Shortened cortical silent period in facial muscles of patients with migraine
- 作者：Antonio Curra ; Francesco Pierelli ; Gianluca Coppola ; Piero Barbanti ; Maria Gabriella Buzzi ; Francesca Galeotti ; Mariano Serrao ; Andrea Truini ; Carlo Casali ; Flavia Pauri ; Giorgio Cruccu
- 关键词：Silent period ; Migraine ; Transcranial magnetic stimulation ; Cortical inhibition ; Cortical excitability ; Thalamo-cortical loops
- 刊名：Pain
- 出版年：2007
- 期刊代码：214_03043959
- 类别：med
- 出版时间：November 2007
- 卷：132
- 期：1-2
- 页码：124-131
- 文件大小：276 K
摘要
Despite intensive neurophysiological research, evidence is lacking to show whether abnormal cortical excitability in migraine reflects a primary cortical disturbance or reduced control by thalamo-cortical loops. One way to contribute to the scientific discussion on this topic is to deliver transcranial magnetic stimulation (TMS) and test the cortical silent period (SP) recorded in facial muscles. The facial-muscle SP is a purely cortical phenomenon that reflects the excitability of inhibitory interneurons, and can disclose changes in cortical inhibition even in patients without documented primary lesions of the motor cortices. To test the interictal excitability of cortical motor inhibitory interneurons in migraine, we investigated the facial-SP in patients with migraine with and without aura between attacks. In 26 patients and 15 age-matched controls, high-intensity magnetic stimuli were delivered with a round coil centered at the vertex during a maximal muscle contraction. Electromyographic responses were recorded from surface electrodes placed over the subjects’ perioral muscles. Facial SPs were significantly shorter in patients than in controls. The SP shortening provides neurophysiological evidence showing hypoexcitability of cortical inhibitory neurons in patients with migraine between attacks. Despite a possible primary deficit of cortical inhibitory interneurons in migraine, we favor the interpretation of a secondary disfacilitation by hypoactive thalamo-cortical loops. Based on this interpretation, the interictal reduced cortical inhibition documented by the shortened SP could be considered the motor counterpart of the reduced preactivation excitability level in the sensory cortices purported to explain why cortical evoked responses habituate poorly in patients with migraine.