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  • Review Article
  • Published:

Altered processing of sensory stimuli in patients with migraine

Nature Reviews Neurology volume 10, pages 144–155 (2014)Cite this article

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Key Points

  • Migraine is the most prevalent neurological disorder in the general population and exerts a considerable societal burden; in some patients, migraine becomes unremittingly chronic

  • Electrophysiological studies can characterize the abnormal functioning of the migrainous brain between, immediately before and during attacks, and aid monitoring of the effects of therapeutic interventions

  • Most electrophysiological studies of migraine describe functional changes between attacks, including hyperresponsivity to repeated sensory stimuli with abnormal temporal processing, malfunctioning sequential recruitment of neuronal networks, and impaired habituation

  • The abnormalities of sensory processing vary over the migraine cycle: they worsen preictally but tend to disappear during the attack; furthermore, the abnormalities differ between episodic and chronic migraine

  • Refined neurophysiological investigations suggest that the cyclic brain dysfunctions in migraine might be related to an abnormal cross-talk between thalamus and cortex (thalamocortical dysrhythmia)

  • Understanding the dysfunction of temporal information processing in migraine paves the way for novel acute and preventive therapies, including pathophysiology-based neuromodulatory techniques

Abstract

Migraine is a cyclic disorder, in which functional and morphological brain changes fluctuate over time, culminating periodically in an attack. In the migrainous brain, temporal processing of external stimuli and sequential recruitment of neuronal networks are often dysfunctional. These changes reflect complex CNS dysfunction patterns. Assessment of multimodal evoked potentials and nociceptive reflex responses can reveal altered patterns of the brain's electrophysiological activity, thereby aiding our understanding of the pathophysiology of migraine. In this Review, we summarize the most important findings on temporal processing of evoked and reflex responses in migraine. Considering these data, we propose that thalamocortical dysrhythmia may be responsible for the altered synchronicity in migraine. To test this hypothesis in future research, electrophysiological recordings should be combined with neuroimaging studies so that the temporal patterns of sensory processing in patients with migraine can be correlated with the accompanying anatomical and functional changes.

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Figure 1: Temporal evolution in effective connectivity, as revealed by kernel Granger causality analysis of averaged EEG data.
Figure 2: Cortical response patterns during the migraine cycle.
Figure 3: Facilitation of temporal pain processing between migraine attacks.
Figure 4: A neurophysiological model of migraine pathogenesis.

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Acknowledgements

M.d.T., A.A., F.B., G.C., A.P., F.P., G.S. and M.V. participated in writing this Review on behalf of the Italian Group for Neurophysiology of Migraine, created by members of the Italian Society for the Study of Headaches and the Italian Society of Clinical Neurophysiology.

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Authors and Affiliations

  1. University of Bari, Italy

    Marina de Tommaso & Sebastiano Stramaglia

  2. University of Palermo, Italy

    Filippo Brighina

  3. G. B. Bietti Foundation, IRCCS, Italy

    Gianluca Coppola

  4. C.Mondino Institute of Neurology Foundation, IRCCS, Italy

    Giorgio Sandrini

  5. Ospedale Pediatrico Bambino Gesù, IRCCS, Italy

    Massimiliano Valeriani

  6. University of Ghent, Belgium

    Daniele Marinazzo

  7. Liège University, Belgium

    Jean Schoenen

  8. Headache Clinic, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Via Atinense 18, Pozzilli, 86077, Isernia, Italy

    Anna Ambrosini, Armando Perrotta & Francesco Pierelli

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  1. Marina de Tommaso
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Contributions

All authors researched data for and participated in writing of the article. In addition,M.d.T., A.A., G.C., F.P. and J.S. contributed to discussion of content, and M.d.T., A.A. and J.S. contributed to reviewing and/or editing of the manuscript before submission. M.d.T. and A.A. contributed equally to this manuscript.

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Correspondence to Anna Ambrosini.

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The authors declare no competing financial interests.

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de Tommaso, M., Ambrosini, A., Brighina, F. et al. Altered processing of sensory stimuli in patients with migraine. Nat Rev Neurol 10, 144–155 (2014). https://doi.org/10.1038/nrneurol.2014.14

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