Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the Disease
Migraine is a primary headache with high prevalence among the general population, characterized by functional hypersensitivity to both exogenous and endogenous stimuli particularly affecting the nociceptive system. The hyperresponsivity of cortical neurons could be due to a disequilibrium in the exc...
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doaj-3a81595ab481420eab3593a740e2a74c2021-02-16T00:00:34ZengMDPI AGJournal of Clinical Medicine2077-03832021-02-011076976910.3390/jcm10040769Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the DiseaseCiro De Luca0Sara Gori1Sonia Mazzucchi2Elisa Dini3Martina Cafalli4Gabriele Siciliano5Michele Papa6Filippo Baldacci7Laboratory of Morphology of Neuronal Network, Department of Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Napoli, ItalyNeurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyNeurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyNeurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyUnit of Neurorehabilitation, Department of Medical Specialties, University Hospital of Pisa, 56126 Pisa, ItalyNeurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyLaboratory of Morphology of Neuronal Network, Department of Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Napoli, ItalyNeurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyMigraine is a primary headache with high prevalence among the general population, characterized by functional hypersensitivity to both exogenous and endogenous stimuli particularly affecting the nociceptive system. The hyperresponsivity of cortical neurons could be due to a disequilibrium in the excitatory/inhibitory signaling. This study aimed to investigate the anatomo-functional pathway from the retina to the primary visual cortex using visual evoked potentials (VEP). Contrast gain protocol was used in 15 patients diagnosed with migraine without aura (at baseline and after 3 months of topiramate therapy) and 13 controls. A saturation (S) index was assessed to monitor the response of VEP’s amplitude to contrast gain. Non-linear nor monotone growth of VEP (S < 0.95) was defined as supersaturation. A greater percentage of migraine patients (53%) relative to controls (7%) showed this characteristic. A strong inverse correlation was found between the S index and the number of days separating the registration of VEP from the next migraine attack. Moreover, allodynia measured through the Allodynia Symptoms Check-list (ASC-12) correlates with the S index both at baseline and after 3 months of topiramate treatment. Other clinical characteristics were not related to supersaturation. Topiramate therapy, although effective, did not influence electrophysiological parameters suggesting a non-intracortical nor retinal origin of the supersaturation (with possible involvement of relay cells from the lateral geniculate nucleus). In conclusion, the elaboration of visual stimuli and visual cortex activity is different in migraine patients compared to controls. More data are necessary to confirm the potential use of the S index as a biomarker for the migraine cycle (association with the pain-phase) and cortical sensitization (allodynia).https://www.mdpi.com/2077-0383/10/4/769migraine without aurabiomarkerneurophysiologyneuroanatomyvisual cortexVEP |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ciro De Luca Sara Gori Sonia Mazzucchi Elisa Dini Martina Cafalli Gabriele Siciliano Michele Papa Filippo Baldacci |
spellingShingle |
Ciro De Luca Sara Gori Sonia Mazzucchi Elisa Dini Martina Cafalli Gabriele Siciliano Michele Papa Filippo Baldacci Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the Disease Journal of Clinical Medicine migraine without aura biomarker neurophysiology neuroanatomy visual cortex VEP |
author_facet |
Ciro De Luca Sara Gori Sonia Mazzucchi Elisa Dini Martina Cafalli Gabriele Siciliano Michele Papa Filippo Baldacci |
author_sort |
Ciro De Luca |
title |
Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the Disease |
title_short |
Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the Disease |
title_full |
Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the Disease |
title_fullStr |
Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the Disease |
title_full_unstemmed |
Supersaturation of VEP in Migraine without Aura Patients Treated with Topiramate: An Anatomo-Functional Biomarker of the Disease |
title_sort |
supersaturation of vep in migraine without aura patients treated with topiramate: an anatomo-functional biomarker of the disease |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-02-01 |
description |
Migraine is a primary headache with high prevalence among the general population, characterized by functional hypersensitivity to both exogenous and endogenous stimuli particularly affecting the nociceptive system. The hyperresponsivity of cortical neurons could be due to a disequilibrium in the excitatory/inhibitory signaling. This study aimed to investigate the anatomo-functional pathway from the retina to the primary visual cortex using visual evoked potentials (VEP). Contrast gain protocol was used in 15 patients diagnosed with migraine without aura (at baseline and after 3 months of topiramate therapy) and 13 controls. A saturation (S) index was assessed to monitor the response of VEP’s amplitude to contrast gain. Non-linear nor monotone growth of VEP (S < 0.95) was defined as supersaturation. A greater percentage of migraine patients (53%) relative to controls (7%) showed this characteristic. A strong inverse correlation was found between the S index and the number of days separating the registration of VEP from the next migraine attack. Moreover, allodynia measured through the Allodynia Symptoms Check-list (ASC-12) correlates with the S index both at baseline and after 3 months of topiramate treatment. Other clinical characteristics were not related to supersaturation. Topiramate therapy, although effective, did not influence electrophysiological parameters suggesting a non-intracortical nor retinal origin of the supersaturation (with possible involvement of relay cells from the lateral geniculate nucleus). In conclusion, the elaboration of visual stimuli and visual cortex activity is different in migraine patients compared to controls. More data are necessary to confirm the potential use of the S index as a biomarker for the migraine cycle (association with the pain-phase) and cortical sensitization (allodynia). |
topic |
migraine without aura biomarker neurophysiology neuroanatomy visual cortex VEP |
url |
https://www.mdpi.com/2077-0383/10/4/769 |
work_keys_str_mv |
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