Abstract
Differences between people with and without migraine on various measures of visual perception have been attributed to abnormal cortical processing due to the disease. The aim of the present study was to explore the dynamics of the basic interictal state with regard to the extrastriate, motion-responsive middle temporal area (MT-complex) with functional magnetic resonance imaging (fMRI) at 3 tesla using coherent/incoherent moving dot stimuli. Twenty-four migraine patients (12 with aura [MwA], 12 without aura [MwoA]) and 12 healthy subjects participated in the study. The individual cortical folding pattern was accounted for by using a cortical matching approach. In the inferior-posterior portion of the MT-complex, most likely representing MT, control subjects showed stronger bilateral activation compared to MwA and MwoA patients. Compared with healthy controls MwoA and MwA patients showed significantly stronger activation mainly at the left side in response to visual stimulation in the superior-anterior portion of the MT-complex, representing the medial-superior temporal area (MST). Our findings strengthen the hypothesis that hyperresponsiveness of the visual cortex in migraine goes beyond early visual areas, even in the interictal period.
Highlights
Migraine is a common disorder in which a dysfunction of the brain has a pivotal role
In our study we have described this area as the middletemporal area (MT)-complex in line with the mean coordinates from several neuroimaging studies given by Wilms et al, [22] and hypothesized that a subdivision of this complex shows increased responsiveness in migraine patients compared to controls
We evaluated if differences exist between migraine with aura (MwA) and migraine without aura (MwoA) subjects
Summary
Migraine is a common disorder in which a dysfunction of the brain has a pivotal role. Abnormal visual cortical excitability has been suggested to play an important role as a possible factor predisposing sufferers to the cortical spreading depression that is thought to represent the pathological basis of the aura during the migraine attack [1] Whether this altered cortical excitability is due to cortical hyperexcitability, to decreased inhibition or to an abnormal responsivity of the cortex as a consequence of a decreased preactivation level remains heavily disputed. Studies of TMS-induced phosphenes in migraineurs have produced conflicting results: some studies [2,3] demonstrated an increased excitability of the visual cortex in migraine with aura (MwA) patients while other studies suggested decreased excitability [4,5] or no differences between migraineurs and controls concerning PTs [6]. We evaluated if differences exist between MwA and migraine without aura (MwoA) subjects
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