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Reduced Short-Latency Afferent Inhibition Indicates Impaired Sensorimotor Integrity During Migraine Attacks.

Abstract

BACKGROUND AND OBJECTIVE

Migraine attacks disrupt sensory information processing and may also disturb sensorimotor integration. This prospective pilot study aimed to assess the sensorimotor integration and inhibitory circuitry in the sensorimotor cortex using short-latency afferent inhibition (SAI) paradigm in migraine.

METHODS

Twenty-five migraine without aura patients (10 interictal, 5 preictal, 10 ictal) and 16 healthy controls were enrolled. SAI was elicited by combining the right median nerve electrical stimulation and left motor cortical magnetic stimulation at the 21-millisecond interval. Mean motor evoked potential (MEP) amplitude ratio, recorded from right abductor pollicis muscle after single and conditioned stimulations, was calculated as SAI.

RESULTS

Average MEP inhibition ratio after single and conditioned stimuli in healthy controls was not significantly different from interictal patients (45.1% ± 20.3% vs 44.5% ± 14.75% [P = .93]). However, SAI was significantly reduced during preictal/prodromal (-14.6% ± 42.8% [P = .002]) and ictal/headache (-7.4% ± 31.1% [P = .0001]) periods of migraine compared to healthy controls.

CONCLUSION

Pronounced decrease in SAI during preictal and ictal periods in migraine was shown for the first time. Instead of inhibition to a conditioned stimulus, facilitation in the sensorimotor cortex was detected both ictally and preictally. Preictal SAI results suggest the presence of increased excitability state several hours prior to the headache phase. This phenomenon could be related to the cortical hyperresponsivity to sensory stimuli and cognitive disturbances accompanying migraine attacks as SAI is modulated by cholinergic activity.

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  • Authors+Show Affiliations

    ,

    Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey.

    ,

    Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey. Division of Algology, Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey.

    ,

    Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey.

    ,

    Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey.

    ,

    Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey. Division of Clinical Neurophysiology, Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey.

    Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey. Division of Algology, Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey.

    Source

    Headache 59:6 2019 Jun pg 906-914

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31106418

    Citation

    Alaydin, Halil Can, et al. "Reduced Short-Latency Afferent Inhibition Indicates Impaired Sensorimotor Integrity During Migraine Attacks." Headache, vol. 59, no. 6, 2019, pp. 906-914.
    Alaydin HC, Vuralli D, Keceli Y, et al. Reduced Short-Latency Afferent Inhibition Indicates Impaired Sensorimotor Integrity During Migraine Attacks. Headache. 2019;59(6):906-914.
    Alaydin, H. C., Vuralli, D., Keceli, Y., Can, E., Cengiz, B., & Bolay, H. (2019). Reduced Short-Latency Afferent Inhibition Indicates Impaired Sensorimotor Integrity During Migraine Attacks. Headache, 59(6), pp. 906-914. doi:10.1111/head.13554.
    Alaydin HC, et al. Reduced Short-Latency Afferent Inhibition Indicates Impaired Sensorimotor Integrity During Migraine Attacks. Headache. 2019;59(6):906-914. PubMed PMID: 31106418.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Reduced Short-Latency Afferent Inhibition Indicates Impaired Sensorimotor Integrity During Migraine Attacks. AU - Alaydin,Halil Can, AU - Vuralli,Doga, AU - Keceli,Yeliz, AU - Can,Ezgi, AU - Cengiz,Bulent, AU - Bolay,Hayrunnisa, Y1 - 2019/05/20/ PY - 2019/03/24/accepted PY - 2019/5/21/pubmed PY - 2019/5/21/medline PY - 2019/5/21/entrez KW - cortical excitability KW - migraine KW - sensorimotor integration KW - short-latency afferent inhibition KW - transcranial magnetic stimulation SP - 906 EP - 914 JF - Headache JO - Headache VL - 59 IS - 6 N2 - BACKGROUND AND OBJECTIVE: Migraine attacks disrupt sensory information processing and may also disturb sensorimotor integration. This prospective pilot study aimed to assess the sensorimotor integration and inhibitory circuitry in the sensorimotor cortex using short-latency afferent inhibition (SAI) paradigm in migraine. METHODS: Twenty-five migraine without aura patients (10 interictal, 5 preictal, 10 ictal) and 16 healthy controls were enrolled. SAI was elicited by combining the right median nerve electrical stimulation and left motor cortical magnetic stimulation at the 21-millisecond interval. Mean motor evoked potential (MEP) amplitude ratio, recorded from right abductor pollicis muscle after single and conditioned stimulations, was calculated as SAI. RESULTS: Average MEP inhibition ratio after single and conditioned stimuli in healthy controls was not significantly different from interictal patients (45.1% ± 20.3% vs 44.5% ± 14.75% [P = .93]). However, SAI was significantly reduced during preictal/prodromal (-14.6% ± 42.8% [P = .002]) and ictal/headache (-7.4% ± 31.1% [P = .0001]) periods of migraine compared to healthy controls. CONCLUSION: Pronounced decrease in SAI during preictal and ictal periods in migraine was shown for the first time. Instead of inhibition to a conditioned stimulus, facilitation in the sensorimotor cortex was detected both ictally and preictally. Preictal SAI results suggest the presence of increased excitability state several hours prior to the headache phase. This phenomenon could be related to the cortical hyperresponsivity to sensory stimuli and cognitive disturbances accompanying migraine attacks as SAI is modulated by cholinergic activity. SN - 1526-4610 UR - https://www.unboundmedicine.com/medline/citation/31106418/Reduced_Short-Latency_Afferent_Inhibition_Indicates_Impaired_Sensorimotor_Integrity_During_Migraine_Attacks L2 - https://doi.org/10.1111/head.13554 DB - PRIME DP - Unbound Medicine ER -