore, the contested notion of MO attacks with silent aura is resolved. We briefly discuss model-based control and means by which neuromodulation techniques may affect pathways of pain formation.

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“…Clinical, experimental, and neuroimaging evidence demonstrates that cortical spreading depression (CSD) is the phenomenon underlying the pathophysiology of bizarre visual perceptions among migraineurs. Computerized models simulating a CSD wave passing through cortical area V1 convincingly reproduce the teichopsia pattern 2 .…”

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confidence: 77%

Aura-like features and photophobia in sightless migraine patients

Silva

Goes

Vincent

2014

Arq. Neuro-Psiquiatr.

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Migraine is a neurological disorder that frequently involves cortical paroxysmal dysfunction expressed as aura 1 . The most frequent type of aura is visual, sometimes experienced as fortification spectra, known as teichopsia. This typical zigzag, horseshoe-shaped expanding bright perception, usually perceived as complex interlacing lines named "chevaux de frises" by Gowers, followed by a bean-shaped loss of visual acuity, strongly suggests the involvement of visual processing areas. Clinical, experimental, and neuroimaging evidence demonstrates that cortical spreading depression (CSD) is the phenomenon underlying the pathophysiology of bizarre visual perceptions among migraineurs. Computerized models simulating a CSD wave passing through cortical area V1 convincingly reproduce the teichopsia pattern 2 .The cortical function is deeply dependent on neuronal input. Depriving the cortex of its natural input may influence the cerebral function and change the cortical maps both locally and distantly 3 . In blind individuals, the occipital cortex is critical for tactile Braille reading 4 . The visual cortex is pivotal in the pathophysiology of the migraine aura, the objective of the present study was to investigate whether the phenotype of migraine-related visual phenomena would change in amaurotic patients. AbstrActMigraine is a central nervous system disorder frequently expressed with paroxysmal visual dysfunctions. Objective: To test the hypothesis that a normal visual input is vital for migrainous aura and photophobia. Methods: We studied the migraine-related visual disturbances in 8 sightless migraineurs identified among 200 visually impaired subjects. Results: The main findings were visual aura and photophobia disappearance along with the development of blindness, abnormal aura [too short, colorful (e.g., blue or fire-like), auditory in nature, or different in shape (round forms)], and the lack of photophobia. Conclusions: We propose that the aura duration should be accepted as shorter in visually impaired subjects. The changes in the aura phenotype observed in our patients may be a result of cerebral plasticity induced by visual impairment and/or the lack of a visual input per se. Integrity of visual pathways plays a key role in migraine visual aura and photophobia.Keywords: migraine with aura, subnormal vision, blindness, visual aura, photophobia resumo A enxaqueca é doença neurológica frequentemente associada a anormalidades visuais transitórias. Objetivo: Testar a hipótese de que a visão normal é importante para o fenótipo da aura e da fotofobia. Métodos: Estudamos 8 enxaquecosos deficientes visuais identificados em uma população de 200 indivíduos com visão subnormal. Resultados: Os principais achados foram: o desaparecimento da aura visual e da fotofobia com o início da cegueira; a ocorrência de aura atípica -muito curta, colorida (p. ex. azul, ou cor de fogo) auditiva ou diferente na forma (arredondadas); e a ausência de fotofobia. Conclusões: Propomos que a duração da aura possa ser admitida como mais cur...

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Does the migraine aura reflect cortical organization?

Cited by 35 publications

References 32 publications

Structural and Functional Neuroimaging in Migraine: Insights From 3 Decades of Research

Structural and Functional Neuroimaging in Migraine: Insights From 3 Decades of Research

Transient Localized Wave Patterns and Their Application to Migraine

Aura-like features and photophobia in sightless migraine patients

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