Neurophysiologische Befunde bei Migräne - Spiegelbild der Pathophysiologie oder Epiphänomen?

T. Probst; A. Wolters; R. Benecke; E. Kunesch

doi:10.1055/s-2003-814844

Klinische Neurophysiologie, Inhaltsverzeichnis

Klinische Neurophysiologie 2004; 35(1): 22-38
DOI: 10.1055/s-2003-814844

Originalia

Neurophysiologische Befunde bei Migräne - Spiegelbild der Pathophysiologie oder Epiphänomen?

Neurophysiological Findings in Migraine - Do they Reflect Pathophysiological Events or Epiphenomena?T. Probst¹ , A. Wolters¹ , R. Benecke¹ , E. Kunesch¹

¹Neurologische Klinik und Poliklinik der Universität Rostock

Abstract

Zusammenfassung

Neuronale Dysfunktionen von Kortex und Hirnstamm spielen für die Pathophysiologie der Migräne eine entscheidende Rolle. Funktionelle bildgebende Verfahren (fMRT), Perfusionsmessungen und elektrophysiologische Untersuchungsverfahren wie EEG und MEG, multimodal evozierte Potenziale, ereigniskorrelierte Potenziale und Reflexuntersuchungen haben bei Migränepatienten eine Vielzahl von auffälligen und teilweise widersprüchlichen Befunden erbracht. Diese hängen vom Zeitpunkt der Untersuchung innerhalb des Migränezyklus (interiktual, Aura, Kopfschmerzphase) und zum Teil vom Migränetyp (Migräne mit oder ohne Aura) ab. Dysfunktionen von Filter- und Schutzmechanismen, die das ZNS regulär vor einem exzessiven sensorischen Informationsfluss abschirmen, besitzen wahrscheinlich für die Auslösung von Migräneattacken eine große Bedeutung. In konkurrierenden Modellvorstellungen werden eine neuronale Hyperexzitabilität im ZNS, aber auch eine kortikale Hypoexzitabilität als Prädispositionsfaktoren für Migräneattacken propagiert.

Abstract

Neuronal dysfunctions of the cortex and brainstem play a major role in the pathophysiology of migraine. Functional brain imaging (fMRI), perfusion measurements and electrophysiological investigations such as EEG and MEG, multimodal evoked potentials, event-related potentials and reflex measurements have revealed many abnormal and even contradictory findings. These depend on the investigation time within the migraine cycle (interictual, aura and acute headache) and partly on the migraine subtype (migraine with or without aura). Dysfunctions of filter mechanisms protecting the brain from an overflow of sensory input might play a crucial role in inclucing migraine attacks. Competing pathophysiological models suggest neuronal hyperexcitability within the CNS, but also hypoexcitability of the cerebral cortex as predisposing factors in migraine.

Key words

Migraine - pathophysiology - cortex - hyperexcitability - evoked potentials

Volltext

Referenzen

Literatur

1 Russell M B, Rasmussen B K, Thornvaldesen P, Olesen J. Prevalence and sex ratio of the subtypes of migraine. Int J Epidemiol. 1995; 24 612-618
2 Göbel H, Petersen-Braun M, Soyka D. The epidemiology of headache in Germany: A nationwide survey of a representative sample on the basis of the headache classification of the International Headache Society. Cephalalgia. 1994; 14 97-106
3 Stewart W F, Lipton R B, Simon D. Work-related disability: Results from the American migraine study. Cephalalgia. 1996; 16 231-238
4 Spierings E L. Mechanism of migraine and action of antimigraine medications. Med Clin North Am. 2001; 85 943-958
5 Goadsby P J, Lipton R B, Ferrari M D. Migraine-current understanding and treatment. N Engl J Med. 2002; 346 257-269
6 Ferrari M. Migraine. Lancet. 1998; 351 1043-1051
7 Headache classification committee of the international headache society . Classification and diagnosis criteria for headache disorders, cranial neuralgia and facial pain. Cephalalgia. 1988; 8 (Suppl 7) 1-92
8 Tunis M M, Wolff H G. Long-term observations of the reactivity of the cranial arteries in subjects with vascular headache of the migraine type. Arch Neurol Psychiatry. 1953; 70 551-557
9 Leao A AP, Morrison R S. Propagation of spreading cortical depression. J Neurophysiol. 1945; 8 33-45
10 Gorji A. Spreading depression: a review of the clinical relevance. Brain Res Brain Res Rev. 2001; 38 33-60
11 Sramka M, Brozek G, Bures J, Nadvornik P. Functional ablation by spreading depression: Possible use in human stereotaxic neurosurgery. Appl Neurophysiol. 1977; 40 48-61
12 Mayevski A, Doron A, Manor T, Meilin S, Zarchin N, Ouaknine G E. Cortical spreading depression recorded from the human brain using a multipametric monitoring system. Brain Res. 1996; 740 268-274
13 Gorji A, Scheller D, Straub H, Tegtmeier F, Kohling R, Hohling J M, Tuxhorn I, Ebner A, Wolf P, Werner Panneck H, Oppel F, Speckmann E J. Spreading depression in human neocortical slices. Brain Res. 2001; 906 74-83
14 Lauritzen M. Cortical spreading depression in migraine. Cephalalgia. 2001; 21 757-760
15 Cutrer F, O'Donnell A. Recent advances in functional neuroimaging. Curr Opin Neurol. 1999; 12 255-259
16 O'Brien M D. Cerebral blood changes in migraine. Headache. 1971; 10 139-143
17 Olesen J, Larsen B, Lauritzen M. Focal hyperemia followed by spreading oligemia and impaired activation of rCBF in classic migraine. Ann Neurol. 1981; 9 344-352
18 Andersson J L, Muhr C, Lilja A, Valind S, Lundberg P O, Langstrom B. Regional cerebral blood flow and oxygen metabolism during migraine with and without aura. Cephalalgia. 1997; 17 570-579
19 Hadjikhani N, Sanchez Del Rio M, Wu O, Schwartz D, Bakker D, Fischl B, Kwong K K, Cutrer F M, Rosen B R, Tootell R B, Sorensen A G, Moskowitz M A. Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci USA. 2001; 98 4687-4692
20 Cao Y, Aurora S K, Nagesh V, Patel S C, Welch K M. Functional MRI-BOLD of brainstem structures during visually triggered migraine. Neurology. 2002; 59 72-78
21 Aurora S K, Cao Y, Bowyer S M, Welch K MA. The occipitial cortex is hyperexcitable in migraine: Experimental evidence. Headache. 1999; 39 469-476
22 Weiller C, May A, Limmroth V, Juptner M, Kaube H, Schayck R V, Coenen H H, Diener H C. Brainstem activation in spontaneous human migraine attacks. Nat Med. 1995; 1 658-660
23 Bednarczyk E M, Remler B, Weikart C, Nelson A D, Reed R C. Global cerebral blood flow, blood volume, and oxygen metabolism in patients with migraine headache. Neurology. 1998; 50 1736-1740
24 Bahra A, Matharu M, Buchel C, Frackowiak R S, Goadsby P J. Brainstem activation specific to migraine headache. Lancet. 2001; 357 1016-1017
25 Woods R P, Iacoboni M, Mazziotta J C. Brief report: bilateral spreading cerebral hypoperfusion during spontaneous migraine headache. N Engl J Med. 1994; 331 1689-1692
26 Smith M, Cros D, Sheen V. Hyperperfusion with vasogenic leakage by fMRI in migraine with prolonged aura. Neurology. 2002; 58 1308-1310
27 Raskin N H, Hosobuchi Y, Lamb S. Headache may arise from perturbation of the brain. Headache. 1987; 27 416-420
28 May A, Bahra A, Buchel C, Frackowiak R SJ, Goadsby P J. Hypothalamic activation in cluster headache attacks. Lancet. 1998; 352 275-278
29 Moskowitz M A. The visceral organ brain: implications for the pathophysiology of vascular head pain. Neurology. 1991; 41 182-186
30 Golla F L, Winter A L. Analysis of cerebral responses to flicker in patients complaining of episodic headache. Electroencephalogr Clin Neurophysiol. 1959; 11 539-549
31 Smyth V OGS, Winter A L. The EEG in migraine. Electroencephalogr Clin Neurophysiol. 1964; 16 194-202
32 Chorlton P, Kane N. Investigation of the cerebral response to flicker stimulation in patients with headache. Clin Electroencephalogr. 2000; 31 83-87
33 Gronseth G S, Greenberg M K. The utility of the electroencephalogram in the evaluation of patients presenting with headache: a review of the literature. Neurology. 1995; 45 1263-1267
34 De Tommaso M, Sciruicchio V, Bellotti R, Guido M, Sasanelli G, Specchio L M, Puca F. Photic driving response in primary headache: diagnostic value tested by discriminant analysis and artificial neural network classifiers. Ital J Neurol Sci. 1999; 20 23-28
35 De Tommaso M, Sciruicchio V, Guido M, Sasanelli G, Specchio L M, Puca F M. EEG spectral analysis in migraine without aura attacks. Cephalalgia. 1998; 18 324-328
36 Schachter S C, Ito M, Wannamaker B B, Rak I, Ruggles K, Matsuo F, Wilner A, Jackel R, Gilliam F, Morris G, Skantz J, Sperling M, Buchhalter J, Drislane F W, Ives J, Schomer D L. Incidence of spikes and paroxysmal rhythmic events in overnight ambulatory computer-assisted EEGs of normal subjects: a multicenter study. J Clin Neurophysiol. 1998; 15 251-255
37 Vonderheid-Guth B, Todorova A, Wedekind W, Dimpfel W. Evidence for neuronal dysfunction in migraine: concurrence between specific qEEG findings and clinical drug response - a retrospective analysis. Eur J Med Res. 2000; 5 473-483
38 Siniatchkin M, Gerber W D, Kropp P, Vein A. How the brain anticipates an attack: a study of neurophysiological periodicity by migraine. Functional Neurol. 1999; 14 69-77
39 Strenge H, Fritzer G, Goder R, Niederberger U, Gerber W D, Aldenhoff J. Non-linear electroencephalogram dynamics in patients with spontaneous nocturnal migraine attacks. Neurosci Lett. 2001; 309 105-108
40 Schoenen J, Jamart B, Delwaide P J. Electroencephalographic mapping in migraine during the critical and intercritical periods. Rev Electroencephalogr Neurophysiol Clin. 1987; 17 289-299
41 Thomaides T, Tagaris G, Karageorgiou C. EEG and topographic frequency analysis in migraine attack before and after sumatriptan infusion. Headache. 1996; 36 111-114
42 Barkley G L, Tepley N, Nagel-Leiby S, Moran J E, Simkins R T, Welch K M. Magnetoencephalographic studies of migraine. Headache. 1990; 30 428-434
43 Barkley G L, Tepley N, Simkins R, Moran J, Welch K M. Neuromagnetic fields in migraine: preliminary findings. Cephalalgia. 1990; 10 171-176
44 Bowyer S M, Aurora K S, Moran J E, Tepley N, Welch K M. Magnetoencephalographic fields from patients with spontaneous and induced migraine aura. Ann Neurol. 2001; 50 582-587
45 Connolly J F, Gawel M, Rose F C. Migraine patients exhibit abnormalities in the visual evoked potential. J Neurol Neurosurg Psychiatry. 1982; 45 464-467
46 Diener H C, Scholz E, Dichgans J, Gerber W D, Jack A, Bille A, Niederberger U. Central effects of drugs used in migraine prophylaxis evaluated by visual evoked-potentials. Ann Neurol. 1989; 25 125-130
47 Drake M E, Pakalnis A, Hietter S A, Padamadan H. Visual and auditory evoked potentials in migraine. Electromyogr Clin Neurophysiol. 1990; 30 77-81
48 Gawell M, Connolly J, Clifford Rose F. Migraine patients exhibit abnormalities in the visual evoked potential. Headache. 1983; 23 49-52
49 Khalil N M, Legg N J, Anderson D J. Long-term decline of P100 amplitude in migraine with aura. J Neurol Neurosurg Psychiatry. 2000; 69 507-511
50 Kochar K, Srivastava T, Maurya R K, Jain R, Aggarwal P. Visual evoked potential & brainstem auditory evoked potentials in acute attack & after the attack of migraine. Electromyogr Clin Neurophysiol. 2002; 42 175-179
51 Mariani E, Moschini V, Pastorino G C, Rizzi F, Severgnini A, Tiengo M. Pattern reversal visual evoked-potentials (Vep-Pr) in migraine subjects with visual aura. Headache. 1990; 30 435-453
52 Moreira Filho P F, Dantas A M. Pattern reversal visual evoked potentials in migraine subjects without aura. Arq Neuropsiquiatr. 1994; 52 484-488
53 Oelkers R, Grosser K, Lang E. et al . Visual evoked potentials in migraine patients alterations depend on pattern spatial frequency. Brain. 1999; 122 1147-1155
54 Sener H O, Haktanir I, Demirci S. Pattern-reversal visual evoked potentials in migraineurs with or without visual aura. Headache. 1997; 37 449-451
55 Afra J, Ambrosini A, Genicot R, Albert A, Schoenen J. Influence of colors on habituation of visual evoked potentials in patients with migraine with aura and in healthy volunteers. Headache. 2000; 40 36-40
56 Afra J, Cecchini A P, Sandor P S, Schoenen J. Comparison of visual and auditory evoked potentials in migraine patients between attacks. Clin Neurophysiol. 2000; 111 1124-1129
57 Bohotin V, Fumal A, Vandenheede M, Gerard P, Bohotin C, Maertens de Noordhout A, Schoenen J. Effects of repetitive transcranial magnetic stimulation on visual evoked potentials in migraine. Brain. 2002; 125 912-922
58 Logi F, Bonfiglio L, Orlandi G, Bonanni E, Iudice A, Sartucci F. Asymmetric scalp distribution of pattern visual evoked potentials during interictal phases in migraine. Acta Neurol Scand. 2001; 104 301-307
59 Shibata K, Osawa M, Iwata M. Simultaneous recording of pattern reversal electroretinograms and visual evoked potentials in migraine. Cephalalgia. 1997; 17 742-747
60 Tagliati M, Sabbadini M, Bernardi G, Silvestrini M. Multichannel visual evoked potentials in migraine. Electroencephalogr Clin Neurophysiol. 1995; 96 1-5
61 Tsounis S, Milonas J, Gilliam F. Hemi-field pattern-reversal visual-evoked potentials in migraine. Cephalalgia. 1993; 13 267-271
62 Yilmaz M, Bayazit Y A, Erbagci I, Pence S. Visual evoked potential changes in migraine: influence of migraine attack and aura. J Neurol Sci. 2001; 184 139-141
63 Woestenburg J C, Kramer C J, Orlebeke J F, Passchier J. Brain potential differences related to spatial attention in migraineurs with and without aura symptoms support supposed differences in activation. Headache. 1993; 33 413-416
64 Yucesan C, Sener O, Mutluer N. Influence of disease duration on visual evoked potentials in migraineurs. Headache. 2000; 40 384-388
65 Marrelli A, Tozzi E, Porto C, Cimini N, Aloisi P, Valenti M. Spectral analysis of visual potentials evoked by pattern-reversal checkerboard in juvenile patients with headache. Headache. 2001; 41 792-797
66 Brinciotti M, Guidetti V, Matricardi M, Cortesi F. Responsiveness of the visual system in childhood migraine studied by means of VEPs. Cephalalgia. 1986; 6 183-185
67 Sand T, Vingen J V. 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. 2000; 20 804-820
68 Shibata K, Osawa K, Iwata M. Pattern reversal visual evoked potentials in migraine with aura and migraine aura without headache. Cephalalgia. 1998; 18 319-323
69 Afra J, Cecchini A P, De Pasqua V, Albert A, Schoenen J. Visual evoked potentials during long periods of pattern-reversal stimulation in migraine. Brain. 1998; 121 233-241
70 Judit A, Sandor P, Schoenen J. Habituation of visual and intensity dependence of cortical auditory evoked potentials tend to normalise just before and during migraine attacks. Cephalalgia. 2000; 20 714-719
71 Puca F M, De Tommaso M, Tota P, Sciruicchio V. Photic driving in migraine: correlations with clinical features. Cephalalgia. 1996; 16 246-250
72 Mortimer M J, Good P A, Marsters J B. The VEP in acephalgic migraine. Headache. 1990; 30 285-288
73 Van Dijk J G, Dorresteijn M, Haan J, Ferrari M D. No confirmation of visual evoked potential diagnostic test for migraine. Lancet. 1991; 337 517-518
74 Van Dijk J G, Dorresteijn M, Haan J, Ferrari M D. Visual evoked potentials and background EEG activity in migraine. Headache. 1991; 31 392-395
75 De Tommaso M, Sciruicchio V, Tota P, Megna M, Guido M, Genco S, Puca F. Somatosensory evoked potentials in migraine. Funct Neurol. 1997; 12 77-82
76 Ozkul Y, Uckardes A. Median nerve somatosensory evoked potentials in migraine. Eur J Neurol. 2002; 9 227-232
77 Reisecker F. Frühe somatosensorisch evozierte Potentiale bei zerebrovaskulär ischämischen Erkrankungen - Teil II: Normwerte und Befunde bei asymptomatischen Gefäßstenosen/Verschlüssen, komplizierter Migräne, transitorisch-ischämischen Attacken, reversiblem ischämischen neurologischen Defizit, komplettem Schlaganfall und Multiinfarktdemenz. EEG EMG. 1988; 19 61
78 Marlowe N. Somatosensory evoked potentials and headache: a further examination of the central theory. J Psychosom Res. 1995; 39 119-131
79 Chayasirisobhon S. Somatosensory evoked potentials in acute migraine with sensory aura. Clin Electroencephalogr. 1995; 26 65-69
80 Altenmüller E. Ereigniskorrelierte Potentiale. In: Stöhr M, Dichgans J, Buettner UW, Hess CW, Altenmüller E (Hrsg) Evozierte Potenziale. Berlin, Heidelberg, New York; Springer 1996: 557-587
81 Buettner U W. Akustisch evozierte Potenziale. In: Stöhr M, Dichgans J, Buettner UW, Hess CW, Altenmüller E (Hrsg) Evozierte Potenziale. Berlin, Heidelberg, New York; Springer 1996: 411-486
82 Maurer K. Akustisch evozierte Potentiale (AEP) und ereigniskorrelierte Potentiale (P300). In: Lowitzsch K, Maurer K, Hopf HC, Tackmann W, Claus D (Hrsg) Evozierte Potentiale bei Erwachsenen und Kindern. Stuttgart, New York; Thieme 1993: 142-212
83 Hegerl U, Juckel G. Intensity dependence of auditory evoked potentials as an indicator of central serotonergic neurotransmission: a new hypothesis. Biol Psychiatry. 1993; 33 173-187
84 Bhargava V K, McKean C M. Role of 5-hydroxytryptamine in the modulation of acoustic brainstem (farfield) potentials. Neuropharmacology. 1977; 16 447-449
85 Bhargava V K, Salamy A, McKean C M. Effect of cholinergic drugs on the brainstem auditory evoked responses (far-field) in rats. Neuroscience. 1978; 3 821-826
86 Bank J. Brainstem auditory evoked potentials in migraine after Rausedyl provocation. Cephalalgia. 1991; 11 277-279
87 Podoshin L, Ben-David J, Pratt H, Fradis M, Sharf B, Weller B. et al . Auditory brainstem and visual evoked potentials in patients with migraine. Headache. 1987; 27 27-29
88 Schlake H P, Grotemeyer K H, Hofferberth B, Husseth I W, Wiesner S. Brainstem auditory evoked potentials in migraine: evidence of increased side differences during the pain-free interval. Headache. 1990; 30 129-132
89 Wang W, Timsit-Berthier M, Schoenen J. Intensity dependence of auditory evoked potentials is pronounced in migraine: an indication of cortical potentiation and low serotonergic transmission?. Neurology. 1996; 46 1404-1409
90 Bickford-Wimer P C, Nagamoto H, Johnson R, Adler L E, Egan M, Rose G M, Freedman R. Auditory sensory gating in hippocampal neurons: a model system in the rat. Biol Psychiatry. 1990; 27 183-192
91 Reese N B, Garcia-Rill E, Skinner R D. Auditory input to the pedunculopontine nucleus: I. Evoked potentials. Brain Res Bull. 1995; 37 257-264
92 Miyazato H, Skinner R D, Crews T, Williams K, Garcia-Rill E. Serotonergic modulation of the P13 midlatecy auditory evoked potential in the rat. Brain Res Bull. 2000; 51 387-391
93 Ambrosini A, De Pasqua V, Afra J, Sandor P S, Schoenen J. Reduced gating of middle-latency auditory evoked potentials (P50) in migraine patients: another indication of abnormal sensory processing?. Neurosci Lett. 2001; 306 132-134
94 Wang W, Schoenen J. Interictal potentiation of passive „oddball” auditory event-related potentials in migraine. Cephalalgia. 1998; 18 261-265
95 Wang W, Wang Y H, Fu X M, Sun Z M, Schoenen J. Auditory evoked potentials and multiple personality measures in migraine and post-traumatic headaches. Pain. 1999; 79 235-242
96 Siniatchkin M, Kropp P, Neumann M, Gerber W, Stephani U. Intensity dependence of auditory evoked cortical potentials in migraine families. Pain. 2000; 85 247-254
97 Sandor P S, Afra J, Cecchini A P, Albert A, Schoenen J. From neurophysiology to genetics: cortical information processing in migraine underlies familial influences: a novel approach. Funct Neurol. 2000; 15 (Suppl 3) 68-72
98 Walter G, Cooper R, Aldridge V J, Mc Callum W C. Contingent negative variation: An electrical sign of sensorimotor association and expectancy in human brain. Nature. 1964; 203 380-384
99 Nagel-Leiby S, Welch K MA, D'Andrea G, Grunfeld S, Brown E. Event-related potentials and associated catecholamine function in migraine. Cephalalgia. 1990; 10 317-329
100 Kropp P, Gerber W D. Contingent negative-variation during migraine attack and interval: evidence for normalization of slow cortical potentials during the attack. Cephalalgia. 1995; 15 123-128
101 Ahmed I. Contingent negative variation in migraine: effect of beta blocker therapy. Clin Electroencephalogr. 1999; 30 21-23
102 Kropp P, Kirbach U, Detlefsen J O, Siniatchkin M, Gerber W D, Stephani U. Slow cortical potentials in migraine: a comparison of adults and children. Cephalalgia. 1999; 19 (Suppl 25) 60-64
103 Maertens de Noordhout A, Timsit-Berthier M, Schoenen J, Timsit M. Contingent negative-variation in headache. Ann Neurology. 1986; 19 78-80
104 Siniatchkin M, Kirsch E, Kropp P, Stephani U, Gerber W D. Slow cortical potentials in migraine families. Cephalalgia. 2000; 20 881-892
105 Siniatchkin M, Kropp P, Gerber W D. Contingent negative variation in subjects at risk for migraine without aura. Pain. 2001; 94 159-167
106 Mulder E, Linssen W, Passchier J, de Geus E JC. Interictal and postictal contingent negative variation migraine without aura. Headache. 2001; 41 72-78
107 Mulder E J, Linssen W H, de Geus E I. Reduced sensory anticipation in migraine. Psychophysiology. 2002; 39 166-174
108 Siniatchkin M, Gerber W D, Kropp P, Voznesenskaya T, Vein A M. Are the periodic changes of neurophysiological parameters during the pain-free interval in migraine related to abnormal orienting activity?. Cephalalgia. 2000; 20 20-29
109 Siniatchkin M, Kropp P, Gerber W D, Stephani U. Migraine in childhood - are periodically occurring migraine attacks related to dynamic changes of cortical information processing?. Neurosci Lett. 2000; 279 1-4
110 Evers S, Bauer B, Suhr B, Husstedt I W, Grotemeyer K H. Cognitive processing in primary headache: a study on event-related potentials. Neurology. 1997; 48 108-113
111 Evers S, Bauer B, Grotemeyer K H, Kurlemann G, Husstedt I W. Event-related potentials (P300) in primary headache in childhood and adolescence. Child Neurol. 1998; 13 322-326
112 Grosser K, Oelkers R, Hummel T, Geisslinger G, Brune K, Kobal G, Lotsch J. Olfactory and trigeminal event-related potentials in migraine. Cephalalgia. 2000; 20 621-631
113 Muller B W, Sartory G, Tackenberg A. The movement-related potential in children with migraine and tension-type headache. Cephalalgia. 2002; 22 125-131
114 Kropp P, Gerber W D. Prediction of migraine attacks using a slow cortical potential, the contingent negative variation. Neurosci Lett. 1998; 257 73-76
115 Evers S, Quibeldey F, Grotemeyer K H. et al . Dynamic changes of cognitive habituation and serotonin metabolism during the migraine interval. Cephalalgia. 1999; 19 485-491
116 Aurora S K, Welch K MA. Brain excitability in migraine: evidence from transcranial magnetic stimulation studies. Curr Opin Neurol. 1998; 11 205-209
117 Battelli L, Black K R, Wray S H. Transcranial magnetic stimulation of visual area V5 in migraine. Neurology. 2002; 58 1066-1069
118 Afra J, Mascia A, Gerard P, Maertens de Noordhout A, Schoenen J. Interictal cortical excitability in migraine: a study using transcranial magnetic stimulation of motor and visual cortices. Ann Neurol. 1998; 44 209-215
119 Aurora S K, Ahmad B K, Welch K M, Bhardhwaj P, Ramadan N M. Transcranial magnetic stimulation confirms hyperexcitability of visual cortex in migraine. Neurology. 1998; 50 1105-1110
120 Brighina F, Piazza A, Daniele O, Fierro B. Modulation of visual cortical excitability in migraine with aura: effects of 1 Hz repetitive transcranial magnetic stimulation. Exp Brain Res. 2002; 145 177-181
121 Mulleners W M, Chronicle E P, Palmer J E, Koehler P J, Vredeveld J W. Visual cortex excitability in migraine with and without aura. Headache. 2001; 41 565-572
122 Mulleners W M, Chronicle E P, Vredeveld J W, Koehler P J. Visual cortex excitability in migraine before and after valproate prophylaxis: a pilot study using TMS. Eur J Neurol. 2002; 9 35-40
123 Mulleners W M, Chronicle E P, Palmer J E, Koehler P J, Vredeveld J W. Suppression of perception in migraine: evidence for reduced inhibition in the visual cortex. Neurology. 2001; 56 178-183
124 Palmer J E, Chronicle E P, Rolan P, Mulleners W M. Cortical hyperexcitability is cortical under-inhibition: evidence from a novel functional test of migraine patients. Cephalalgia. 2000; 20 525-532
125 McColl S L, Wilkinson F. Visual contrast gain control in migraine: measures of visual cortex excitability and inhibition. Cephalalgia. 2000; 20 74-84
126 Hallett M. Transcranial magnetic stimulation and the human brain. Nature. 2000; 406 147-150
127 Rossini P M, Barker A T, Berardelli A, Caramia M D, Caruso G, Cracco R Q, Dimitrijevic M R, Hallett M, Katayama Y, Lucking C H. et al . Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application. Report of an IFCN committee. Electroencephalogr Clin Neurophysiol. 1994; 91 79-92
128 Werhahn K J, Kunesch E, Noachtar S, Benecke R, Classen J. Differential effects on motorcortical inhibition induced by blockade of GABA uptake in humans. J Physiol. 1999; 517 591-597
129 Aurora S K, al-Sayeed F, Welch K M. The cortical silent period is shortened in migraine with aura. Cephalalgia. 1999; 19 708-712
130 Bettucci D, Cantello M, Gianelli M, Naldi P, Mutani R. Menstrual migraine without aura: cortical excitability to magnetic stimulation. Headache. 1992; 32 345-347
131 Maertens de Noordhout A, Pepin J, Schoenen J, Delwaide P. Percutaneous magnetic stimulation of the motor cortex in migraine. Electroencephalogr Clin Neurophysiol. 1992; 85 110-115
132 Van der Kamp W, Maassen VanDenBrink A, Ferrari M D, van Dijck J G. Interictal cortical excitability to magnetic stimulation in familial hemiplegic migraine. Neurology. 1997; 48 1462-1464
133 Ozturk V, Cakmur R, Donmez B, Yener G G, Kursad F, Idiman F. Comparison of cortical excitability in chronic migraine (transformed migraine) and migraine without aura. A transcranial magnetic stimulation study. J Neurol. 2002; 249 1268-1271
134 Van der Kamp W, Maassen VanDenBrink A, Ferrari M D, van Dijck J G. Interictal cortical excitability in migraine patients demonstrated with transcranial magnetic stimulation. J Neurol Sci. 1996; 139 106-110
135 Werhahn K J, Wisemann K, Herzog J, Förderreuther S, Dichgans M, Straube A. Motor cortex excitability in patients with migraine with aura and hemiplegic migraine. Cephalalgia. 2000; 20 45-50
136 Schoenen J. Exteroceptive suppression of temporalis muscle activity in patients with chronic headache and in normal volunteers: methodology, clinical and pathophysiological relevance. Headache. 1993; 33 3-17
137 Berardelli A, Cruccu G, Kimura J, Ongerboer de Visser B W, Valls-Solé J. The orbicularis oculi reflexes. Electroenzephalogr Clin Neurophysiol. 1999; 52, Suppl 249-253
138 Rossi B, Vignocchi M G. Methodological considerations of the use of blink reflex R3-Komponent in the assessment of pain in man. Int J Neurol Sci. 1993; 14 217-224
139 Aktekin B, Yaltkaya K, Ozkaynak S, Oguz Y. Recovery cycle of the blink reflex and exteroceptive suppression of temporalis muscle activity in migraine and tension-type headache. Headache. 2001; 41 142-149
140 De Tommaso M, Guido M, Libro G, Sciruicchio V, Puca F. The three responses of the blink reflex in adult and juvenile migraine. Acta Neurol Belg. 2000; 100 96-102
141 De Tommaso M, Guido M, Libro G. et al . Zolmitriptan reverses blink reflex changes induced during the migraine attack in humans. Neurosci Lett. 2000; 289 57-60
142 Kaube H, Katsarava Z, Przywara S, Drepper J, Ellrich J, Diener H C. A cute migraine headache: possible sensitization of neurons in the spinal trigeminal nucleus?. Neurology. 2002; 58 1234-1238
143 De Tommaso M, Murasecco D, Libro G, Guido M, Sciruicchio V, Specchio L M, Gallai V, Puca F. Modulation of trigeminal reflex excitability in migraine: effects of attention and habituation on the blink reflex. Int J Psychophysiol. 2002; 44 239-249
144 Sandrini G, Proietti Cecchini A, Milanov I, Tassorelli C, Buzzi M G, Nappi G. Electrophysiological evidence for trigeminal neuron sensitization in patients with migraine. Neurosci Lett. 2002; 317 135-138
145 Kors E E, van den Maagdenberg A M, Plomp J J, Frants R R, Ferrari M D. Calcium channel mutations and migraine. Curr Opin Neurol. 2002; 15 311-316
146 May A, Ophoff R A, Terwindt G M, Urban C, Van Eijk R, Haan J, Diener H C, Lindhout D, Frants R R, Sandkuijl L A. et al . Familial hemiplegic migraine locus on 19p13 is involved in the common forms of migraine with and without aura. Hum Genet. 1995; 96 604-608
147 Nyholt D R, Lea R A, Goadsby P J, Brimage P J, Griffiths L. Familial typical migraine: linkage to chromosome 19p13 and evidence for genetic heterogeneity. Neurology. 1998; 50 1428-1432
148 Ambrosini A, de Noordhout A M, Schoenen J. Neuromuscular transmission in migraine patients with prolonged aura. Acta Neurol Belg. 2001; 101 166-170
149 Ambrosini A, Maertens de Noordhout A, Schoenen J. Neuromuscular transmission in migraine: a single-fiber EMG study in clinical subgroups. Neurology. 2001; 56 1038-1043
150 Welch K, D'Andrea G, Tepley N, Barkley G, Ramadan N M. The concept of migraine as a state of central neuronal hyperexcitability. Neurol Clin. 1989; 8 817-828
151 Chronicle E P, Mulleners W M. Visual system dysfunction in migraine: a review of clinical and psychophysical findings. Cephalalgia. 1996; 16 525-535
152 Wray S H, Mijovicprelec D, Kossyln S M. Visual processing in migraineurs. Brain. 1995; 118 25-35
153 Wilkins A, Nimmo-Smith I, Tait A, McManus C, Della Sala S, Tilley A, Arnold K, Barrie M, Scott S. A neurological basis for visual discomfort. Brain. 1984; 107 989-1017
154 Hay K M, Mortimer M J, Barker D C, Debney L M, Good P A. 1044 women with migraine: the effects of environmental stimuli. Headache. 1994; 34 166-168
155 Andermann F. Migraine and the benign partial epilepsies of childhood: evidence for an association. Epileptic Disord. 2000; 2 (Suppl 1) S37-39
156 Donnet A, Bartolomei F. Migraine with visual aura and photosensitive epileptic seizures. Epilepsia. 1997; 38 1032-1034
157 Martinovic Z. Clinical correlations of electroencephalographic occipital epileptiform paroxysms in children. Seizure. 2001; 10 379-381
158 Ogunyemi A, Adams D. Migraine-like symptoms triggered by occipital lobe seizures: response to sumatriptan. Can J Neurol Sci. 1998; 25 151-153
159 Velioglu S K, Ozmenoglu M. Migraine-related seizures in an epileptic population. Cephalalgia. 1999; 19 797-801
160 Maertens de Noordhout A, Schoenen J. Transcranial magnetic stimulation in migraine. Electroencephalogr Clin Neurophysiol. 1999; 51, Suppl 260-264
161 Chronicle E, Mulleners W. Might migraine damage the brain?. Cephalalgia. 1994; 14 415-418
162 Kruger H, Luhmann H J, Heinemann U. Repetitive spreading depression causes selective suppression of GABA-ergic function. Neuroreport. 1996; 7 2733-2736
163 Ramadan N M, Halvorson H, Vande-Linde A, Levine S R, Helpern J A, Welch K MA. Low brain magnesium in migraine. Headache. 1989; 29 590-593
164 Montagna P, Cortelli P, Monari L. et al . 31P-magnetic resonance spectroscopy in migraine without aura. Neurology. 1994; 44 666-669
165 Boska M D, Welch K M, Barker P B, Nelson J A, Schultz L. Contrasts in cortical magnesium, phospholipid and energy metabolism between migraine syndromes. Neurology. 2002; 58 1227-1233
166 Lodi R, Lotti S, Cortelli P, Pierangeli G, Cevoli S, Clementi V, Soriani S, Montagna P, Barbiroli B. Deficient energy metabolism is associated with low free magnesium in the brains of patients with migraine and cluster headache. Brain Res Bull. 2001; 54 437-441
167 Sandor P S, Mascia A, Seidel L, De Pasqua V, Schoenen J. Subclinical cerebellar impairment in the commont types of migraine: a three-dimensional analysis of reaching movements. Ann Neurol. 2001; 49 668-672
168 Ophoff R A, Terwindt G M, Vergouwe M N. et al . Familial hemiplegic migraine and episodic ataxia type-2 are caused by mutations in the Ca2+ channel gene CACNL1A4. Cell. 1996; 87 543-552
169 D'Andrea G, Cananzi A R, Joseph R, Morra M, Zamberlan F, Ferro Milone F, Grunfeld S, Welch K M. Platelet glycine, glutamate and aspartate in primary headache. Cephalalgia. 1991; 11 197-200
170 Hughes A M, Dixon R, Dane A, Kemp J, Cummings L, Yates R A. Effects of zolmitriptan (Zomig) on central serotonergic neurotransmission as assessed by active oddball auditory event-related potentials in volunteers without migraine. Cephalalgia. 1999; 19 100-106
171 Schoenen J, Maertens de Noordhout A, Timsit-Berthier M, Timsit M. Contingent negative variation and efficacy of beta-blocking agents in migraine. Cephalalgia. 1986; 6 229-233
172 Sandor P S, Afra J, Ambrosini A, Schoenen J. Prophylactic treatment of migraine with beta-blockers and riboflavin: differential effects on the intensity dependence of auditory evoked cortical potentials. Headache. 2000; 40 30-35
173 Siniatchkin M, Gerber W D, Vein A. Clinical efficacy and central mechanisms of cyclandelate in migraine: a double-blind placebo-controlled study. Funct Neurol. 1998; 13 47-56

Dr. med. T. Probst,
Prof. Dr. med. E. Kunesch

Klinik für Neurologie und Poliklinik · Universität Rostock

Gehlsheimer Straße 20

18147 Rostock

eMail: thomas.probst@med.uni-rostock.de

eMail: erwin.kunesch@med.uni-rostock.de