Abstract and Keywords
Transcranial magnetic stimulation (TMS) has been used to search for cortical dysfunction in migraine. Both, the motor and the visual cortices have been explored in this area. This article reviews and discusses the results of the various studies performed in migraine patients with TMS of motor or visual cortices. The majority of evoked and event-related potential studies in migraine have shown two abnormalities: increased amplitude of grand averaged responses and lack of habituation in successive blocks of averaged responses with decreased amplitude in the first block. These abnormalities suggest that the excitability state of the cerebral cortex, particularly of the visual cortex, is abnormal in migraineurs between attacks. The use of TMS to assess motor and visual cortex excitability has yielded conflicting results, which could be due to methodological differences. Taken together, all studies indicate that the changes in cortical reactivity are more complex in migraineurs than initially thought and suggest that both larger multidisciplinary studies and focused analyses of subgroups of patients with more refined clinical phenotypes are necessary to disentangle the role of the cerebral cortex in migraine pathophysiology.
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