Abstract Details

Title Cortical Excitability Changes and Precipitation/Resolution of Migraine Attacks: A Study with Sound Induced Flash Illusions (SIFI)

Topic Headache

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 15-020

Objective In this study we used Sound-Induced Flash Illusions (SIFI) to explore the role of changes of cortical
excitability in precipitation/resolution of migraine attacks across the migraine cycle.

Background In a previous study using transcranial magnetic stimulation, we found paradoxical inhibitory
responses in the ictal phase, where an increased response due to cortical hyperexcitability was
expected. In 2015, we adopted a different approach based on SIFI. Here, subjects are presented
with auditory (0, 1, 2, 3, or 4 beeps) and visual stimuli (1, 2, 3, or 4 flashes) and must report the
number of flashes seen. As beeps occur a few milliseconds before flashes, flash perception is
influenced by beeps: when two or more beeps accompany one flash, subjects report two flashes
(fission illusions). Such illusions depend on visual-cortical excitability (increased excitability
reduces illusions). Using SIFI, we obtained clear, linear responses in migraine, supporting the
hypothesis of cortical hyperexcitability.

Design/Methods One hundred migraine without aura patients (26 interictal, 24 preictal, 25 ictal, and 25 postictal)
and 25 sex- and age-matched healthy controls underwent the SIFI induction procedure. The
protocol was performed in similar conditions for each subject using identical equipment.
Responses were recorded, and the mean number of perceived flashes was compared among
groups.

Results Cortical excitability was increased in the interictal phase in migraineurs compared to controls (<.001). Moreover, we found a progressive significant rise from interictal to preictal (<.01 vs.
interictal and ictal) and ictal (<.001 vs. interictal and <.05 vs. preictal), followed by a decline
through postictal (<.01 vs. ictal and interictal) back to the interictal state.

Conclusions The higher level of excitability in the interictal phase with respect to healthy control could represent
a predisposition to migraine attacks, while further excitability increase and deacrease could be at
the basis respectively of precipitation/resolution of migraine attacks.

Authors/Disclosures
Paolo Alonge, MD PRESENTER	Dr. Alonge has nothing to disclose.
Filippo Brighina, MD (University of Palermo)	Prof. Brighina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Prof. Brighina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TEVA. Prof. Brighina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lilly. Prof. Brighina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alnylam Pharmaceuticals.
Angelo Torrente	Mr. Torrente has nothing to disclose.
Vincenzo Di Stefano, MD, PhD	Dr. Di Stefano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen.
Laura Pilati, MD	Dr. Pilati has nothing to disclose.
Nadia Bolognini, PhD	Prof. Bolognini has nothing to disclose.
Umberto Quartetti, MD	Dr. Quartetti has nothing to disclose.
Valentina Portera, MD	Miss Portera has nothing to disclose.

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