Abstract
The cerebral cortex serves a primary role in the pathogenesis of migraine. This aberrant brain activation in migraine can be noninvasively detected with magnetoencephalography (MEG). The objective of this study was to investigate the differences in motor cortical activation between attacks (ictal) and pain free intervals (interictal) in children and adolescents with migraine using both low- and high-frequency neuromagnetic signals. Thirty subjects with an acute migraine and 30 subjects with a history of migraine, while pain free, were compared to age- and gender-matched controls using MEG. Motor cortical activation was elicited by a standardized, validated finger-tapping task. Low-frequency brain activation (1∼50 Hz) was analyzed with waveform measurements and high-frequency oscillations (65–150 Hz) were analyzed with wavelet-based beamforming. MEG waveforms showed that the ictal latency of low-frequency brain activation was significantly delayed as compared with controls, while the interictal latency of brain activation was similar to that of controls. The ictal amplitude of low-frequency brain activation was significantly increased as compared with controls, while the interictal amplitude of brain activation was similar to that of controls. The ictal source power of high-frequency oscillations was significantly stronger than that of the controls, while the interictal source power of high-frequency oscillations was significantly weaker than that of controls. The results suggest that aberrant low-frequency brain activation in migraine during a headache attack returned to normal interictally. However, high-frequency oscillations changed from ictal hyper-activation to interictal hypo-activation. Noninvasive assessment of cortical abnormality in migraine with MEG opens a new window for developing novel therapeutic strategies for childhood migraine by maintaining a balanced cortical excitability.
Highlights
Previous studies of migraine have suggested that can untreated or ineffectively treated migraines become progressive, but over the long-term, they may cause neurological changes significant enough to be quantified with neuroimaging [1,2,3,4,5,6]
Since the pain of many migraine sufferers worsens with physical activity [42,43] and previous reports have confirmed that neuromagnetic signals in 65– 150 Hz in motor cortex can be reliably elicited by a finger tapping task [34,44,45], this study focused on neuromagnetic high-gamma oscillations in the motor cortex
The mathematical reasoning is that a small natural variation in time among multiple trials may significantly change the phase of high-frequency signals but not the low-frequency signals
Summary
Previous studies of migraine have suggested that can untreated or ineffectively treated migraines become progressive, but over the long-term, they may cause neurological changes significant enough to be quantified with neuroimaging [1,2,3,4,5,6]. With an alternate finger tapping task, psychomotor dysfunction has been found in typical migraine diagnosed according to international headache society (IHS) criteria [16] It seems that motor coordination is impaired in patients with migraine during headache attacks [17]. Recent reports have revealed that the spread of abnormal ictal brain activation triggered by movements plays a key role in the pathogenesis of pediatric migraine [27,28,29]. It remains unclear whether these changes in motor cortical activation persist during the headache free period
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