Abstract
The neurophysiology of migraine covers different topics. Neurophysiological testing is usually not necessary to diagnose migraine but may be helpful in case of atypical aura symptoms or migraine presentation. The neurophysiological evaluation is able to detect some features of the migrainous brain (excitability, adaptation and sensitization) that may shed some light on migraine pathophysiology and, possibly, on drug treatment. Finally, the neurophysiological evaluation of the vestibular system is useful for the diagnosis of vestibular migraine.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Coppola G, Di Lorenzo C, Schoenen J, Pierelli F (2013) Habituation and sensitization in primary headaches. J Headache Pain 14:65
Sandrini G, Friberg L, Coppola G, Janig W, Jensen R et al (2011) Neurophysiological tests and neuroimaging procedures in non-acute headache (2nd edition). Eur J Neurol 18:373–381
Ambrosini A, Magis D, Schoenen J (2010) Migraine – clinical neurophysiology. Handb Clin Neurol 97:275–293
Brainin M, Barnes M, Baron JC, Gilhus NE, Hughes R et al (2004) Guidance for the preparation of neurological management guidelines by EFNS scientific task forces – revised recommendations 2004. Eur J Neurol 11:577–581
Sand T (2003) Electroencephalography in migraine: a review with focus on quantitative electroencephalography and the migraine vs. epilepsy relationship. Cephalalgia 23(Suppl 1):5–11
Sand T (1991) EEG in migraine: a review of the literature. Funct Neurol 6:7–22
Lauritzen M, Trojaborg W, Olesen J (1981) EEG during attacks of common and classical migraine. Cephalalgia 1:63–66
Schoenen J, Jamart B, Delwaide PJ (1987) Electroencephalographic mapping in migraine during the critical and intercritical periods. Rev Electroencephalogr Neurophysiol Clin 17:289–299
Khalil NM, Legg NJ, Anderson DJ (2000) Long term decline of P100 amplitude in migraine with aura. J Neurol Neurosurg Psychiatry 69:507–511
Raudino F (1988) Visual evoked potential in patients with migraine. Headache 28:531–533
Tagliati M, Sabbadini M, Bernardi G, Silvestrini M (1995) Multichannel visual evoked potentials in migraine. Electroencephalogr Clin Neurophysiol 96:1–5
Shibata K, Yamane K, Nishimura Y, Kondo H, Otuka K (2011) Spatial frequency differentially affects habituation in migraineurs: a steady-state visual-evoked potential study. Doc Ophthalmol 123:65–73
Shibata K, Yamane K, Iwata M, Ohkawa S (2005) Evaluating the effects of spatial frequency on migraines by using pattern-reversal visual evoked potentials. Clin Neurophysiol 116:2220–2227
Sand T, Vingen JV (2000) Visual, long-latency auditory and brainstem auditory evoked potentials in migraine: relation to pattern size, stimulus intensity, sound and light discomfort thresholds and pre-attack state. Cephalalgia 20:804–820
Dash AK, Panda N, Khandelwal G, Lal V, Mann SS (2008) Migraine and audiovestibular dysfunction: is there a correlation? Am J Otolaryngol 29:295–299
Chayasirisobhon S (1995) Somatosensory evoked potentials in acute migraine with sensory aura. Clin Electroencephalogr 26:65–69
de Tommaso M (2008) Laser-evoked potentials in primary headaches and cranial neuralgias. Expert Rev Neurother 8:1339–1345
de Tommaso M, Federici A, Franco G, Ricci K, Lorenzo M et al (2012) Suggestion and pain in migraine: a study by laser evoked potentials. CNS Neurol Disord Drug Targets 11:110–126
de Tommaso M, Libro G, Guido M, Difruscolo O, Losito L et al (2004) Nitroglycerin induces migraine headache and central sensitization phenomena in patients with migraine without aura: a study of laser evoked potentials. Neurosci Lett 363:272–275
de Tommaso M, Losito L, Libro G, Guido M, Di Fruscolo O et al (2005) Effects of symptomatic treatments on cutaneous hyperalgesia and laser evoked potentials during migraine attack. Cephalalgia 25:359–368
Mesulam MM (1990) Large-scale neurocognitive networks and distributed processing for attention, language, and memory. Ann Neurol 28:597–613
Akben SB, Subasi A, Tuncel D (2011) Analysis of EEG signals under flash stimulation for migraine and epileptic patients. J Med Syst 35:437–443
Anagnostou E, Spengos K, Naoumis D, Paraskevas GP, Vassilopoulou S et al (2009) Lack of visual evoked potential habituation in the syndrome of HaNDL. J Neurol 256:1374–1376
Chen WT, Wang SJ, Fuh JL, Ko YC, Lee YC et al (2012) Visual cortex excitability and plasticity associated with remission from chronic to episodic migraine. Cephalalgia 32:537–543
Coppola G, Curra A, Sava SL, Alibardi A, Parisi V et al (2010) Changes in visual-evoked potential habituation induced by hyperventilation in migraine. J Headache Pain 11:497–503
de Tommaso M, Stramaglia S, Marinazzo D, Guido M, Lamberti P et al (2004) Visually evoked phase synchronisation changes of alpha rhythm in migraine. Correlations with clinical features. Neurol Sci 25(Suppl 3):S283–S284
Judit A, Sandor PS, Schoenen J (2000) Habituation of visual and intensity dependence of auditory evoked cortical potentials tends to normalize just before and during the migraine attack. Cephalalgia 20:714–719
Sand T, Zhitniy N, White LR, Stovner LJ (2008) Visual evoked potential latency, amplitude and habituation in migraine: a longitudinal study. Clin Neurophysiol 119:1020–1027
Shibata K, Yamane K, Iwata M (2006) Change of excitability in brainstem and cortical visual processing in migraine exhibiting allodynia. Headache 46:1535–1544
de Tommaso M, Guido M, Libro G, Losito L, Difruscolo O et al (2004) Interictal lack of habituation of mismatch negativity in migraine. Cephalalgia 24:663–668
Sand T, Zhitniy N, White LR, Stovner LJ (2008) Brainstem auditory-evoked potential habituation and intensity-dependence related to serotonin metabolism in migraine: a longitudinal study. Clin Neurophysiol 119:1190–1200
Lang E, Kaltenhauser M, Neundorfer B, Seidler S (2004) Hyperexcitability of the primary somatosensory cortex in migraine – a magnetoencephalographic study. Brain 127:2459–2469
Ozkul Y, Uckardes A (2002) Median nerve somatosensory evoked potentials in migraine. Eur J Neurol 9:227–232
Bohotin V, Fumal A, Vandenheede M, Gerard P, Bohotin C et al (2002) Effects of repetitive transcranial magnetic stimulation on visual evoked potentials in migraine. Brain 125:912–922
Pierelli F, Iacovelli E, Bracaglia M, Serrao M, Coppola G (2013) Abnormal sensorimotor plasticity in migraine without aura patients. Pain 154:1738–1742
Coppola G, Vandenheede M, Di Clemente L, Ambrosini A, Fumal A et al (2005) Somatosensory evoked high-frequency oscillations reflecting thalamo-cortical activity are decreased in migraine patients between attacks. Brain 128:98–103
Di Clemente L, Coppola G, Magis D, Fumal A, De Pasqua V et al (2005) Nociceptive blink reflex and visual evoked potential habituations are correlated in migraine. Headache 45:1388–1393
Di Clemente L, Coppola G, Magis D, Gerardy PY, Fumal A et al (2009) Nitroglycerin sensitises in healthy subjects CNS structures involved in migraine pathophysiology: evidence from a study of nociceptive blink reflexes and visual evoked potentials. Pain 144:156–161
Kroner-Herwig B, Ruhmland M, Zintel W, Siniatchkin M (2005) Are migraineurs hypersensitive? A test of the stimulus processing disorder hypothesis. Eur J Pain 9:661–671
Magis D, Vigano A, Sava S, D’Elia TS, Schoenen J et al (2013) Pearls and pitfalls: electrophysiology for primary headaches. Cephalalgia 33:526–539
de Tommaso M, Libro G, Guido M, Losito L, Lamberti P et al (2005) Habituation of single CO2 laser-evoked responses during interictal phase of migraine. J Headache Pain 6:195–198
de Tommaso M, Lo Sito L, Di Fruscolo O, Sardaro M, Pia Prudenzano M et al (2005) Lack of habituation of nociceptive evoked responses and pain sensitivity during migraine attack. Clin Neurophysiol 116:1254–1264
de Tommaso M, Valeriani M, Sardaro M, Serpino C, Fruscolo OD et al (2009) Pain perception and laser evoked potentials during menstrual cycle in migraine. J Headache Pain 10:423–429
Ferraro D, Vollono C, Miliucci R, Virdis D, De Armas L et al (2012) Habituation to pain in “medication overuse headache”: a CO2 laser-evoked potential study. Headache 52:792–807
Chen WT, Wang SJ, Fuh JL, Lin CP, Ko YC et al (2009) Peri-ictal normalization of visual cortex excitability in migraine: an MEG study. Cephalalgia 29:1202–1211
Coppola G, Parisi V, Di Lorenzo C, Serrao M, Magis D et al (2013) Lateral inhibition in visual cortex of migraine patients between attacks. J Headache Pain 14:20
Coppola G, Curra A, Di Lorenzo C, Parisi V, Gorini M et al (2010) Abnormal cortical responses to somatosensory stimulation in medication-overuse headache. BMC Neurol 10:126
de Tommaso M, Guido M, Libro G, Losito L, Sciruicchio V et al (2002) Abnormal brain processing of cutaneous pain in migraine patients during the attack. Neurosci Lett 333:29–32
Burstein R, Cutrer MF, Yarnitsky D (2000) The development of cutaneous allodynia during a migraine attack clinical evidence for the sequential recruitment of spinal and supraspinal nociceptive neurons in migraine. Brain 123(Pt 8):1703–1709
de Tommaso M, Valeriani M, Guido M, Libro G, Specchio LM et al (2003) Abnormal brain processing of cutaneous pain in patients with chronic migraine. Pain 101:25–32
Kaube H, Katsarava Z, Przywara S, Drepper J, Ellrich J et al (2002) Acute migraine headache: possible sensitization of neurons in the spinal trigeminal nucleus? Neurology 58:1234–1238
Ayzenberg I, Obermann M, Nyhuis P, Gastpar M, Limmroth V et al (2006) Central sensitization of the trigeminal and somatic nociceptive systems in medication overuse headache mainly involves cerebral supraspinal structures. Cephalalgia 26:1106–1114
Afra J, Mascia A, Gerard P, Maertens de Noordhout A, Schoenen J (1998) Interictal cortical excitability in migraine: a study using transcranial magnetic stimulation of motor and visual cortices. Ann Neurol 44:209–215
Antal A, Arlt S, Nitsche MA, Chadaide Z, Paulus W (2006) Higher variability of phosphene thresholds in migraineurs than in controls: a consecutive transcranial magnetic stimulation study. Cephalalgia 26:865–870
Aurora SK, Ahmad BK, Welch KM, Bhardhwaj P, Ramadan NM (1998) Transcranial magnetic stimulation confirms hyperexcitability of occipital cortex in migraine. Neurology 50:1111–1114
Aurora SK, Barrodale P, Chronicle EP, Mulleners WM (2005) Cortical inhibition is reduced in chronic and episodic migraine and demonstrates a spectrum of illness. Headache 45:546–552
Aurora SK, Welch KM, Al-Sayed F (2003) The threshold for phosphenes is lower in migraine. Cephalalgia 23:258–263
Brighina F, Piazza A, Daniele O, Fierro B (2002) Modulation of visual cortical excitability in migraine with aura: effects of 1 Hz repetitive transcranial magnetic stimulation. Exp Brain Res 145:177–181
Brigo F, Storti M, Nardone R, Fiaschi A, Bongiovanni LG et al (2012) Transcranial magnetic stimulation of visual cortex in migraine patients: a systematic review with meta-analysis. J Headache Pain 13:339–349
Gunaydin S, Soysal A, Atay T, Arpaci B (2006) Motor and occipital cortex excitability in migraine patients. Can J Neurol Sci 33:63–67
Khedr EM, Ahmed MA, Mohamed KA (2006) Motor and visual cortical excitability in migraineurs patients with or without aura: transcranial magnetic stimulation. Neurophysiol Clin 36:13–18
Lo YL, Lum SY, Fook-Chong S, Cui SL, Siow HC (2008) Clinical correlates of phosphene perception in migraine without aura: an Asian study. J Neurol Sci 264:93–96
Mulleners WM, Chronicle EP, Palmer JE, Koehler PJ, Vredeveld JW (2001) Visual cortex excitability in migraine with and without aura. Headache 41:565–572
Mulleners WM, Chronicle EP, Palmer JE, Koehler PJ, Vredeveld JW (2001) Suppression of perception in migraine: evidence for reduced inhibition in the visual cortex. Neurology 56:178–183
Palermo A, Fierro B, Giglia G, Cosentino G, Puma AR et al (2009) Modulation of visual cortex excitability in migraine with aura: effects of valproate therapy. Neurosci Lett 467:26–29
Siniatchkin M, Reich AL, Shepherd AJ, van Baalen A, Siebner HR et al (2009) Peri-ictal changes of cortical excitability in children suffering from migraine without aura. Pain 147:132–140
Young W, Shaw J, Bloom M, Gebeline-Myers C (2008) Correlation of increase in phosphene threshold with reduction of migraine frequency: observation of levetiracetam-treated subjects. Headache 48:1490–1498
Bohotin V, Fumal A, Vandenheede M, Bohotin C, Schoenen J (2003) Excitability of visual V1-V2 and motor cortices to single transcranial magnetic stimuli in migraine: a reappraisal using a figure-of-eight coil. Cephalalgia 23:264–270
Clarke BM, Upton AR, Kamath MV, Al-Harbi T, Castellanos CM (2006) Transcranial magnetic stimulation for migraine: clinical effects. J Headache Pain 7:341–346
Diener HC (2010) Single-pulse transcranial magnetic stimulation: a new way to treat migraine attacks with aura. Lancet Neurol 9:335–337
Lipton RB, Dodick DW, Silberstein SD, Saper JR, Aurora SK et al (2010) Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura: a randomised, double-blind, parallel-group, sham-controlled trial. Lancet Neurol 9:373–380
Magis D, Schoenen J (2012) Advances and challenges in neurostimulation for headaches. Lancet Neurol 11:708–719
Martelletti P, Jensen RH, Antal A, Arcioni R, Brighina F et al (2013) Neuromodulation of chronic headaches: position statement from the European Headache Federation. J Headache Pain 14:86
McComas A, Upton A (2009) Therapeutic transcranial magnetic stimulation in migraine and its implications for a neuroinflammatory hypothesis. Inflammopharmacology 17:68–75
Misra UK, Kalita J, Bhoi SK (2012) High frequency repetitive transcranial magnetic stimulation (rTMS) is effective in migraine prophylaxis: an open labeled study. Neurol Res 34:547–551
Misra UK, Kalita J, Bhoi SK (2013) High-rate repetitive transcranial magnetic stimulation in migraine prophylaxis: a randomized, placebo-controlled study. J Neurol 260:2793–2801
Artemenko AR, Kurenkov AL, Filatova EG, Nikitin SS, Kaube H et al (2008) Effects of topiramate on migraine frequency and cortical excitability in patients with frequent migraine. Cephalalgia 28:203–208
Aurora SK, Barrodale PM, Vermaas AR, Rudra CB (2010) Topiramate modulates excitability of the occipital cortex when measured by transcranial magnetic stimulation. Cephalalgia 30:648–654
Gerwig M, Niehaus L, Stude P, Katsarava Z, Diener HC (2012) Beta-blocker migraine prophylaxis affects the excitability of the visual cortex as revealed by transcranial magnetic stimulation. J Headache Pain 13:83–89
Strupp M, Versino M, Brandt T (2010) Vestibular migraine. Handb Clin Neurol 97:755–771
Neuhauser HK, Radtke A, von Brevern M, Feldmann M, Lezius F et al (2006) Migrainous vertigo: prevalence and impact on quality of life. Neurology 67:1028–1033
Dieterich M, Brandt T (1999) Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol 246:883–892
Lempert T, Olesen J, Furman J, Waterston J, Seemungal B et al (2012) Vestibular migraine: diagnostic criteria. J Vestib Res 22:167–172
Headache Classification Committee of the International Headache S (2013) The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 33:629–808
Marcus DA, Furman JM (2006) Prevention of motion sickness with rizatriptan: a double-blind, placebo-controlled pilot study. Med Sci Monit 12:I1–I7
Lewis RF, Priesol AJ, Nicoucar K, Lim K, Merfeld DM (2011) Dynamic tilt thresholds are reduced in vestibular migraine. J Vestib Res 21:323–330
Harno H, Hirvonen T, Kaunisto MA, Aalto H, Levo H et al (2003) Subclinical vestibulocerebellar dysfunction in migraine with and without aura. Neurology 61:1748–1752
Bir LS, Ardic FN, Kara CO, Akalin O, Pinar HS et al (2003) Migraine patients with or without vertigo: comparison of clinical and electronystagmographic findings. J Otolaryngol 32:234–238
Versino M, Sances G, Anghileri E, Colnaghi S, Albizzati C et al (2003) Dizziness and migraine: a causal relationship? Funct Neurol 18:97–101
Celebisoy N, Gokcay F, Sirin H, Bicak N (2008) Migrainous vertigo: clinical, oculographic and posturographic findings. Cephalalgia 28:72–77
Cass SP, Furman JM, Ankerstjerne K, Balaban C, Yetiser S et al (1997) Migraine-related vestibulopathy. Ann Otol Rhinol Laryngol 106:182–189
Rzeski M, Stepien A, Kaczorowski Z (2008) Evaluation of the function of the vestibular system in patients with migraine. Neurol Neurochir Pol 42:518–524
Teggi R, Colombo B, Bernasconi L, Bellini C, Comi G et al (2009) Migrainous vertigo: results of caloric testing and stabilometric findings. Headache 49:435–444
Baier B, Stieber N, Dieterich M (2009) Vestibular-evoked myogenic potentials in vestibular migraine. J Neurol 256:1447–1454
Hong SM, Kim SK, Park CH, Lee JH (2011) Vestibular-evoked myogenic potentials in migrainous vertigo. Otolaryngol Head Neck Surg 144:284–287
Crevits L, Vanacker L, Verraes A (2012) Patients with migraine correctly estimate the visual verticality. Clin Neurol Neurosurg 114:313–315
Asai M, Aoki M, Hayashi H, Yamada N, Mizuta K et al (2009) Subclinical deviation of the subjective visual vertical in patients affected by a primary headache. Acta Otolaryngol 129:30–35
Liao LJ, Young YH (2004) Vestibular evoked myogenic potentials in basilar artery migraine. Laryngoscope 114:1305–1309
Taylor RL, Zagami AS, Gibson WP, Black DA, Watson SR et al (2012) Vestibular evoked myogenic potentials to sound and vibration: characteristics in vestibular migraine that enable separation from Meniere’s disease. Cephalalgia 32:213–225
Radtke A, von Brevern M, Neuhauser H, Hottenrott T, Lempert T (2012) Vestibular migraine: long-term follow-up of clinical symptoms and vestibulo-cochlear findings. Neurology 79:1607–1614
Neugebauer H, Adrion C, Glaser M, Strupp M (2013) Long-term changes of central ocular motor signs in patients with vestibular migraine. Eur Neurol 69:102–107
Polensek SH, Tusa RJ (2010) Nystagmus during attacks of vestibular migraine: an aid in diagnosis. Audiol Neurootol 15:241–246
von Brevern M, Zeise D, Neuhauser H, Clarke AH, Lempert T (2005) Acute migrainous vertigo: clinical and oculographic findings. Brain 128:365–374
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Versino, M., Sacco, S., Colnaghi, S. (2014). Neurophysiology of Migraine. In: Colombo, B., Teggi, R. (eds) Vestibular Migraine and Related Syndromes. Springer, Cham. https://doi.org/10.1007/978-3-319-07022-3_2
Download citation
DOI: https://doi.org/10.1007/978-3-319-07022-3_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-07021-6
Online ISBN: 978-3-319-07022-3
eBook Packages: MedicineMedicine (R0)