Spectral analysis of photic stimulation in migraine

Simon, Richard H.; Zimmerman, Andrew W.; Tasman, Allan; Hale, Mahlon S.

doi:10.1016/0013-4694(82)90084-0

Cited by 52 publications

(33 citation statements)

References 16 publications

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“…This is in line with the majority of studies that evaluated the utility of the H response on EEG to distinguish migraine from normal subjects, or migraine from other headache types [17]. In a few studies, nonetheless, PD was found useful to discriminate primary headaches sufferers (migraine and tension type headache) from controls [18], while failing to differentiate primary headaches [19] . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 We included patients without taking into account the period in their migraine cycle.…”

Section: Discussionsupporting

confidence: 80%

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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Section: Discussionsupporting

confidence: 80%

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

et al. 2014

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“…In previous studies of visual evoked potentials (VEPs) in migraine, the EEG during steady-state flash stimulation showed an amplitude increase in the alpha band [Simon et al, 1982] and in the frequency ranges corresponding to the flicker stimulation rates (F1 component) [Nyrke and Lang, 1982;Genco et al, 1994;de Tommaso et al, 1999], with more powerful spectra in these frequency ranges under fast Fourier analysis [Genco et al, 1994]. These results concur with the pioneering finding of an increased photic driving of the EEG in migraine patients [Golla and Winter, 1959], and suggest that sustained visual stimulation induces more synchronous net activity in the visual cortex of migraine patients between attacks.…”

Section: Neurophysiologic Patterns In Migrainementioning

confidence: 98%

Effects of antiepileptic drugs on neurophysiologic abnormalities subtending migraine

Tommaso

2007

Drug Development Research

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Recent theories about migraine pathogenesis have outlined migraine as a brain disorder. Migraine can be considered an aberrant physiological state with a low threshold for intermittent neuronal excitability. Neurophysiologic findings in migraine emphasized the presence of abnormal neuronal function during the asymptomatic phase, predisposing to attack occurrence, the main patterns being the loss of habituation of evoked and event related potentials and the hypersynchronization of electroencephalographic (EEG) activity. These studies confirmed the need of preventive agents able to act on neuronal excitability, with growing evidence in favor of the clinical efficacy of anti-epileptic drugs (AED), though electrophysiological evidence supporting migraine as a state of neuronal hypoexcitability rendered the rationale of their use and their fundamental action mechanism in preventing migraine rather questionable. In the last years, many studies reported the efficacy of other preventive agents than AED, such as -blockers, in reversing neurophysiologic abnormalities of migraine, while reducing headache frequency. Our recent results showed a normalizing effects of levetiracetam and topiramate vs. placebo on the dishabituation pattern of the contingent negative variation (CNV) and the efficacy of levetiracetam vs. both topiramate and placebo in reversing the hypersynchronization of alpha rhythm under flash stimulation. All these effects concurred with the clinical efficacy on migraine frequency, and confirmed the action of AED on the basal mechanisms of migraine. Considering our and previous results, migraine may be considered as a state of ''altered'' excitability, where the AED are modulating agents able to reverse the electrophysiological patterns predisposing to the attack occurrence. The challenge for the future may be the identification of subgroups of migraine patients with pronounced expression of some neurophysiologic indexes of migraine predisposition, e.g., hypersynchronization, which may optimize the choice of the preventive agent. Drug Dev Res 68: 369-375, 2007. r 2007

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“…There have been a number of reports on steadystate VEPs induced by flash stimuli [16][17][18][19][20][21][22][23][24][25][26][27], including an habituation study [28]. These studies suggest a general modification in the pattern of visual reactivity.…”

Section: Introductionmentioning

confidence: 96%

Spatial frequency differentially affects habituation in migraineurs: a steady-state visual-evoked potential study

et al. 2011

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A lack of habituation in visual-evoked potentials (VEPs) is the main abnormality observed in migraineurs. However, no study of steady-state VEPs has yet evaluated pattern-reversal stimuli with respect to habituation behavior or spatial frequency. The aim of this study was to clarify habituation behavior in migraineurs between attacks and to establish characteristics of VEPs in these patients. Steady-state VEPs were sequentially recorded as checkerboard patterns in four consecutive blocks from 12 patients with migraine without aura (MO), 12 patients with migraine with aura (MA), and 12 healthy controls (HC) at four spatial frequencies of 0.5, 1.0, 2.0, and 4.0 cycles per degree (cpd) with a stimulus rate of 7.5 Hz (15 reversal/s). VEP amplitudes were consistently higher in migraineurs. However, habituation was not demonstrated in HCs, and migraineurs did not reveal a clear lack of habituation. MAs exhibited high-amplitude VEPs, depending on spatial frequency. In the MA patients, amplitude differences reached statistical significance at 2.0 cpd. The sequential amplitude changes at 0.5 cpd were significantly different in MAs compared with HCs. Migraine patients exhibited high-amplitude VEPs, which were dependent on spatial frequency, and may be related to altered excitability in pre-cortical and cortical visual processing.

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Spectral analysis of photic stimulation in migraine

Cited by 52 publications

References 16 publications

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

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

Effects of antiepileptic drugs on neurophysiologic abnormalities subtending migraine

Spatial frequency differentially affects habituation in migraineurs: a steady-state visual-evoked potential study

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